
Glass 


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Book 






i 


COPYRIGHT DEPOSIT 




■ ■ 



E ALTH AM © BEAUTY, 



ROBB'S 

Family Physician: 

BEING A CONCISE AND 

COMPREHENSIVE TREATISE ON DISEASES, AS 
THEY OCCUR IN EVERY-DAY LIFE. 

SHOWING 

THUS CAUSES, 

EXPLAINING 

the Symptoms and treatment, 

AND 

DEMONSTRATING THE CURE 

OF THE 

VARIOUS ILLS HUMANITY IS SUBJECT TO. 

BY i^~ 

J. V. BEAN, M. D., R. L. ROBB, M. D., 

Allopathic. Homoeopathic. 

SARAH L. ROBB, M.D., 

Diseases of Women and Children. 

SOLD BY SUBSCRIPTION ONLY. 




11 L * ■ o" ir L 



PUBLISHED BY 

THE NATIONAL PUBLISHING CO., 

PHILADELPHIA, CHICAGO, ST. LOUIS, AND ATLANTA. 






Entered according to Act of Congress, in the year 18&>. 

By R. L. & S. L. ROBB, 

In the office of the Librarian of Congress at Washington. 

ALL RIGHTS RESERVED. 




DEDICATED 



TO THE 



THINKING MASSES 



OF ALL 



English-Speaking Countries. 




AUTHORS' PREFACE 

TO THE SEVENTH EDITION. 



When, a few months ago, we saw this fruit of our labors issue from 
the press, we thought " Now all the long years of labor, study, care, 
and anxiety bestowed upon its preparation are ended ; " but already 
our publishers ask of us a preface to the Seventh Edition. 

We take this opportunity to express our thanks for the very kind 
and unusually grateful manner in which the work has been received 
by the people, press, and medical profession. In token of our 
thanks we have subjected every page to a careful revision, adding to 
every part matter likely to enhance its value. The arrangement of 
the type is more condensed and the book enlarged, so that there ap- 
pears in this edition man}^ pages of new matter in addition to what 
the first contained. Every article has been carefully compared and 
made to contain the very best of the thoughts, researches and treat- 
ment appearing in the medical literature of the old and new schools. 
Thus we have aimed, up to the hour of going to press, to make this 
the most complete Hand-Book on Domestic Medicine ever issued 
from any press. While we thus prepared a work for the people, we 
have been both surprised and pleased to learn that it has been 
adopted by hundreds of physicians as a daily companion in their 
professional labors, placing upon us a responsibility we had never 
intended to assume. Realizing the extent of this added field, we 
have endeavored to make this edition more worthy of the liberal 
patronage and generous praise the first editions received. 

While it has been our aim to produce a book giving in plain lan- 
guage the "seed thoughts" of our best American and English physi- 
cians, we are not unaware that such is the wide range of our subjects, 
and such the abundance of the material, that a collection of this kind, 
large as it is, must be like a bouquet picked from the fields in June, 
when hundreds of flowers will be left in unvisited spots, as beautiful 
as those which have been taken. 

THE AUTHORS. 

Chicago, III , May, 1884. 
(4) 



PUBLISHER'S PREFACE 

TO THE FIRST EDITION. 



In presenting this work, the publishers take a special pride, believing 
it is a book which will be the means of saving many valuable lives, 
and a vast amount of needless suffering from disease. 

There has never been published any work on domestic medicine which 
aimed to put in the hands of the people the vast amount of information 
as to disease, its causes, the circumstances modifying it, its course, its careful 
and systematic treatment, and all the signs of the pulse, tongue, breath- 
ing, digestive organs, evacuations, appetite, thirst, position, mental state, 
eyes, ears, nose, etc., and the indications of those signs, as used by physi- 
cians, in determining the nature of the disease and its probable termina- 
tion ; all this has been kept back from the masses, by physicians, as their 
individual stock in trade; here it is all shown in plain language. While 
the authors do not claim this as a purely original work with them, we 
claim that they have brought together in this compact form, the gems of 
useful information gleaned from the whole field of medical art and litera- 
ture, and adapted in language to the comprehension of the common 
reader who is entirely unversed in the technical language of medical 
science 

While it has been necessary to use a very few of those medical words, 
whenever they do appear, there and then appear their meaning, enclosed 
in parenthesis. Efforts have been heretofore made to produce a book 
giving the treatment of a few diseases, with their Allopathic and Homoe- 
opathic treatment, but both treatments written up by the same author; 
and, in the nature of the human mind, there would be some bias in favor 
of one or the other of the leading schools of medicine; and the treatment 
of the school of their choice would be fair, while that of the opposite 
would be more or less incomplete or unfair. 

Here we offer a work complete— covering the whole field of the art 
of medicine. 

The treatment includes only those remedies which have been proven 
by personal observations to be truly reliable, and are accompanied by 
practically verified curative indications in every case. 

The Allopathic Treatment, by Dr. J. V. Bean, must satisfy the 
friends of that school of medicine. As a staunch, rock-rooted, educated 
and experienced physician of that school, he stands in the front rank of 
his profession. While his education gives him command of the whole 
field of his art, his experience enables him to select his remedies from the 
very best, and present them to his readers in the manner they can most 

5 



6 PREFACE. 

safely use, and receive the most benefit from them, 
plain, forcible, to the point, and very easily understood. 

The Homoeopathic Treatment, following each separate disease, is 
clear, concise, careful, full, and entirely reliable. 

The " Repertory " is one of the many valuable features of this work. 
By its help the remedy may be surely selected that will most certainly 
remove any disease, or symptom of disease, that can be cured at all. 

The Hydropathic treatment is recommended by all the authors 
whenever it may accomplish, or aid in accomplishing, the desired end. 

Dr. S. Lucretia Robb has added much valuable information on the 
treatment of the diseases of women and children, suggested by, and 
proven to be good, during years of experience. Being a thoroughly edu- 
cated physician, and herself a mother, she has been able to write upon 
the subjects connected with diseases peculiar to her sex fully, knowing, 
from personal experience and a large practice, just what would be most 
useful to mothers and daughters, in trying to understand and treat 
themselves, in all those cases in which a lady's natural and proper deli- 
cacy prevents her from going to a physician and telling him just what is 
the matter. Many and many a young lady, or young mother, has lost her 
life, for the reason that she could not bring herself to the determination 
to tell all to her physician. Mrs. Robb here removes that necessity, and 
we must say, she has done it successfully. Her work is a model of clear- 
ness in expression, and completeness in covering all this most delicate 
subject. This, alone, is worth many times the price of the complete work 
to any family. 

The Home Remedies.— A great many times, in cases of extreme 
emergency, there is some simple remedy in the house, which, if known, 
could be used, and thereby cure, or at least relieve, until something more 
could be done in the way of selecting a better remedy, or procuring the 
aid of a physician. These home remedies are pointed out and are always 
safe and at hand. 

The Index is very complete. If you have any name for your disease, 
you will find that in the index, and from the index will be guided to the 
description and treatment you are in search of. 

While we do not expect or desire this work to entirely do away with 
the good, faithful physician, we do expect to make a very great reduction 
in the number of his professional visits and office prescriptions to every 
one of our subscribers. And we do hope and desire to assist in educating 
the masses of the people in the art of medicine, until it will be altogether 
impossible for any of those designing or ignorant pretenders, now living 
off the ignorance of the people on this subject, to so live at all. We aim 
to encourage every competent and educated physician, and by helping 
our subscribers to know the true and good from the false, we know we 
are surely gaining that end ; and while greatly reducing the amount of 
his bill to any one family where our work enters, we increase greatly the 
number of families he will be called upon to treat. 

With the strong conviction that we are offering a work of no ordinary 
merit, we present this to a discerning and appreciative public, believing 
they will, on examination, fully confirm our convictions. 

THE PUBLISHERS. 



AUTHORS' PREFACE. 



In undertaking a work of this character, it is but natural to feel the 
great weight of the responsibility assumed. Taking the holding of the 
health and life of thousands upon thousands of fellow human beings, 
with all that life and health contains of usefulness, happiness, love and 
power, to individuals, families, communities, states and nations, upon 
ourselves, we cannot avoid a feeling of solemn responsibility. A desire 
and deliberate determination takes possession of our minds to write 
nothing without careful consideration — to hold nothing back from the 
people, that can give them a better understanding of themselves and 
their diseases. 

In this work, we have endeavored to bring together in a compact 
form, all the information necessary to give the reader (without any ref- 
erence to other books,) all the information needed to fully understand the 
cause, nature, course and treatment of any disease they may feel called 
upon to treat, or may in any way come in contact with. Following the 
description of the peculiarities of each disease, we have arranged a care- 
fully prepared treatment. Those who prefer to employ the Hydro- 
pathic, or water treatment, will find a chapter giving full directions for 
the preparing and using the different baths; and, in the treatment of 
separate diseases, you will find full and frequent directions for their use. 

We have omitted all treatment and reference to diseases of the sexual 
organs of a venereal nature. It is felt that their introduction into any 
work, save one intended strictly for physicians, is highly improper. 
They are of so grave a character, and so long-lasting and often terrible 
in their effects upon the organism, as to demand the highest professional 
skill in their treatment. 

We have included articles on the treatment of numerous complaints 
not heretofore included in any work on domestic medicine — especially 
of those which are peculiarly prevalent in certain climates — such as 
Tropical Diseases, etc.; directions for the discrimination between what is 
really a symptom of disease, and what is not, etc. The public is entitled 
to an explanation of the more cogent reasons we have for such a course, 
and for so enlarging the work over others heretofore offered to the 
public. 



authors' preface. 9 

First of all, the common sense of every reader will admit, that we 
should write for the many, and not for individual cases — that we should 
attempt to embrace all contingencies as much as possible, and not con- 
fine ourselves to merely local circumstances ; and that it does not, there- 
fore, follow that persons whose situation and the like render any of these 
details unnecessary to them, should be compelled to adopt our suggestions, 
simply because we have published them ; whereas, it does necessarily 
follow, that those who are beyond the reach of any other resource — eitlier 
by reason of distance or want of means — must loholly depend, either upon 
their own unaided judgment, or upon the directions afforded in works of 
this kind. 

Suppose, for instance, a family resident in the center of a highly 
cultivated country; that family is not, therefore, within easy and imme- 
diate reach of the best professional advice, in which case, it is best that a 
work like this should be in the house to represent the physician, in so far 
as that is possible. 

And suppose another, and a very common case, as of the emigrant to 
distant states and territories; to sparsely inhabited or desolate regions; 
from whence, we would ask, are these to obtain the professional advice 
which would be so essential to them, unless it be from such directions as 
we are able to afford them in a work of this kind? In this case, it must 
be admitted on all hands, that the work does good in comparison to its 
extent, amplitude, enlargement and comprehensiveness. Wherefore, 
then, should these essential conditions be withheld? 

Again, these are not all the questions involved ; there are yet more 
vital points relating to the variations which may become necessary in the 
actual treatment of disease when once undertaken. In these cases, it is 
sufficiently obvious that those who prefer to exclude professional advice, 
should be so far removed from the chance of error as possible, which cannot 
be done without ample detail, because disease has scarcely ever, in two 
distinct cases, the same positive and exact characteristics. 

It is for this reason, also, that we have entered so largely into the 
consideration of the "Investigation of the Patient," and of "Disease." 
We are convinced that the great fault of domestic works in general is, 
that they do not give enough information, and, consequently, that they 
often mislead, instead of enlightening, the reader. 

It is, also, for these reasons, as well as for those already given, that 
we object to the extreme condensation of a domestic work, or to the lim- 
itation of its sphere to a particular class of diseases, and that we consider 
works founded upon this affected idea practically useless. 

We nowhere enjoin a person who has means and immediate access to 
educated and reliable professional advice, to undertake the treatment of 
dangerous diseases without it. We endeavor to provide for those who do 
not possess these advantages. 

Upon such grounds as these, we trust this work to the verdict of a 
liberal and discriminating people. We anticipate a hearty welcome to 
our evident endeavor, even if the product of our labor should fall short 
of its earnest purpose. 



LETTER TO MOTHERS. 



Dear Mothers: 

I really wish it could be my privilege to meet each one of you face to 
face, who may read that part of this work intended more particularly for 
you. In a brief manner I have endeavored to treat, with as much simplic- 
ity as possible, the more common disorders of women and children. 

You know how much and how often we, as females, suffer from dis- 
eases peculiar to our sex. First, On account of the dread we have of going 
to a man and telling him plainly just what is the matter with us, (if we 
know) — which is unfortunately not always the case. Second, From the 
inability of the average physician to understand our mental and physical 
diseases, on account of not knowing " how it is" himself. Third, From 
the harsh and often outrageous treatment we are subjected to by his harsh 
injections, burning with caustics, and deluging our systems with powerful 
drugs, which you and I know to be not only needless, but decidedly harm- 
ful. In this work, I believe you will find the needed information to ena- 
ble you to understand and treat all our ailments in a manner that is not 
only rational but really curative. And in the treatment of your daughters 
you will find what you long have needed — reliable help. 

I have long felt a deep interest in my own sex and have often felt the 
desire to warn mothers, more particularly in regard to daughters, as they 
attain the age of puberty ; tell them what they may expect in the way of 
11 monthly changes." Who can guide girls at such an age as well as a 
mother? Experience has shown how many women there are, whose 
happy girlhood days were blighted, with health, beauty, merriment, yes, 
and virtue too, gone forever, all through ignorance of themselves. 

It is false delicacy that would hide from girls that which, by all means 
it belongs to them to know. Mothers, teachers, it is with you this respon- 
sibility rests. The thousands of wretched wives who are thus suffering 
from a neglect of proper instruction at this turning point of their lives, 
warn you how serious this responsibility is. 

Every mother should carefully study all that is said in regard to in- 
fants in this work. There is a frightful waste of life caused from ignor- 
ance and neglect. Hence the need that mothers should understand and 
practice the means best adapted to preserve the health of their frail 
charges; and the importance of timely corrective measures in infantile 
affections. 

One of the fertile causes of disease and death in early life, is to be found 
in the ignorance displayed in regard to the dress of children. And it is 
not the poorly attired, but in many cases, the fashionably robed child 
which suffers the most. To parental vanity can be traced many of the 
causes which have resulted in death. 

SARAH L. ROBB. 
10 



INTRODUCTION. 



It is my purpose, in writing a description of the treatment of disease 
for popular use, to represent as fairly and plainly as I can, the principles 
and practice of the regular allopathic profession or school of 
medicine, in a manner which can be comprehended by all. It is not 
my intention to present an exhaustive treatise upon the practice of med- 
icine in all its departments. 

It is a matter of great importance how far it is proper to interfere in 
the management of diseases. Obvious is the fact, that in the great ma- 
jority of cases, diseases will, without special treatment, end in recovery. 
It is not to be supposed, therefore, that every instance of recovery is a 
cure. The prevalence of quackery depends largely upon the popular 
error, that the favorable termination of disease is always owing to the 
means employed. The greater the enlightenment of the public upon 
this subject, the less frequent will be imposition in medicine. The fact is, 
that disease, as a rule, tends to recovery and not to death, by the powers 
of nature alone. In all such diseases, the true course of treatment is 
indicated by a study of the way in which nature effects her cure, and in 
following that course. Much harm is often done by the unnecessary em- 
ployment of medicines. It is, therefore, a rule which should never be 
violated, that active treatment should not be employed, except in cases 
where it is certain to do good. 

It should not be inferred that proper treatment is useless. On the 
contrary, even in cases which would end favorably, if trusted to nature 
alone, much good may be done by shortening the duration of the disease, 
relieving the sufferings of the sick, and in preventing unpleasant and 
even dangerous consequences. In other instances, proper treatment is 
the means of saving life. The successful application of remedies, and the 
power of choosing between those of less or greater energy, depend upon 
experience and observation (or knowledge) not only, but a logical mind, 
judgment, common sense, and tact. 

The General Rules for Treatment of the sick may be sum- 
marized as follows : 

1. The removal of the cause upon which the disease depends, is 
among the most important. In many instances this suffices. For exam- 
ple, nervous headaches may depend upon the continual use of coffee; dys- 
pepsia upon improper food and insufficient exercise in the open air: 
colic upon irritating matters in the bowels, etc , eic. Causes are also sure 
to interfere with a cure, as cholera infantum and the summer diarrhoea 

11 



12 INTRODUCTION. 

often resist treatment until the patient is removed from the air of a large 
city to the country. In other cases, the cause once operating ends its 
influence and adds nothing thereafter to the violence of the disease; as in 
most of the contagious diseases. In other instances, the cause generally 
ceases when it has produced its effect, as is often the case in inflammation 
resulting from cold. Attention to the cause is important in the treat- 
ment, as far as it leads to a correct estimate of the nature of the disease. 
In endeavoring to remove the cause of disease, the attention must be 
directed to those within the system, as well as to the external agents One 
disease action is frequently the result of another, so that by removing the 
cause of the first, the latter trouble is cured 

2. The exact seat of the disease should be ascertained, and, as "the life 
is in the blood,'' it should be determined whether or not this is in the 
blood, and if so, its condition should be corrected and improved. Many 
cases are known to have continued for weeks and months, obstinately 
resisting treatment, or which only temporarily improve, quickly relapsing 
again, which have immediately and permanently yielded to treatment 
calculated to restore the blood to health. Even when the depraved con- 
dition of the blood is only secondary, measures to correct its condition are 
almost equally important, for the health cannot be regained while the 
blood remains impaired. Most diseases affect the solid tissues, and it is 
obviously necessary to restore the proper grade to the vital actions. 

3. It may be stated, as a general law, that diseases are rarely station- 
ary. They tend to get better or to get worse. This fact affords valuable 
indications for treatment. 

It should be determined whether the disease intermits or not— i. e, 
whether the pain, fever, or other disordered sensation or action returns 
at regular intervals of time, and going off again after a longer or shorter 
period of duration ; or whether the disease remits— i. e., becomes less vio- 
lent at regular intervals. Such diseases will yield to the treatment known 
as anti-periodic, which will be given in the article on the treatment of 
intermittent fever. 

Some diseases run a definite course and cannot be safely interrupted, 
such as the irruptive fevers. In such cases, when fully formed, proper 
management consists in preventing or removing injurious influences, 
mitigating their violence, correcting, as far as possible, any tendency to a 
fatal issue, and conducting them to a favorable termination. 

There are diseases which are indefinite in their course, and have a 
tendency, when not unusually severe, to get well sometime, and are often 
arrested or shortened by treatment. The apparent danger should be then 
kept in view, and energetic measures never used, if moderate means will 
accomplish the end. 

Again, there are diseases which have a tendency to a fatal result, 
unless interrupted. These must be checked with mild means, if you can, 
but with the most energetic, if necessary. 

Then again, we find there are diseases which are necessarily fatal in 
their character, or at least are so in the present state of our knowledge. 
Here our endeavors should be to support the powers of life, and so prolong 
it, and to relieve the suffering of the patient and render him more com- 
fortable. 



INTRODUCTION. 13 

In the diseases involving great danger to life, the way in which the 
affection will cause death, affords an important guide in treatment, by 
means of which a fatal termination may be averted. In many cases, the 
whole aim of treatment will be to obviate the tendency to death. For 
our purpose here, we can reduce ail modes of death to two, viz : by inter- 
ruption of respiration (called apnoea), and by failure of the circulation or 
exhaustion (called asthenia). These two modes of dying may be com- 
bined. The best illustration of the first mode named, {apnoea), is furn- 
ished by cases of strangling. Other instances, are in diseases involving 
obstruction to the passage of air to the lungs, or which make them incom- 
petent to receive air, as croup and other inflammations of the air passages, 
catarrhal fever in children, extensive inflammation affecting both lungs, 
dropsy of the lung or pleural sac, and acute consumption. In all these 
cases, the obvious indication is, to supply oxygen to the blood. Obstruc- 
tion to the circulation may be caused by paralysis of the heart, by over- 
distension, by pressure upon the great vessels, by tumor, by dropsy of the 
sack covering the heart (pericardium), or coagulation. In these cases, the 
indication is to prevent or overcome, if possible, these obstructions. But 
in all diseases which prove fatal by exhaustion, the mode of dying is by 
asthenia, as in the continued fevers fatal of themselves. The indication 
is then to obviate this tendency by tonics, nourishment, and, perhaps, 
also by stimulants. 

4. The use of remedies is also governed by the stage of the disease. 
In the commencement of a disease, experience shows that a measure may 
be effectual in arresting its progress, which would be harmful or useless 
at any later period in its course. A beginning cold is frequently cut 
short by a full dose of Opium or Dover's powder, but so favorable a result 
would not follow later in the case. Depletion is frequently useful in the 
commencement of diseases, but is harmful when advanced; on the other 
hand, stimulation is frequently of great importance in the latter stages of 
acute prostrating diseases, where, if employed at the commencement, 
it would have worked an injury. When one disease follows or appears in 
the course of another, or an accompanying symptom develops an undue 
importance, great watchfulness, and frequently new measures of treat- 
ment, are demanded. 

5. The condition of the system, at the time of the attack., has the most 
important bearing upon the treatment. Measures which would be proper 
in a robust, hearty person, with an abundance of healthy blood, would 
be wholly unsuited in a feeble constitution, and those in whom the blood 
is impoverished or vitiated. The latter would necessarily require tonic 
and supporting treatment from the very first, while depletion might be 
beneficial in the former. The circumstances under which the patient is 
constantly placed, or those to which he was exposed previous to the 
occurrence of the disease, must be taken into account. 

The age of the patient has an important bearing upon treatment. 
Infancy is well known to be more than proportionately susceptible to 
many medicines, and while the restorative processes are rapid, the sys- 
tem is also easily depressed below the point of recovery. Supporting 
treatment is early called for in prolonged diseases of infants. In ad- 



14 INTRODUCTION. 

vanced life, though less susceptible than middle life to the action of med- 
icines, excesses, of any kind whatever, are not well borne, caution is 
demanded and large doses should never be given. 

Supporting measures are demanded earlier in the course of disease in 
the old than in middle life, though excessive stimulation is not safe. 

Women are more susceptible than men, and should be treated more 
delicately. Particular care is required during menstruation, and unless 
treatment is demanded, it should be suspended during menstruation. In 
pregnancy, all purturbating treatment, such as emetics and cathartics, 
should be avoided. 

Individual peculiarities should be considered; any special suscepti- 
bility, or peculiar action of a remedy, dictates its avoidance in those per- 
sons. 

Hereditary influences must be considered ; the known constitutional 
habits of the parents should be weighed and govern the treatment of the 
child. 

For example, the child of scrofulous parents should, under some cir- 
cumstances, be treated differently from one in whom there is no heredi- 
tary morbid predisposition. 

The habits of the patient have an important bearing upon the treat- 
ment, and should be thoroughly investigated and known. Exhaustion 
from immoral excesses ; debility and impoverishment of the blood from 
insufficient food in quality, or variety, if not absolute starvation and bad 
air ; gluttonous indulgence of the appetite ; intemperance in the use of 
alcoholic drinks, and the effects of one's occupation or business, all have 
an important bearing upon the treatment. All these conditions call for 
supporting treatment at once, and often for stimulants. 

Previous disease often leaves a debility which calls promptly for sup- 
porting treatment. Peculiar tendencies to different diseases (diatheses) 
such as rheumatism, gout, consumption, etc., modify greatly different 
diseases, and may impress upon them more or less of their own character. 
The patient cannot be properly treated without giving these facts their 
proper bearing. 

6. Co-existing influences often modify greatly the disease results of 
particular causes. The most prominent of these, are the epidemic (a 
widely prevailing disease,) or endemic (a locally prevalent disease) influ- 
ences and the miasmatic, especially marsh miasma, which causes ague and 
other periodical diseases. Without attending to these influences which 
modify disease, the treatment will be liable to be attended with fatal 
blunders. In all miasmatic districts, it is well known, that all diseases 
assume a character resembling more or less closely the periodical fevers 
with which these districts are infested. In all these localities, especially 
in autumn and winter, when other fevers, from whatever cause, and also 
inflammatory diseases, exhibit the remittent character of the proper 
miasmatic (or marsh) fever, we also see the best results follow the admin- 
istration of Quinine. Epidemics, (wide-spread prevalent diseases) it is 
well known, impart more or less of their own character to all coincident 
diseases. Sometimes, notwithstanding the epidemic influence, there is 
maintained a vigorous state of the system ; when this is the case, the 
type of disease is said to be ethenic. At other times, the tendency is to 



INTRODUCTION. 15 

a feeble and weak, or typhoid, condition ; this is said to be asthenic. The 
latter condition calls at once for supporting and nutritious measures, and 
in the former, these measures are not as early called for, and even deplet- 
ing remedies may be useful. 

7. The pointing of nature, as shown by the expression of wants by 
the patient, should not be disregarded, but should be watched for, and 
cautiously gratified, even though they are opposed by the dictates of our 
own reason, or even to the whole course of our experience. It is some- 
times noticed that the patient, during the progress of a severe disease, 
expresses a wish for some drink, or article of food, or some change in 
other respects, which would seem to be highly improper. As such wants 
are expressed, often as the mere result of restlessness, or whim of the 
patient, it should, of course, be properly denied. But, if the same wish 
is repeated from time to time, against the authority of physician, attend- 
ant, and the judgment of the patient himself, it may be looked upon as a 
real want of the system, and indication by nature, which ought to be com- 
plied with. At first, it should be gratified cautiously, and in a manner 
that little harm could result, if it should happen to be a mistake. If 
good should result from careful trial, a greater indulgence may be per- 
mitted. On this point, Prof. Geo. B. Wood forcibly says: "The prac- 
titioner will often be gratified at witnessing a rapid recovery, dating from 
the moment of his judicious surrender of his own judgment to the impe- 
rious call of the system.'' If error is committed on this point, let it be 
on the side of caution. 

8. In the treatment of any disease, it is a good general rule to attend 
to the state of the functions, (secretions and excretions,) and to correct any 
disorder there, even though they are not directly connected with the 
disease. Especially should the bowels be kept regular, and constipation 
(fecal accumulations) carefully guarded against. The secretions of the 
skin and kidneys should be maintained, as nearly as possible, in a healthy 
state, and to this end, frequent examination of the urine is to be made. 
An irregular circulation, the temperature and nervous action should also 
receive attention. By these means alone, we occasionally cut off one of 
the chief sources of disease, and give great aid to recovery, for it is not 
always easy to determine how far diseases are mutually dependent. 

j. y. b. 



CONTENTS. 



Preface to Seventh Edition Page 4 

Publisher's Preface to First Edition Page 5-6 

Authors' Preface ! Page 8-9 

Mrs. Dr. Robb's Letter to Mothers Page 10 

Introduction to Allopathic Treatment Page 11-15 

Table of Contents Page 16-23 

List of Illustrations Page 24 

♦ 

Part I^irsst. 

DIAGNOSIS AND PE0GN0SIS; OR, WHAT IS THE 
DISEASE, AND HOW WILL IT END? 

HOW TO INVESTIGATE THE CONDITION" OF THE 
PATIENT AND DISTINGUISH BETWEEN A 
STATE OF HEALTH AND DISEASE, 
AND DETERMINE THE PECU- 
LIAR NATURE OF THE 
DISEASE. 

CHAPTER I Page 25 

THE GENERAL INVESTIGATION OF THE PATIENT. 

The Constitution and its Varieties: Plethoric or Sanguine, Feeble, 
Bilious, Apoplectic, Nervous, Dry, Wiry, Lax, Lymphatic or Mucous, 
Catarrhal or Rheumatic, Scrofulous, and Consumptive. 

The Temperaments and their Varieties: The Sanguine, The Bil- 
ious, The Melancholic, and The Phlegmatic. 

The Antecedents of the Patient's Family. 

The Sexes and their Distinctions. 

The Age and the Conditions Which Qualify It: The earliest 
period of childhood. The second period of childhood. The third period 
of childhood. The first period of maturity. Full maturity. The first 
period of decline. The second period of decline, or old age. 

Individual Characteristics: Diseases to which (if any) the patient is 

liable. 
Manner of Living, General Habits, Occupation. 

16 




I N E"B PETS, 






CONTENTS. 17 

CHAPTER II Page 32 

THE INVESTIGATION OF DISEASE. 

By Consideration of the Cause, General Character and Particular Symptoms. 

The Causes of Diseases: First, Individual exposure, excesses, etc.. 
Second, Endemic, or those peculiar to a certain locality. Third, Epi- 
demic causes, or those for the time being prevailing over a large extent 
of country. 

The Pulse, its Variations and Indications: The art of feeling the 
pulse, in order to determine its character accurately. What to do before 
you feel the pulse. How to place the fingers to get the most informa- 
tion, and what you learn from the fingers correctly placed. The average 
standard of health. General inferences deducible from the pulse. Var- 
ious names for alterations of the pulse, as frequent, slow, quick, slug- 
gish, or tardy, soft, strong, feeble, large, small, full, empty, unequal and 
intermittent pulse, Indications attributable to these varieties, respec- 
tively and jointly. 

The Condition of the Blood, its characteristics. Spontaneous dis- 
charges of blood generally. 

The Urine, its Varieties and Indications: The variations apparent 
in the urine, and their indications. The urine as a guide in fevers. 

Breathing, its Varieties and their Indications: The breath in 
health. The variations to which breathing is subject, and their indi- 
cations. 

The Digestive Functions, and the indications which they afford. The 
evacuations and their indications. Nausea and vomiting, and their 
meaning. Information derived from the appetite, and its variations. 
Absence of appetite. Natural appetite. Excess of appetite. 

Thirst, and the Indications it affords. 

The Tongue, and its indications and differences of appearance. 

The Nerves, Brain, Sensations and senses, and the information de- 
rived from their study. Loss of consciousness. Delirium. Fainting, 
etc. 

Motion, or muscular action, and rest orsleep, including spasms, convul- 
sions and paralysis. 

The Sensations and their Indications: Pain Discomfort, Anxiety. 
Heat, Chill. 

The Organs of Sense, eyes, ears, nose, taste, etc., and the knowledge 
derived from them. 

CHAPTER III Page 72 

INVESTIGATION OF THE DISEASE CONTINUED. 

Coughs, and their indications. The condition of the skin, hot, natural 
or sweaty, and the lesson it teaches. The complexion, its changes 
and varieties. Sounds given out by the chest, and the method of ex- 
amining and interpreting them. Thevoice and speech. Tearfulness 
and laughter, as signs of health or disease. Loss of, or unhealthy in- 
crease of flesh. Sneezing, yawning, groaning, etc. The saliva, defi- 
ciency and increase. The expectoration, and its valuable indica- 
tions. 



2 3 CONTENTS. 

CHAPTER IV Page 78 

DIET AND MANNER OF LIVING. 
CLOTHING AND HABITS. 

CHAPTER V Page 80 

ADMINISTRATION AND REPETITION OF THE HOMEOPATHIC ME- 
DICINES. 

External applications. Internal remedies and doses. Forms of medi- 
cines. Table of analogous remedies. 

THE BATH. 

Cold Salt Water Bath. Cold Fresh Water Bath. Hot Fresh Water Bath. 
Tepid, Shower, Vapor and Medicated Baths. Instructions, when and 
how to use the different baths. Acclimation. 



Part Second.. 



DISEASES OF THE BRAIN, THE SPINAL CORD, 
AND THE NERVOUS SYSTEM GENERALLY. 

CHAPTER VI Page 113 

Spotted Fever— Cerebro-Spinal Meningitis. Hypersemia of the Brain, or 
Excess of Blood to the Brain. Anaemia, or Lack of Blood to the Brain. 
Apoplexy. Paralysis. Brain Fever. Acute Inflammation of the 
Brain. Hydrocephalus. — Dropsy of the Brain, or Water on the Brain. 
Lock Jaw — Tetanus — Trismus. Delirium Tremens. Epilepsy — 
Spasms. Spasms of Infants— Eclampsia Infantum. Chorea.— St. 
Vitus' Dance. Catalepsy— Trance. Hysteria— Hysterics. 



Part Third. 

DISEASES OF THE HEAD. 

CHAPTER VII Page 167 

THE BRAIN AND NERVES. 

Headache — Cephalalgia — Hemicrania. Nerve Pain. Face Ache. Face Ague 
Neuralgia of the Face. 

CHAPTER VIII Page 180 

DISEASES OF THE EYE. 

Inflammation of the Eye— Ophthalmia— Acute and Chronic. Cataract. — 
Specks on the Eye. Strabismus — Cross-Eye. Weeping, or Watery 
Eye. Bloodshot Eye. Stye. Blindness Conjunctivitis. 

CHAPTER IX Page 105 

DISEASES OF THE EAR. 

Inflammation of the Ear and Earache— Ostitis- Otalgia. Discharge from 
the Ears— Otorrhea. Deafness. Humming or buzzing in the Ear. 



CONTENTS. 19 

CHAPTER X Page204 

DISEASES OF THE NOSE. 

Catarrh— Cold in the Head— Coryza— Acute and Chronic. Inflammation 
of the Nose. Bleeding at the Nose — Epistaxis. 



Part Fourth.. 

THE GATE. 

CHAPTER XI Page 215 

DISEASES OF THE MOUTH AND THROAT. 

Inflammation of the Mouth. Canker of the Mouth— Stomatitis. Angina, 
Aphthous Sore Throat. Catarrhal Sore Throat. Quinsy. Diphtheria. 
Mumps — Parotitis. Scurvy of the Gums — Scorbutus. Toothache— 
Odontalgia. 



Psiirt Fifth. 

DISEASES OF THE STOMACH AND INTESTINES. 

CHAPTER XII Page 240 

DISEASES OF THE STOMACH. 

Dyspepsia — Acute and Chronic. Nausea. Eructations. Sick Headache. 
Bleeding from the Stomach — Hozmatamesis. Spasm or Cramp of the 
Stomach — Cardialgia. Heartburn. — Waterbrash — Pyrosis. 

CHAPTER XIII Page 277 

DISEASES OF THE INTESTINES. 

Diarrhoea — Intestinal Catarrh. Simple Diarrhoea. Chronic Diarrhoea. 
Cholera Morbus. Fevers. Bilious Fever. Gastric Fever. Inflamma- 
tion of the Bowels — Enteritis. Catarrhal Dysentery. Epidemic Dys- 
entery—Flux. Co\\c-~Enteralgia. Flatulent, Bilious, Hysteric. Rheu- 
matic, Neuralgic, Printers' and Copper Colic. Constipation— Stenosis. 
Piles — Hemorrhoids. Worms — Helminthiasis. Prolapsus Ani. In- 
flammation of the Peritoneum — Peritonitis. 



Part Sixth. 

DISEASES OF THE LIVER AND SPLEEN. 

CHAPTER XIV Page 338 

DISEASES OF THE LIVER. 

Inflammation of the Liver— Acute— Chronic and Suppurative. Conges- 
tion of the Liver. Jaundice. Gravel in the Gall-bladder— Gall Stones. 
Cancer of the Liver. 



20 CONTENTS. 

CHAPTER XV Page 349 

DISEASES OF THE SPLEEN. 

Inflammation of the Spleen. 

Part Seventh. 

DISEASES OF THE KIDNEYS AND BLADDER 

CHAPTER XVI Page 352 

DISEASES OF THE KIDNEYS. 

Inflammation of the Kidneys— Nephritis. Bright's Disease of the Kia 
neys— Morbus Brightii. Gravel— Renal Calculi. 

CHAPTER XVII Page 364 

DISEASES OF THE BLADDER. 

Inflammation of the Bladder— Cystitis. Bloody V rine— Hematuria. Wet- 
ting the Bed— Enuresis Nociurna Spasm of the Bladder— Cystospas- 
mus. Paralysis of the Bladder. 

<► _^-_ 

.Part Eighth. 

THE MALE SEXUAL ORGANS. 

CHAPTER XVIII Page 373 

Orchitis — Inflammation of the Testicles. Nightly Emissions — Sperma- 
torrhcea. 

o 

Part Ninth. 

DISEASES OF THE RESPIRATORY ORGANS. 

CHAPTER XIX Page380 

DISEASES OF THE LARYNX AND TRACHEA. 

Catarrh or Common Cold . Catarrhal Fever. Inflammation of the Lar- 
ynx or upper part of the windpipe. Cough. Croup— Laryngitis. Mem- 
branous Croup. Hoarseness. 

CHAPTER XX Page 400 

DISEASES OF THE LUNGS. 

Congestion of the Lungs. Hemorrhage of the Lungs. Bronchitis — 
Acute and Chronic. Influenza. Whooping Cough— Pertussis. Pneu- 
monia — Inflammation of the Lungs. Asthma. Hiccup — Singultus. 

CHAPTER XXI Page 446 

DISEASES OF THE PLEURA. 

Pleurisy — Inflammation of the Pleura. 

Part Tenth. 

DISEASES OF THE ORGANS OF CIRCULATION. 

CHAPTER XXII Page455 

DISEASES OF THE HEART. 

Inflammation of the Heart— Carditis. Palpitation of the Heart. Fatty 



CONTENTS. 21 

Degeneration of the Heart. Hypertrophy of the Heart— Enlarge- 
ment of the Heart. Angina Pectoris. 

CHAPTER XXIII Page 470 

DISEASES OF THE ARTERIES AND VEINS. 

Diseases of the Arteries. Inflammations of the Veins — Phlebitis, Vari- 
cose Veins or Dilation of the Veins. 



X^^irt Eleventh. 

DERANGEMENTS OF SINGLE SYSTEMS. 

CHAPTER XXIV Page 476 

DISEASES OF THE BONES, MUSCLES, AND JOINTS. 

Ostitis — Inflammation of the Bones and the Membranes covering them. 
Rickets — Rachitis. Lumbago. Inflammation of the Joints. Hip 
Joint — Coxalgia. Knee Joint — White Swelling — Gonitis. Joints of 
the Foot. 

CHAPTER XXV Page 494 

DISEASES OF THE LYMPHATIC VESSELS AND GLANDS. 

Acute Inflammation. Chronic Inflammation. 

CHAPTER XXVI Page 497 

DISEASES OF THE SKIN. 

Erythema— Simple redness of the Skin — Erysipelas. Hives— Urticaria. 
Dandruff— Pityriasis. Scaly Tetter. Barbers' Itch. Bottle Nose. 
Ring Worm. Tetter Salt Rheum — Eczema. Shingles. Boils and 
Carbuncles. Scald Head— Favus. Itch— Scabies. Ulcers. Abscess. 
Whitlow— Felon. Chilblains. Corns. 

-^~-^ — 4» — .- 

Part Twelfth. 

CONSTITUTIONAL DISEASES. 

CHAPTER XXVII Page 521 

ACUTE CONTAGIOUS DISEASES. 

Measles. Scarlet Fever. Smallpox — Variola — Varioloid. Chicken Pox. 

CHAPTER XXVIII Page 544 

EPIDEMIC AND ENDEMIC INFECTIOUS DISEASES. 

Fever and Ague— Intermittent Fever. Inflammatory Fever — Synochia 
Typhoid Fever — Enteric Fever. Yellow Fever. Cholera. 

CHAPTER XXIX Page 595 

CONSTITUTIONAL DISEASES WITHOUT DEFINITE INFECTION. 

Eheumatism of Joints and Muscles. Rheumatism of Sciatic Nerve. Con- 
sumption — Tuberculosis. Scrofula— Scrofulosis. 



22 CONTENTS. 

IPart Thirteenth.. 

DISEASES PECULIAR TO WOMEN. 

CHAPTER XXX Page 621 

DISEASES OF THE FEMALE SEXUAL ORGANS. 

Menstruation ; what it means. Its course in health. Derangements at- 
tendant on its appearance. Chlorosis— Green Sickness. Amenorrhea 
—Suppression or Delay of the Menses. Menorrhagia — Profuse Men- 
struation. Leucorrhcea— Whites— Catarrh of the Sexual Mucous 
Lining. Prolapsus Uteri— FaUing of the Womb. Menopause— The 
change of life. Mastitis— Inflammation of the Breasts. Carcinoma 
Uteri — Cancer of the Womb. Carcinoma Mammce— €ancer of the 
Breast. 

CHAPTER XXXI Page 652 

CONDENSED SIGNS OF PREGNANCY. 

General Observations, Air and Exercise, Clothing, Diet Employment of the 
Mind, and habits during. 

Morning Sickness. Heartburn— Acidity— Waterbrash. Constipation. 
Diarrhoea. Toothache. Urinary Difficulties. Swelling of the lower 
limbs. 

MISCARRIAGE. 

General Symptoms. Exciting Causes. 

TREATMENT BEFORE CONFINEMENT. 

Preparation of the Breasts. Preparations for Labor. The Bowels. Diet. 
False Pains. Parturition or Labor. Treatment after Deli very. Gen- 
eral Management. After Pains. Flooding. Spasm of the Bladder— 
Retention of the Urine. Duration of Confinement. 

CHAPTER XXXII Page 674 

DISEASES FOLLOWING CONFINEMENT, 

Secretion of Milk. Excessive Secretion of Milk. Perspiration after De- 
livery. Milk Fever. Childbed Fever. Puerperal Fever. The Lochial 
Discharge. Diarrhoea of Lying-in Women. Abdominal Deformities. 
Weakness after Labor. Sore Nipples. Inflammation of the Breasts. 

Part Fourteenth. 

TREATMENT OF INFANTS. 

CHAPTER XXXIII Page 685 

TREATMENT AFTER BIRTH. 

Stillborn children — Suspended Animation, treatment, mechanical mea- 
sures, etc. Swelling of the Head. Navel rupture in Infants ; mecha- 
nical treatment. Rupture in the Groin. Expulsion of the Meconium. 
Suckling of the Infant. The choice of the Nurse. Diet during Nur- 
sing. Additional Diet of Infants. Sleep — Sleeplessness. Exercise. 
Weaning. 




FROM © : 






CONTENTS. 23 

CHAPTER XXXIV Page 695 

DISEASES OF INFANCY. 

Inflammation of the Eyes. Hiccup. Cold in the Head. Crying and 
Wakefulness of Infants— Colic. Regurgitation of Milk. Acidity. 
Flatulence, etc. Milk Crust— Milk {Scab— Milk Blotches. Thrush— 
Aphthae. Constipation. Diarrhoea of Infants. Cholera Infantum— 
Summer Complaint. Chafing — Excoriations. Asthma of Infants. 
Swelling of the Breasts. Atrophy — Emaciation Dentition. Spasms 
—Convulsions of Infants and Children. Vaccination. 

Part Fifteenth. 

SURGERY. 

CHAPTER XXXV Page 724 

Accidents of various kinds. Apparent Death, from Hunger; from a Fall; 
from Suffocation; from Lightning; from Drowning; from being Frozen. 
Verification of Death. Concussion of the Brain. Concussion of the Chest. 
Sprains — Partial Dislocation. Hemorrhage — with Means of Suppres- 
sing. Wounds, with their Divisions; Incised, Lacerated, Bruised, 
Punctured, and Gunshot Wounds. Bandages and how to apply them. 
Fractures — Broken Bones. Burns and Scalds. Sunstroke — Sun Fe- 
ver. Stings of Insects. Dropsy. 

CHAPTER XXXVI Page 744 

FOOD FOR INFANTS AND INYALIDSo 

FOOD FOR INFANTS. 

Starchy Food. English "Pap." Cow's Milk. Infants Broth. Baby 
Pudding. Food for Young Children. Children's Pie. Brown Mush 
for Supper. Bread and Milk. Cranberries. 

FOOD FOR INVALIDS. 

Gruel. Panada. Soft Toast. Egg Toast. Soft Boiled Eggs. Dry Toast. 
Milk Toast. Thickened Milk. Milk and Eggs. Beef Tea. Oyster' 
Soup. Broiled Tenderloin. Arrowroot Gruel. Mutton Tea. Chicken 
Broth. Water Gruel. Rice Gruel. Sago Gruel. Tapioca Cup Pud- 
ding. Invalid Apple Pie. Roast Apples. Stewed Prunes. Lemon- 
ade. Apple Water. Toast Water. Flaxseed Tea. Barley Coffee. 
Oatmeal Coffee. Rice Water. Mucilage of Elm Bark. Alum Whey. 
Mustard Whey. Vinegar Whey. Rennet Whey. Orange Whey. 



Table of Remedies with abbreviation of Latin name. Full Latin (or 
technical) name. Common English name. Name of antidote to 
be used when the medicine has, from any reason, been taken in too large 
doses, and the names of a few diseases which are often cured by the rem- 
edy they follow. 

, «> 

Part Sixteenth. 

THE REPERTORY. 
CHAPTER XXXVII Page m 

A list of all the symptoms developed by different diseases. Arranged 
with relation to the part of the body affected, and the symptoms of each 
part follow each other in alphabetical order. After each symptom is 
given the abbreviated name of a few remedies known to be excellent as a 
means of curing that particular condition. 



ROBB'S FAMILY PHYSICIAN. 

PART FIRST. 



DIAGNOSIS AND PROGNOSIS; OR, WHAT IS THE 
DISEASE, AND HOW WILL IT END? 

CHAPTER I. 

HOW TO INVESTIGATE THE CONDITION OF THE PATIENT AND DIS- 
TINGUISH BETWEEN A STATE OF HEALTH AND DISEASE, 
AND DETERMINE THE PECULIAR NATURE 
OF THE DISEASE. 

The investigation of the condition of the Patient, and the deter- 
mining the particular nature of the Disease, are evidently essential to 
appropriate treatment. It is, therefore, imperative that a work of this 
kind should contain such simple instructions on this head as may lead 
unprofessional persons easily and simply to a clear and positive conclu- 
sion. Such an investigation may properly be divided into two distinct 
sections, namely: first, the general investigation of the patient, and 
secondly, the particular investigation of the disease- 

THE GENERAL INVESTIGATION OF THE PATIENT. 

The general investigation of the patient should comprise a scrutiniz- 
ing inquiry into the particular constitution of the individual— the tem- 
perament — the antecedents of the patient's family, as of general health, 
habits, etc., of the parents, and of each of their families respectively — the 
sex, and the relative state of the secretions especially consistent with the 
state of health in such sex— the age of the patient, and the circumstances 
which qualify this condition— conditions, impressions, or habits, etc., 
which are individually peculiar to the patient — the weak or particularly 
susceptible part, and what, if any, be the particular affections to which 
the patient has been subject— the general habits, occupation, method of 
living, diet, etc., — the relations between the climate and the individual, 
or any transitions of climate to which the patient may have been exposed. 

THE CONSTITUTION AND ITS VARIETIES. 

A plethoric {sanguine) constitution, or full habit of body, characterized 
by redundancy of animation and vital energy in health, and a prevailing 
and predominant activity in the circulative system ; the complexion being 



26 INVESTIGATION OF THE PATIENT. 

florid and glowing, the frame full and stalwart, the limbs generally active, 
the spirits and muscular apparatus buoyant and elastic, the generation of 
natural warmth abundant, and the pulse full and strong ; but consequently 
with susceptibility to inflammatory influences, and a predisposition to 
local, organic, or general congestions, suffusions, or emissions of blood. 

A feeble constitution, as opposed to the foregoing— in which fatigue is 
naturally a ready consequence of exertion ; when the breath will easily 
be exhausted by sudden or rapid motion ; when the generation of heat 
will be naturally deficient, and the operation of the functions generally 
slow and easily impeded, or vexed, by being the least overtaxed, the mus- 
cles being readily wearied and incapacitated — the secretions varying from 
excess to deficiency or suspension — and the organs being either too readily 
provoked and stimulated, or very dull and insusceptible of external cir- 
cumstances—and the pulse being naturally feeble, soft, and yielding. The 
patient is consequently subject to diseases characterized by torpidity and 
utter inaction of the functions, or by excessive relaxation. 

A bilious constitution, characterized by dark and somewhat turgid 
skin, or even by superabundant yellowness of the skin, (an imperceptible 
proportion of yellow in the skin, observed on close examination, being 
indispensible to a really healthy complexion,) and by the readiness with 
which the liver sympathizes in, and becomes affected by, every external or 
internal contingency, with predisposition to derangements affecting the 
digestive functions and the stomach generally, and to irregularity of such 
functions ; as also to dark colored urine, costiveness (with dark motions,) 
and piles; the piclse is apt to be wiry. 

An apoplectic constitution, (a sub-division which is important here,) 
characterized by the short, thick-set, or close, full frame, with large head, 
apparently buried between the shoulders, the neck being very short and 
thick, and the pulse being more or less of the character of the plethoric 
habit, and the patient being predisposed to sudden rushes of blood to the 
brain. 

A nervous constitution, (a variety which is often found in combination 
with the bilious,) especially characterized by predominant excitability of 
body and of mind ; absence of fixity (or changeableness) of ideas, habits, 
inclinations, etc. ; irritability, and extreme sensitiveness and inequalities 
of temper — the pulse being accordingly also variable, easily subject to 
exceeding acceleration, but often subsiding, in sedate moments, to a move- 
ment slower than is customary. The patient is subject to the various 
affections so difficult of distinction and classification, which come under 
the head of nervous diseases ; such as spasmodic affections, fits, apparently 
traceable to no distinct cause; fugitive and inexplicable pains, particularly 
sueh as are aggravated by very slight touch, or by approximation, but which 
are relieved by pressure. 

A dry, wiry constitution, (not uncommonly combined with the biliowi 
or nervous,) characterized by swarthy complexion, sharp, deep-set fea- 
tures, searching glance, persistently dry condition of the the skin, firm, 
hard, wiry condition of the muscular and tendinous fibre; deficiency of 
flesh and angular frame; generally, also, a rapid motion and quick per- 
ception; the urine is dark, the motions are habitually hard and scanty, 
the secretions and sweat are usually deficient, and the pulse is generally 



INVESTIGATION OF THE PATIENT. 27 

distinct and wiry, but commonly, also, quicker than that of the ner- 
vous habit (when unexcited). The patient is subject to inflammatory 
affections— to which the intestines are especially predisposed — as also to 
diseases generally, which occur (as it were) with superabundant animal 
power. 

A lax, lymphatic, or mucous constitution. — These three varieties, which 
are, indeed, susceptible of very nice distinctions, are, however, sufficiently 
analogous to be united in a work of this kind; they are opposed to the fore- 
going. The complexion is generally fair, the flesh apparently full, but 
soft, flaccid, and puffy : the skin pallid, the frame rounded, the muscular 
and tendinous fibre unstrung, yielding, and relaxed ; sensations of chilli- 
ness prevail, and the individual is usually more sensitive of cold than of 
heat, but is also alive to immoderate elevation of the latter; the natural 
generation of heat is deficient, the circulation sluggish, the pulse being 
slow, (sometimes rather full, but always soft, easily compressed, yielding). 
The patient is subject to the transmutation of every disease into a sluggish, 
persistent, or chronic form, (the crisis and resolution being in general 
imperfect,) to superabundant secretions or accumulations of phlegm, to 
catarrhal affections, to abcesses, to excessive discharges of phlegm, etc., 
etc. ; to the accumulation of water (by decomposition, or imperfect compo- 
sition of the blood,) about particular organs, or throughout the body, 
(generally as the immediate consequence of inflammation,) and sometimes 
to the sudden suppression of discharges. 

The catarrhal or rheumatic constitution, (nearly analogous to the last, 
but having one very distinctive feature in the susceptibility of the exter- 
nal surfaced characterized especially by want of sufficient activity and 
nervous tension and vitality in the skin, which, therefore, remains easily 
affected by every external circumstance, effects transpiration (throwing off 
moisture and unhealthy matter, through the pores of the skin,) very defec- 
tively and inadequately, and is apt, by being susceptible to the sudden 
suppression or repercussion of such transpiration, to re-convey the morbid 
humors which have been expelled by internal organs, upon those organ? 
themselves, and thereby to generate diseases of the character indicated by 
the name here selected. A very decided feature of this habit of body 
consists of extreme susceptibility to derangement of digestion, which, if 
inherited, may be considered as the predisposing cause to such tendencies. 

A constitution in which the skin is especially liable to become diseased, 
(psoric) (more distinctly capable of individual classification than the scrofu' 
lous habit, but yet a mere modification of the latter)— distinguishable by 
the predominance, recurrence, or continuance of irregular and unhealthy 
secretions from the skin, and irregular action of the glands associated 
with it; eruptions of various characters— ulcerative sores, general foul- 
ness—which seem to appear as the result of every affection, of whatever 
kind, and either to accompany or to follow every derangement. 

The consumptive constitution, (in the majority of instances, again, a 
modification of the scrofulous habit, but more subject to appropriate class- 
ification in a work of this nature,)— identified in general by a very clear, 
transparent skin, bright flush-spot on the cheeks, especially on the left 
cheek; flatness >f the chest, and hollowness on the breast-bone ; slender, 
attenuated, lengthened, fragile frame; elongation and spareness of the 
neck ; prominent protrusion or the shoulder-blades ; sudden and rapid 



28 INVESTIGATION OF THE PATIENT. 

growth ; prevalence of heat of the hands after eating ; irritability of the 
circulative system, and consequently a, pulse characterized by smallness and 
quickness. The patient is particularly susceptible to complications affect- 
ing the lungs, resulting from every inflammatory or irritative process 
(which is also very frequent, and readily provoked;) to want of breath, 
and complete exhaustion after every unusual degree of exertion, especially 
after rapid motion, and often in consequence of mere mental excitement, 
or momentary irritability; to inflammatory affections of the lungs and 
adjacent membranes, (and expectoration of blood,) which will always be 
liable to result in decay of those organs. 

THE TEMPERAMENTS AND THEIR VARIETIES. 

The temperaments are subject to an infinity of individual peculiari- 
ties which might constitute separate divisions, but which, in our estima- 
tion, will be no more readily comprehended by the reader in his investi- 
gation into individual characteristics. We shall, therefore, confine the 
division of temperaments to the following distinctions, which, even then, 
are often compounded, and which should be held to modify the relations 
of morbid manifestations. 

A sanguine temperament, (usually associated with a plethoric constitu- 
tion,) — which is characterized by habitual animation and buoyancy of 
spirits, gaiety, good humor, etc.; the mind and body are alike quickly 
stimulated into excessive action, but every affection, or disturbance, is 
usually of as rapid a course, and brief duration, as it is severe while it 
lasts. The bodily health is, usually, good and strong, — and slow or last- 
ing diseases are of rare occurrence ; but the majority of affections, (which 
have a predisposition to assume a violent and inflammatory type,) are 
exceedingly severe, when they do occur, and run a very rapid course. 

A choleric temperament, (usually associated with the bilious constitu- 
tion,) characterized by the violence of the reaction occasioned by any irri- 
tation, or stimulus, or impulse, and, particularly, by its severe implica- 
tion of the biliary apparatus, which, with increased and altered secretion 
of bile, reacts upon the moral and mental faculties, and has a tendency 
to engender a liability to the provocation of ill-humor, and even venge- 
fulness, and malignity, or to rancor, and acrimony of temper, upon the 
revival of causes of excitement. The complexion is usually swarthy, 
with a yellowish tinge; the muscular and tendinous fibre hard, wiry, 
and tightly strung; the hair dark, and the features acute or deep-set. 
The patient is subject to bilious derangements, and to bilious complica- 
tions with every derangement, not uncommonly provoked by the violent 
fits of excitement to which he is constitutionally subject. 

The melancholic temperament is identified by the slow, meditative dis- 
position ; the gloomy, retiring, solitary, and hypochondriacal temper ; 
the tacit, latent, and unobservable progress of affections produced by 
external impressions, but silently harbored. Every impression is deep 
and lasting, and broods upon the mind and body; but the patient is not 
subject to violent impulses, nor very susceptible to sudden impressions, 
the organs being none the less alive to such impressions; the sensibility 
is apparently blunted or subjected to the reflective powers. The body is 
alike slowly, but progressively, affected by external circumstances. The 



INVESTIGATION OF THE PATIENT. 29 

patient is subject to diseases affecting the intestinal apparatus, especially 
those which assume a chronic and continuous character. 

A Phlegmatic temperament (which is usually associated with the feeble 
and lax, or lymphatic constitution,) is distinguishable by the tardy ope- 
ration of all functions, mental as well as bodily ; by the slowness with 
which irritation, or stimulation, is produced, and by the no less remark- 
able slowness, as well as by the inadequacy of the reactionary power. The 
predispositions are to be gathered from the remarks on the "feeble," and 
on the "lax," or '' lymphatic constitutions." 

THE ANTECEDENTS OF THE PATIENT'S FAMILY. 

"We should pay especial attention to the general health, habits, or 
particular diseases (if they be known) of the parents of the patient, and 
of the paternal and maternal relations, which may serve to elucidate the 
origin of a bad habit of body, especially if such diseases as scrofula (in 
any of its multiplied forms,) cutaneous (skin) disorders, consumption, 
gout, piles, etc , be habitual with any member of the family, whose consti- 
tution could have been inherited by the patient. This is a most essential 
consideration, for it will, very frequently, be found that when a remedy is 
distinctly indicated in the case r it fails to operate without previous prepar- 
atory treatment, and we are puzzled by the failure; whereas, after the 
previous administration of an opposite preparatory remedy, the medi- 
cine already selected as appropriate, but administered without effect, fre- 
quently becomes signally successful. This is generally owing to hereditary 
defects of constitution. 

THE SEXES AND THEIR DISTINCTIONS. 

In the male, we anticipate redundancy of animal strength, vigor, 
energy, and circulative power, and we must consider disease in a modified 
or aggravated aspect, according to the ascendency or deficiency of these 
characteristics. 

In the female, we may anticipate more acute sensibility, greater ten- 
derness and excitability, and a less vigorous and persistent reactionary 
power. We must not, moreover, omit to consider the conditions depend- 
ent peculiarly upon the organs of parturition, etc., and upon the func- 
tions associated with them; the progress of pregnancy, and the genera- 
tion of milk; or, on the other hand, the presence of periodical changes 
should be duly considered, in relation to every simultaneous derange- 
ment. 

Relaxation of fibre, and lymphatic accumulations, are, also, (to a 
greater or less degree,) inseparably associated with the peculiarities of the 
sex; and the greater intensity and additional sphere of nervous sensibil- 
ity should lead us to consider, with great caution, such nervous, spas- 
modic, or hysterical indispositions, as occur, associated with natural pre- 
disposing causes. 

THE AGE AND THE CONDITIONS WHICH QUALIFY IT. 

Age is not to be considered, without regard to conditions of previous 
health or disease — of habits, manner of living, climate, avocations, etc., 
especially in relation to persons who have attained maturity. It may, 
however, (subject to such modifications,) be considered under seven dis- 
tinct sections, viz: — childhood constituting three, maturity two, and 
decline two. 



80 INVESTIGATION OF THE PATIENT. 

1. In the earliest period of childhood (the first of infancy,) extend- 
ing to the period of the earliest teeth, the human being is extraordinarily 
susceptible to external influences ; sensitive, to a higher degree, and, con- 
sequently, alive to any sudden irritation from, apparently, slight causes; 
the brain, in particular, is liable to precipitation of bknd, and the acute 
sensitiveness of the whole nervous structure renders spasmodic affections 
predominant. 

2. In the second period of childhood — extending to the seventh year 
in our climate — we have to consider the natural irritability of the system, 
the want of firmness of fibre, the susceptibility to fatigue, readily obvi- 
ated by the provision of nature — a preponderance of tendency to rest ; 
and we have to anticipate the occurrence of organic inflammations, par- 
ticularly as connected with the respiratory or cerebral apparatus, and 
irregularities in the accumulation of flesh. 

3. In the third period of childhood— extending to the beginning of 
manhood, or womanhood— the equilibrium between the functions, facul- 
ties, etc., being better established, and the tissues having become inured 
to external influences, we should consider the occurrence of such affec- 
tions, as already described more minutely, with reference to particular 
habit of body, circumstances, individual habits, avocations, etc. ; situation, 
and other local and general external causes. 

4. In the period of approaching and progressive maturity — extend- 
ing to the twenty-fifth year, in our climate — the vigor of the circulative 
system should be developed ; it is then, also, that we may anticipate the 
serious development of latent, or declared bad habits of body, traceable to 
parentage, and particular care should then be taken — especially, if in 
infancy, or childhood, a course of constitutional treatment has been neg- 
lected—to neutralize, or modify such constitutional defects — affecting the 
Lungs, and the Brain especially — as in Epileptic or Consumptive affec- 
tions; both being considered in due relation with the progress of sexual 
powers. 

5. The period of maturity — extending, generally, from the twenty- 
fifth to forty-fifth year, in our climate, must, especially, be considered in 
relation with habits, mode of life, avocations, locality inhabited, trans- 
itions of climate, (if any,) etc., because any of these circumstances may 
tend, very materially, to lengthen or abbreviate the stage of vigorous 
maturity. In some cases, we may extend it to the fifty-fifth year ; in 
others, it may as reasonably be limited to the thirty-fifth year. In gen- 
eral, the period of maturity, properly so called (whether of long or short 
duration,) is characterized by continual, even, regular, and vigorous ope- 
ration of all the functions and faculties. 

6. The first period of decline— which may, at present, be said to 
extend, in our climate, generally, from the forty-fifth to the fifty-fifth 
year — may be distinguished by diminished activity of mind and body, 
supervening irregularity of the functions, decreased powers of endurance 
and strength, returning susceptibility to external influences, and debili- 
tation of the attributive powers of either sex. This period, whether 
deferred or premature, is almost infallibly distinguishable by such char- 
acteristics. 



INVESTIGATION OF THE PATIENT. 31 

7. The second period of decline, or old age, which may set in from 
the fiftieth to the sixtieth year, in our climate— or sooner, or later, accord- 
ing to antecedent circumstances, is indelibly characterized by the decrease 
of acuteuess in the perceptive faculties, and in the organs which convey 
sensations— as of light, sound, smell, taste, and sensitiveness of touch — 
by growing obtuseness of moral and mental sensibilities; by decreasing 
retentive mental power; by general attenuation of frame, diminution of 
physical power, stiffness of joints, muscles, etc., aridity and puckering of 
the skin, the development of latent defects of circulation, and the like. 

INDIVIDUAL, CHARACTERISTICS. 

The peculiarities of individual patients, and the particular effect of 
particular external influences, etc., upon them, both as to mind and body, 
should be very carefully considered ; and it is absolutely necessary, for 
the thorough appreciation of the distinctive points relating to the case of 
a patient, with whose habits, constitution, and susceptibilities, etc., we 
are not perfectly conversant, that we should most carefully gather the 
history of the particular and characteristic mannerism (if it may so be 
termed) which identifies him. Every person whatsoever, must, in some 
point or other, be considered to constitute an exceptional case, and be so 
studied, for successful treatment. 

DISEASES TO WHICH (IF ANY) THE PATIENT IS ESPECIALLY LIABLE. 

It can hardly occur that a patient is not more subject to one class of 
disorders than to any other; and although this, to a certain extent, falls 
within the pale of the considerations suggest ed above, (see 6.,) yet there is 
one essential point to be considered here, namely, the issue, or final crisis, 
in which such disorders terminate, which is ever characteristic. 

METHOD OF LIVING, AND GENERAL HABITS. 

It is a most important comparison to institute, in the study of any 
case, to consider the relation between the habit of body in health or disease, 
and the method of living, occupation, etc. The habits may be especially 
considered in respect to the following distinctions: — (1) whether seden- 
tary or active ; (2) whether the chief exertion be of mind or body ; (3) 
whether the locality generally inhabited be of a close, artificial, (town) 
or of a free, natural atmosphere ; (4) whether the clothing, food, and other 
comforts, or even necessaries of life, have been sufficient, but moderate, or 
excessive, (both as to quantity, -in proportion to actual requirement, or 
richness) or deficient in quantity simply; or, not only insufficient, but 
also unwholesome; (5) whether the domicile and person, or either, have 
been habitually cleanly, carefully attended to, or foul and neglected, (as 
to domicile, particularly as to cleanliness, drainage, and ventilation ; order 
and regularity are, however, also essential) ; (6) whether the habits as 
regards eating and fasting, labor and rest, etc., occupation or want of 
occupation, have been regular or. irregular. 

With excessive confinement, close atmosphere, deficiency of exercise, 
etc., we may associate affections of the stomach and liver (especially,) of 
the digestive functions generally, and depression of spirits, as also (if the 
place of occupation be of a foul atmosphere,) affections of the lungs. 
With excess of mental labor we may associate nervous complaints, and 
habitual irritative fevers. With insufficiency or unhealthy kind of food, 



82 INVESTIGATION OF DISEASE. 

deficient ventilation, drainage, and cleanliness, we associate low fevers, 
eruptive fevers, typhoid and putrid, or even intermittent complaints, and 
skin diseases. With excess of nutrition and indulgence (in comparison to 
physical exercise,) we may associate inflammatory complaints, and rushes 
of blood to particular organs. And in all cases, analogically, we may ally 
the nature of the complaint with the nature of the habits, occupation, 
food, etc. 

THE PART OR ORGAN USUALLY DISEASED. 

By investigation into the most frequent result of casual, accidental, 
external or internal causes, we may readily ascertain what part of the 
system is particularly liable to irregular or unhealthy action. And this 
research is always requisite, because every individual will be found to 
have one organ especially susceptible, and liable to become deranged by 
given causes, in some cases even, such as would seem to involve any other 
complication, rather than that which actually occurs. 

ATMOSPHERIC AND OTHER LOCAL INFLUENCES. 

The atmosphere, soil, etc., of particular localities, is known to be 
prone to engender particular derangements. It is also known that the 
water of particular springs and rivers, whether owing to the presence of 
mineral substances, to excessive hardness, or to other causes, has a ten- 
dency to generate particular diseases. It is, therefore, very important 
that these, and the like particulars, should be submitted to close investiga- 
tion. 



CHAPTER II. 



THE INVESTIGATION OF DISEASE. 



BY CONSIDERATION OF THE CAUSE, GENERAL CHARACTER, EXAMPLES, 
AND PARTICULAR SYMPTOMS. 

The investigation of disease may properly be confined to the consid- 
eration (1) of the various general, particular and local causes ; (2) of the 
general character of the disease; (3) of the general characteristics of 
the disease, as compared with existing or recorded examples; (4) of 
the symptoms — which last must again be divided into the consider- 
ation of the pulse, its varieties and indications; the discharges generally; 
the nature of the blood, if any be discharged ; the state of the digestive 
functions; the mouth and tongue; the eyes; the breathing, and its pecu- 
liarities; the peculiarities of complexion, motion, action, or inactivity; 
appearance, etc. ; the symptoms exhibited by the nervous system gener- 
ally, and especially by the brain. 

THE CAUSES OF DISEASE. 

These are either what may be termed constitutional causes, which 
consist in any unhealthy condition of the system, and for the distinction 
of which the reader should consult the part on " Constitution," or they 
are more immediate, as those hereafter described : 




A happy home in which isolation, ventilation and drainage add 
much to the good health of the occupants. 



(33) 



34 CAUSES OF DISEASE. 

This latter class of causes consists:— First. Of such as may be traced 
to individual exposures, excesses, etc , or to particular conditions, either of 
locality, dwellings, atmosphere, circumstances, habits, particular suscep- 
tibility, constitutional predisposition, foregoing diseases, and consequent 
deterioration of constitutional strength, etc., all of which belong, more 
especially, to the " Investigation of the Patient," and have, already, been 
recited. 

Second. Causes, which are peculiar to a district, country, climate, or 
particular spot, and which are, then designated as endemic. Almost 
every district, especially such as are remarkable, for rapid evaporation, 
excessive and sultry heat, stagnant waters, and rapid decomposition of 
vegetable matter, or marshes with little or no drainage, or bleak, exposed 
situations, where dry, cold, and searching winds prevail, and the waters 
are hard, and, generally, impregnated with mineral substances; for sud- 
den and frequent changes of temperature; for general flatness of country, 
or for elevated and irregular surface; for winds of a particular character, 
and from a particular quarter; whether inland, insular, or coasting; 
whether the prevalent occupation be that of factories or fields; and 
whether the habitations of the people are isolated, well ventilated, well 
drained, generally clean, or closely packed, squallid, small, dark, loath- 
some, ill-drained, and ill-ventilated. These, and many local distinctions 
of a similar character, will tend to render the generation and prevalence 
of particular diseases, properly speaking, indiginous, or endemic, and 
should, therefore, be duly considered. 

Third. Causes, which are of a general, indeterminate character, such 
as heat, cold, damp, draught, and particular electric relations, but which 
are prone to become associated with sudden transitions of atmospheric 
condition, and which will be the more surely developed by the presence, 
or precedence, of certain other diseases arising from similarly indeterm- 
inate causes, by the superabundance of particular natural products, (veg- 
etable or fruit,) or by the deficiency of food, as in cases of famine, or by 
calamities of various kinds. These are generally classed as Epidemic 
causes, and are properly divided into three sections, viz: those which 
occur regularly at certain seasons ; those which are of continuous dura- 
tion, and are, apparently, of incessant development, such as small-pox, 
measles, scarlet fever, etc.; and those more properly and exactly epi- 
demic, that is, which appear under particular electric, and other condi- 
tions, from time to time, scouring whole regions, and whole continents, 
wherever the like circumstances tend to engender them, but which, 
then, unaccountably subside. 

It is worthy of especial notice, that all three general classes of these 
causes engendering disease, are to be removed, modified, extenuated, or 
even eradicated, by judicious management, by the removal of the direct 
causes, (if any be apparent,) or by the preparation of the system, by means 
of specific remedies. 

THE GENERAL CHARACTER OF THE DISEASE. 

This is determinable by considering the various manifestations in 
conjunction with the state of the circulation, or action of the heart, as dis- 
tinguishable in the condition and peculiarities of the pulse, which, alone, 
can serve distinctly to characterize disease. Pain is, very generally, no 



INVESTIGATION OF DISEASE. 36 

criterion, except as qualified by the pulse; the muscular and nervous 
action is usually no criterion, except as qualified by the pulse; the diges- 
tive functions, secretions, discharges, etc., will often leave the degree of 
progress, danger, or curability in disease undetermined, without refer- 
ence to the pulse; to the consideration of which we will, therefore, 
proceed . 



THE PULSE: ITS VARIATIONS AND INDICATIONS. 

the art op feeling the pulse in order to determine its char- 
acter accurately. 

First. Avoid feeling the pulse abruptly, and until the patient has 
been beguiled (if possible) by irrelevant conversation. 

Second. Make such an investigation of the history of the case as to 
assure yourself that there may not be some immediate casual circumstance 
calculated to have fluttered, or otherwise affected the patient, and thereby 
to have disturbed the pulse more immediately. 

Third. Place three of the fingers upon the artery on the inner side of 
the left wrist of the patient, having the thumb so applied to the back of 
the wrist that the pressure which you apply to the artery can be modified, 
increased, etc., in any and every degree; and that thereby, and by so vary- 
ing the degrees of pressure,) having a considerable length of the artery 
under the three fingers,) you may be able, not only to distinguish the num- 
ber of beats which occur in the minute, but, also, the particular nature of 
such beats; as, for instance, whether by pressure, you can, apparently, 
suppress the gush of blood through the vessels; or whether, when strongly 
pressed, the current seems to worm through, beneath the fingers, like a 
wire ; or whether the bound is so strong as apparently to force the fingers 
away in its impetuous passage ; or whether the pulsations are very sud- 
den, distinct, abrupt, and, as it were, convulsive; or whether, on the other 
hand, the pulsation appears to linger, and to pass languidly ; or whether, 
again, there is no distinct pulsation, but a rapid thrill, rather to be called 
a vibration than pulsation. In order to thoroughly distinguish these vari- 
ations, it is imperative that the attention should be absolutely centered in 
this one object, and not distracted by any other circumstance. 

THE AVERAGE STANDARD OF HEALTH. 

The healthy pulse of an adult (in the stage of maturity) male person 
of large and expansive frame, should (with the modifications before men- 
tioned, under the head of "Constitutions,") be firm, not compressible, but 
sensibly urged through the artery, notwithstanding pressure, yet neither 
hard, (conveying a shock to the touch,) sudden and twitching, nor like a 
thread, worming its way beneath the fingers; but moderately full, even, 
regular, and numbering from 70 to 75* beats in the minute. 

The healthy pulse of an adult (in the stage of maturity) male person, 
of smaller frame and proportions, should, in general, number from 72 to 
78 beats, subject to the same general characteristics in other respects. 

* If, however, the pulse be habitually slower or quicker, we should assume this as an individual 
Standard, because instances are upon record of the pulse of healthy adult males varying from 30 to 50 
beats. Young infants are known to have a pulse numbering from 140 to 150 beats. If the skin be 
moist at a natural heat, and not flushed, this would be no sign of disease. The pulse also varies 
before and after meals. 



36 INDICATIONS OF THE PULSE. 

The healthy pulse of an adult female should, with the same general 
reservations, number from 80 to 85 beats in the minute; but we should 
not anticipate as strong or full a pulse in a woman as in a man ; nor, 
indeed, should we always attach much importance to the casual precipi- 
tation of the pulse, especially of highly nervous females. 

The healthy pulse of a young person in the second stage of childhood, 
viz.: from seven to fourteen years of age, should number from 80 to 86 
beats in the minute. 

The healthy pulse of a child, under seven years old, from the period 
of teething, may be stated at from 86 to 96 beats in the minute. 

The healthy pulse of an infant, before teething, may be stated at 
from 100 to 120 beats in the minute, according as the child is robust or 
weakly; the robust infant generally exhibiting a less frequent but stronger 
pulsation. 

The healthy pulse of the first stage of declining life may be generally 
stated, for the male, at 70 beats; and for the female at 75 beats in the 
minute. 

The healthy pulse of the second stage of declining life (that is, old 
age,) may be stated for the male, at from 55 to 65 beats ; and for the female, 
at from 65 to 70 beats in the minute. 

GENERAL INFERENCES DEDUCIBLE FROM THE PULSE. 

1. Palpitation of the heart — The palpitation or pulsation of the heart, 
when felt distinctly, and predominantly, or when even heard, or so severe 
as to reverberate, as it were, through the frame, and to shake the side, 
may be considered as characteristic, either of— 

Nervous irritation, the result of sympathetic disturbance, originating 
in the stomach, especially if worms be present ; of hysterical and other 
spasmodic affections; or severe bodily suffering, or of violent emotion, 
etc., and when the result of hysterical disposition, should occasion no 
apprehension ; or of — 

Excessive debilitation, resulting from loss of blood, or other severe, 
excessive and protracted discharges, in which case it generally termin- 
ates in a swoon, which, if only occasional, does not indicate organic disease 
of the heart ; or of — 

Sudden determination of blood to the heart, or other organs, which, 
in females, should apprize us of an approaching menstrual crisis, (if in 
due season ;) or of— 

Organic disease of the heart, when it will be characterized by con- 
tinuance, or very frequent recurrence, constantly terminating in loss of 
consciousness. 

2. The pulse— will serve to determine the most essential questions 
respecting disease, such as (1) the degree of vital power possessed by the 
patient; (2) the nature of the disease, that is, whether or not inflamma- 
tory action be present; (3) specific characteristics of the disease, that is, 
whether it be the result of superabundant strength of the blood and sys- 
tem, or whether it be occasioned by, or attended with, a depressed condi- 
tion of vital energy; (4) the degree of progress made by disease upon the 
vital power, and consequently the greater or less degree of urgency; (5) 
especially in highly critical cases, when no other distinct index is afforded 
the selection of the appropriate reactionary remedy ; (6) according to the 



INVESTIGATION OF DISEASE. 37 

greater or less degree of impression made upon the pulse by such admin- 
istration, whether or not we have properly selected, and how far we should 
be justified in changing the medicine. 

VARIOUS NAMES OF ALTERATIONS OF THE PULSE. 

1. Frequent pulse— A term applied to the succession of the beats. By 
this we understand simply an increased rapidity of repetition. 

2. Slow pulse — The designation of a pulse less rapid than in health. 

3. Quick pulse— A term which designates the rapidity with which the 
current passes through the artery at each beat, qualifying the character of 
the beat; whereas, frequency (as above) is a term denoting the rapidity with 
which one beat follows another. 

4. Sluggish or Tardy pulse— Expressive of the languid, extended nature 
of the beats. 

5. Hard pulse— Expressive of the sensation of firmness and positive- 
ness which it conveys to the touch. 

6. Soft pulse— Expressive of the smooth flow (so to speak) of the blood 
beneath the pressure of the fingers'. 

7. Strong pulse— Is the name of a pulse, which seems to bound beneath 
the touch and repel compression. 

8. Feeble pulse— That which yields to compression, apparently defi- 
cient of vigor to force its way in spite of pressure. 

9. Large pulse— Expressive of the dilation and expansion of the artery 
as evinced to the touch. 

10. Small pulse— Expressive of the apparent retraction of the artery, 
and the minute channel through which the blood passes, as evinced to the 
touch. 

11. Full pulse— A denomination applied to a pulsation which seems 
thoroughly to fill the artery at each beat; whereas, the large pulse is only 
understood of a dilating current, without conveying the idea of solidity, as 
of a well-filled vessel. 

12. Empty pulse— When the beats do not seem to convey a very dis- 
tinct elevation to the artery, and which appears as a combination of the 
characteristics of the soft and small pulse. 

13. Unequal pulse — That which, without being suspended, does not 
beat at regular intervals of time, or in which the quality of the current 
(as hard, soft, feeble, full, etc.,) differs with different beats. 

14. Intermittent pulse — Or that which is characterized by the occa- 
sional suspension of beats. 

INDICATIONS ATTRIBUTABLE TO THESE VARIETIES, SEPARATELY 
AND JOINTLY. 

1. A very important distinction to be determined, namely: whether 
the disease is characterized or engendered by excess or deficiency of vital 
power; that is, by over-luxuriance, or poorness of blood, is to be evinced 
by the strong, hard (incompressible,) pulse, on the one hand, and by the soft 
feeble (compressible,) pulse, on the other hand; the first being indicative of 
excess, and the second of deficiency of strength. 

2. Another distinction, in determining the nature of the disease, con- 
sists in the explicit indications afforded by an unequal or changeable pulse, 



38 LESSONS FROM THE PULSE. 

which, in acute cases, identifies the malady as nervous, not inflammatory ; 
and, in chronic cases, as irrespective of the circulation, and associated with 
the nervous system only. Thus, we should be most cautious not to mistake 
cutting, stitching, pricking, or shooting pains, in the chest, or violent fixed 
pains, (even with violent throbbing,) or pains in the chest, (as just 
described,) with suffocative oppression of breath, accompanied with such 
a state of pulse, for inflammation; for the pulse would distinctly identify 
a purely spasmodic or neuralgic suffering. 

3. A healthy pulse, or a pulse of a purely nervous character, as just 
described, attending affections of the chest, and especially of the air-pas- 
sages, is precisely, in some cases, the unmistakable index of Asthma, in 
contra-distinction to Consumptive affections, which are always character- 
ized by & feverish, feeble, irritative, accelerated pulse. 

4. The accelerated ptdse, if unqualified by any other feature, exhibits 
irritation, or fever, (properly so called,) or increased susceptibility to irrita- 
tion, which may result from mechanical causes, tending to lessen the 
action of the heart; (as tight lacing, etc.;) or from cold in particular, which 
lias caused an irregular retrocession, or congestion of blood; or, again, from 
an increase in the richness, or quantity of the blood, which destroys the 
equilibrium between the motive action and the current of blood. Increas- 
ing acceleration is indicative of increasing inflammatory action; subsiding 
rapidity is indicative of the removal of the irritation, and analogously of 
its cause. If the frequency of the pulse continues or returns after a crisis, 
(resulting in perspiration, sleep, etc.,) we may judge that the effort of 
nature was incomplete, and that, therefore, a continued effort remains. 
Frequency of pulse may be associated with the over-strong or very feeble 
state of the circulation, and will be more continuous and difficult to 
subdue when qualified by feebleness, than by strength; it will, also, in 
many cases, be more excessive. Thus, in cases in which the pulse is very 
frequent, (as, for instance, 120 to 180, or even 200 beats to the minute,) it is 
also small, and then points out the lowest state of debility, or what is called 
a putrid condition. This is, indeed, an imperfect pulse, and sometimes 
proceeds to a mere thrill or vibration, when it is totally indistinct. An 
analogous sensation may, however, be conveyed in very severe cases of 
"inflammation of the substance of the lungs, 7 ' as an inflammatory pulse; 
but then the artery will be dilated and full, if a long breath be drawn and 
held; whereas, the pulse of debility is qualified by a small, retracted artery. 
Again, if the pulse be accelerated, and also strong, or full, and hard, we 
may distinguish a decidedly inflammatory condition— inflammatory fever. 

5. The small pulse, unqualified by any other condition, is indicative, 
either of weakness or of spasmodic condition, which may be easily deter- 
mined by the accompanying or antecedent circumstances, and by the 
following distinctions :— 

If associated with hardness (small and hard,) it is especially indicative 
of a convulsive state. 

If associated with softness (small and soft,) it is especially characteris- 
ticVf debility. 

Further, we may study the following distinctions, either singly or in 
association : — 

The slow pulse (if not habitual — some adult subjects, especially males, 
having habitually a pulse varying from thirty to fifty beats in the minute, 



INVESTIGATION OF DISEASE. 39 

without disease,) is indicative of insufficient quantity of blood — as after 
severe depletion— of advancing age, of the subsidence of fever, (which 
frequently leaves a reactionary pulse below the standard of health,) or of 
pressure on the brain, as in cases of congestion, water in the head, etc. 
Associated with the following variety, especially after concussion of the 
brain, etc., it is of a serious character. 

The sluggish or tardy pulse particularly distinguishes a torpid condition 
and a low typhoid character assumed by the disease, and pressure on the 
brain, when it is of more serious import than the slow pulse, and of still 
more serious consequence when associated with the last. 

The hard pulse (simply) indicates especially inflammation, (as in fever, 
etc.,) or a convulsive condition, when qualified by evidences resulting from 
the investigation of the nervous symptoms distinguishing this condition. 
In old age, again, the hard pulse (especially if large,) is of very frequent 
occurrence, or caused by the drying, contraction, or even ossification of the 
arteries, which convey this sensation to the touch, owing to a decrease of 
suppleness or elasticity. 

The softpidse (simply) proves the absence, both of inflammation and 
convulsive condition. 

The strong pulse, which indicates superfluity of blood, a full habit. 

The feeble pulse, indicating deficiency of blood, an attenuated habit. 

The large pulse, (simply) indicates an unimpeded elasticity of action, 
and is the truest index of the absence of cramp, irritation, or excessive 
irritability; it is the distinctive feature, especially after acute inflamma- 
tions, of a vigorous operation of the heart, and proves that there is an 
ample sufficiency of blood in active circulation, (consequently no local or 
organic determination;) the large pidse (when unqualified by other features,) 
is, therefore, to be considered as a proof of the effectual resolution of an 
irritative effort, (such as fever,) when it sets in at the crisis. 

The large pulse may, however, be associated with fullness (only) when 
it points out the insufficient liquefaction of blood (or thickness) in which 
case it is easily compressed, as often occurs in typhoid fevers, (with debil- 
ity,) and when it is a spurious fullness; or, again, the large pulse may by 
associated with fullness and hardness, when it clearly indicates irritation 
of a peculiar kind. 

The full pulse distinguishes a plethoric or full condition of habit of 
body. 

The empty pulse offers indications analogous to the"6-ma/Z and soft" 
(as above stated.) 

The unequal or changeable pulse generally characterizes a universal 
nervous condition, and is one of the distinctive features of nervous 
fevers, or of fevers resulting from or accompanying deficient vital energy. 
It also indicates spasm at the heart, or even deeper and organic derange- 
ment of the heart, or deficiency of elasticity or energy in the action of the 
heart; and it may, also, in cases of inflammation of the substance of the 
lungs, be held to indicate such a state of congestive, or other obstruction, 
as impedes the progress of the current through those organs, when, conse- 
quently, it is a most serious symptom. 

The intermittent pulse. In this, we may, especially, distinguish a spas- 
modic condition of the heart, (sometimes organic disease,) particularly 
sympathetic as resulting from intestinal affections, such as congestive 



40 CONDITION OF THE BLOOD. 

determination of blood, or such as excessive relaxation of the bowels or 
predisposition to relaxation. 



THE CONDITION OF THE BLOOD. 

By this division of investigation, it must not be suspected that the 
inspection of blood abstracted b\ venesection is indicated, for the use of 
the lancet is the great and grievous error which has been effectually super- 
seded. The artificial abstraction of blood is, therefore, as an all but inva- 
riable rule, out of the question. But it will often occur, when the condi- 
tion of the blood affords very distinctive indications of the nature of the 
disease, or of the system generally, that spontaneous or casual discharges 
take place, which we may have an opportunity of investigating. We 
should, principally, notice. a tendency to coagulate very quickly, or too 
firmly, or in too great a relative proportion to the fluid residue; or, on the 
other hand, an excessive predominance of the fluid proportion or absence 
of coagulation. 

1. Coagulation, which is too rapid, firm, or too great in proportion to 
the fluid residue, especially if further qualified by the superficial floating 
of very little of the watery humor, (which is one of its constituents,) that, 
again, being coated over the surface with a very firm, white skim, is posi- 
tively indicative of inflammation, tendency of the disease to develop 
inflammation, or predisposition of the patient (if in health) to attacks of 
inflammatory disease. Coagulation, in general aspect, as just stated, but 
which throws up a superficial skim, of detached, unconnected, woolly, or 
yellowish, or, sometimes, greenish appearance, distinguishes an irritation 
of nervous rather than of a specifically inflammatory character. 

2. Insufficiency of the watery constituent, that is, when all, or almost 
all, of the blood is dark and thick, indicates a highly bilious habit of the 
body. 

3. Superabundance of the watery humor, as a constituent of the blood, 
that is, when the tendency to coagulate is slow, and affects only a small 
portion, (and that, often, of a paler color than is usual,) and when the 
greater part resolves itself into a watery superfluid, indicates a deficiency 
of power to appropriate and distribute the nourishing portion of the food 
for the sustenance and uses of the system ; and (if of menstrual blood) a 
■constitutional disposition to debilitating disorders, such as "green sickness." 

4. Absence of healthy coagulation, the Mood being dark, but remain- 
ing entirely commingled in all its component parts, not separating the 
watery humor, and remaining in a thick, inadhesive condition, (not jelly- 
like,) indicates what is termed a putrid condition, or that stage of dissolu- 
tion in which the vital energy sinks from deficiency of power to expel 
what is mischievous (as in putrid typhus); and, in general, a scorbutic 
habit of body, which involves a predisposition in every disease to assume 
& putrescent character. 

5. A dark, yet clear, red blood, indicates strength, and a sufficiency of 
reactionary power. 

6. Black, or very dark purple blood — which is associated with such 
diseases as result in predominance of venous over arterial blood, and 
which may indicate organic defect of the structure of the heart, particu- 
larly if the complexion have a bluish or purplish hue; and which may, 



INVESTIGATION OF DISEASE- 41 

also, indicate a highly bilious complication of intestinal derangement in 
scorbutic subjects (particularly,) more especially if the blood be muddy, 
thick, and black. 

7. Pale blood, from superabundance of watery fluid, also, character- 
ized by excessive liquidity, indicates constitutional weakness in the pre- 
dominance of the watery humor, as a constituent. 

Pale blood (from light redness of the coagulating portion) indicates a 
pernicious constitutional habit, such as the constitution heretofore des- 
cribed as "Rheumatic." 

8. The watery humor (as a constituent of the blood) thoroughly and 
distinctly separated from the coagulating portion, which is deposited in a 
firm jelly (and without any of the unhealthy manifestations described 
under 1) above, may be assumed, as an index of a healthy process of circu- 
lation. 

9. The watery humor (as a constituent of the blood) appearing whit- 
ish, and thick, indicates deficiency of constitutional vigor, especially ia the 
distribution of nutriment. 

]0. The watery humor (as a constituent of the blood) appearing of a 
distinctly yellowish hue, indicates an admixture of bile with the blood. 

SPONTANEOUS DISCHARGES OF BLOOD GENERALLY. 

If the discharge be from the nose, in cases of inflammation of the 
brain, severe determination of the blood to the brain, or of inflammatory 
fever of any kind, the symptom is to be considered as a wholesome 
crisis. 

In general, discharges of blood may appear as the crisis of a disease, 
particularly of severe fever; but they may occur as the result of local deter- 
minations of blood, or inflammations, of over-due fullness and distension 
of the vessels, of precipitation of blood upon a weak part, (or, generally, of 
comparative deficiency of firmness and strength in such part, as when a 
blood-vessel is broken ;) or again (as a most critical symptom) of a putrid 
condition. 



THE URINE, ITS VARIETIES AND THEIR INDICATIONS. 

From the consideration of the blood and its appearances, we cannot 
transfer our attention more appropriately than to the like variations in 
the urine, as the discharge, the processes attending the secretion of which 
are most intimately connected with the blood. 

THE HEALTHY APPEARANCE OF THE URINE. 

Unaffected by any of the subjoined or other particular circumstances 
of age, sex, method of living, active, or sedentary, particular articles of 
food or drink, the season of the year, and as a most important exceptional 
condition, the constitution of the patient — the urine should be of a paie, 
bright yellow, or straw-color, remaining clear after standing, precipitat- 
ing no sediment, and of the peculiar ammoniacal smell, but devoid of all 
loathsome odor. 

Exception 1. However, in old age, it is consistent with health that 
the urine should be offensive, lessened in quantity, and deepened in 
color. 



42 APPEARANCE, ETC., OF THE URINE. 

Exception 2. Amongst females a degree of sediment is not always an 
unhealthy sign, and the urine is habitually of a paler hue. 

Exception 3. With respect to the habits of life, it may be expected 
that a person leading a very active life, with especial predominance of 
physical exertion, should emit darker and more scanty urine than the 
stated standard— and. that in an individual of very sedentary habits, it 
should be characterized by more copious, but paler discharge. 

Exception 4. As to eating and drinking, it may be stated as an excep- 
tion to the general rule above, that certain vegetables, (especially those of 
a diuretic nature,) such as asparagus, will usually cause the discharge to be 
offensive; other substances will give it a bright, gold yellow; excess of 
stimulating liquor will render the discharge pale and copious, etc. ; whereas, 
also, within about six hours after eating, it will commonly be cloudy. 

Exception 5. The increase of constitutional vigor, or perhaps more 
directly, the greater enjoyment of open-air exercise, which the summer 
affords, tends to render the urine darker and more scanty, whereas, in win- 
ter, (that is, under contrary circumstances,) it is usually less highly colored 
and more abundant. 

THE PROPER TIME AND METHOD OF INVESTIGATION. 

The urine should not be examined, or, at least, no reliance should be 
placed upon its manifestations, within less than six hours after a meal; 
and such of the urine as is reserved for investigation, should then be set 
aside in a place where the temperature is even and moderate, for at least 
two hours, not being at all exposed to sudden transitions of temperature 
in the interval, after which we may examine whether any of the subjoined 
evidences be present. 

THE VARIATIONS APPARENT IN THE URINE, AND THEIR INDICATIONS. 

1. With respect to the progress of fevers, the urine affords the most 
valuable characteristics, varying with each stage, as the result of the febrile 
course is developed; as, for instance: 

Before the fever has taken any turn towards issue, that is, so long as 
it continues to rage without any tendency to a crisis, the urine, of what- 
ever color, is emitted (and remains after standing) perfectly transparent 
and clear; or, in other cases, (especially nervous fevers, and fevers in 
which the digestive functions are predominantly implicated,) the urine 
will be emitted (and will continue the same, and without deposit after 
standing,) thick and cloudy. 

2. As the crisis of any fever having critical days, approaches, the 
urine, which was previously clear, will become thick, and will form a small 
half-floating cloud, or sometimes a similar cloud completely buoyant, or 
which, should it sink for a time, will rise again to the surface. In other 
cases the cloud will sink to the bottom. If the cloud should float, the 
patient will die, even though they may not appear very sick. If the cloud 
sinks for a time and then comes again to the surface, or, if it remains half- 
floating, there will be about an even chance between recovery and death. 
If, on the other hand, the cloud sinks to the bottom of the vessel, the 
patient will recover, no matter how sick they may apparently be. 

3. The actual determination or crisis of the fever is distinguishable 
by the precipitation of a sediment (simply,)— in cases in which the urine 
had previously been clear— and by the like precipitation of a sediment, 



INVESTIGATION OF DISEASE. 43 

and the complete clearness and transparency (as if filtered) of the over- 
floating fluid, in cases in which the urine had previously been muddy and 
thick. 

But for this precipitation of a sediment to constitute a wholesome indi- 
cation, it should, also, be smooth, undisturbed, light— assuming an appar- 
rent, slight, rounded, elevation towards the center— white, or of a slightly 
gray color. It should not constitute more than one-fifth or one-fourth (at 
the most) of the whole volume discharged, and it should be deposited 
quickly after the emission. For, otherwise, it is a bad sign; as for in- 
stance: 

If black, or very dark, it indicates a putrid condition. 

If of the color of bile, or red, it characterizes an intermittent type of 
disease, or sometimes a rheumatic tendency. 

If white and gritty, or deposited from dark, turbid urine, there is 
depraved habit of body, or perhaps some concreting substance in the urin- 
ary canal. 

Or, generally, if disturbed, irregular, of a purple hue, muddy, heavy, 
and constituting from one-half to two-thirds of the whole volume dis- 
charged, it is a bad sign. 

In General: 

If the urine be red when the pulse is accelerated, there is a decisive, 
and positive indication whereby to distinguish constitutional fever, inflam- 
matory action, and increased development of internal heat — from a similar 
condition of pulse, which might otherwise characterize a purely spasmodic 
affection. 

If of a deep saffron color, it represents the admixture of bile in the 
blood, and if this hue be conveyed to white, absorbent surfaces, mois- 
tened with it, it decisively indicates jaundice. 

If it be thick and black, here is an indication of such a degree of 
inflammatory or putrid condition, as resolves itself into gangrene. 

If bloody, turbid, thick, and depositing an excessive proportion of sedi- 
ment, we have an evidence of approaching decomposition of the blood. 

If, other things being equal, it be characterized by the floating of an 
apparently oily substance on its surface, we have an evidence of what may 
be termed advanced constitutional decay. 

If matter be mingled with it, there must be internal suppuration. 

If the urine (of children) appear, as it were, milky, we have reason to 
suspect the presence of worms in the intestines. 

If it be thick, but pale, or still more, if it be very changeable in appear- 
ance, during the course of a fever, we have reason to look upon the disease 
as of a nervous kind. 

If it be clear, transparent, and watery, and there be continual urging 
to discharge it, the nature of the affection is distinctly spasmodic. 

If it be bloody, there is probably a degree of inflammation about the 
bladder or kidneys. 

If slimy, we look for a discharge of the character of phlegm from 
the bladder, or obstruction of the neck of the bladder by some concreting 
substance. 

Or, again, as regards the manner or sensations which characterize the 
discharge : 



44 VARIETIES OF BREATHLNG. 

If the discharge be involuntary, the affection is of a paralytic char- 
acter; but it should, also, be noticed that in such cases of fever as evince 
this symptom, it is sometimes very difficult to ascertain whether it is 
really involuntary (in the true sense of the term). If really so, it is a 
serious manifestation. 

If, on the other hand, the discharge be either difficult, painful, or 
impeded, it variously represents disease of a locally inflammatory, or spas- 
modic nature. 

It should be noticed that sudden check of perspiration will often 
occasion an exceedingly copious and watery discharge of urine. 

Excessive relaxation of the bowels, the previous use of drastic purga- 
tives, or profuse sweating, will frequently cause a darker and more scanty 
discharge. 

Chemical and Microscopic Distinctions, and the distinctive fea- 
tures of other varieties of the urine, have been intentionally omitted, as 
calculated to lead unprofessional persons into erroneous experiments. 



BREATHING; ITS VARIETIES AND THEIR INDICATIONS. 

In many diseases, especially those whose seat is in the respiratory 
apparatus, the manner of breathing, the pains, etc., developed by the act 
of breathing, the sound emitted by the inward and outward passage of the 
breath, etc., are the only signs upon which we can rely for a thorough and 
distinctive appreciation of the nature of the affection, with the reservation, 
however, that the relations between the pulse and respiration are never to 
be overlooked. In all diseases, especially in those of an inflammatory or 
putrid character, there is much important insight into the direction, etc., 
of the malady, acquired by a careful consideration of the operation of this 
vital function. 

THE BREATH IN HEALTH. 

The frequency, and even the manner of breathing, in individual cases, 
is best determined by the habitual conditions of both. But, as there should 
be about four pulsations to every act of respiration, it may be expected 
that, in health, supposing the medium standard of the adult pulse to be 
80 beats in the minute, there would be 20 inspirations and 20 respirations 
in the same time ; and in the like proportion. 

The breathing would also be easy, slow in repetition, and in inhaling and 
exhaling equal and full. It is not, however, to be inferred that the relative 
equality of proportion between the beating of the pulse and the expansion 
of the lungs, is, in itself, a sign of health although it may be assumed there- 
from that the blood is not deteriorated in quality, on the one hand, and 
that the operation of the lungs is not organically affected, on the other 
hand. 

THE VARIATIONS TO WHICH BREATHING IS SUBJECT, AND THEIR 
INDICATIONS. 

Frequent breathing— by which is understood a rapid and continuous suc- 
cession of inspirations and respirations— is an evidence either of acceler- 
ated circulation, or fever, and consequently of organic inflammatory 
affections of any kind, involving constitutional disturbance ; and also of 



INVESTIGATION OF DISEASE. 45 

insufficient (elasticity) strength of the lungs. Frequency of breathing, 
when associated with inadequate expansion, is an evidence of some 
obstruction which oppresses the operation of the lungs; as, for instance, 
created by congested blood (as in inflammation of the lungs,) by the pres- 
ence of water in the cavity of the chest, (or even, in severe cases, in the 
cavity of the belly,) by inflation with wind, (the oppression being communi- 
cated by the contiguity of the lungs to the inflated parts of the stomach,) 
or by the alteration of the substance of the lungs. 

This variety is opposed to the habitual degree of slowness, in the 
breathing of health. 

Sloio (unfrequent) breathing, when less frequent than in health, and 
further qualified, by deep breathing, at remote intervals, as if in a convul- 
sive effort, is frequently associated with spasmodic affections, swooning, 
etc., and is an evidence of want of strength. 

Quick breathing — a term by which is understood that the zw-spiration 
is incomplete, and is quickly succeeded by the re-spiration— is occasioned 
by the presence of some oppression or obstruction, which renders the 
expansion of the chest so painful as to hurry the operation of decreasing 
the pressure, by expelling the air; it is almost invariably the result of any 
severe inflammatory affection of the intestines, or apparatus of respira- 
tion, and commonly occasions a more sudden and spasmodic effort to 
expel the air, as manifested in cough. It is opposed to the healthy tar- 
diness of respiration; that is, to the deep, slow , protracted inspiration and 
respiration, with power to hold tte breath (full) for a length of time. 

Tardiness — may, however, be excessive, as resulting from weakness. 

The deep or long breath — when even, protracted — as to the inhaling, 
and exhaling— noiseless, and evidently without effort, is one of the charac- 
teristic features of healthy respiration ; but, w T hen deep, long breath, is evi- 
dently the result of a severe effort, somewhat difficult, irregular, sonorous 
and, sometimes, abrupt, it becomes an evidence of spasmodic affection — 
especially involving the anterior (front) portion of the cavity of the chest 
and abdomen, or, sometimes, of great fullness of the vessels about those 
regions ; or, again, (as if there be a long pause between the explosion of 
one draught, and the re-inspiration of another,) of a condition of stupor 
and delirium. 

The small or short breath (simply) — may be considered an evidence 
either of weakness, or of spasm. We have already noticed this variety, as 
associated with frequency. 

Difficult breathing —implies several distinct varieties, either of which 
may, appropriately, bear this name. In any degree, difficulty of breathing 
may be associated with coldness of the extremities, (especially the feet,) 
confusion and heat of the head, an empty, small and remittent pulse, 
owing to the obstructed and dilatory progress of the blood through the 
lungs. If rare, difficult breathing may be attributed to some accidental, or 
even mechanical, cause of oppression. As a symptom of disease, it would 
arise from the presence of any obstructing matter, (blood or water, etc.,) 
impeding the action of the lungs and air passages; or, as a symptom, unat- 
tended with any evidence of inflammation, it would be occasioned by spas- 
modic affection of the respiratory apparatus. 



46 VARIETIES OF BREATHING. 

Moaning or sighing breath is a variety of difficult breathing, and seems 
rather to identify the enveloping membranes of the lungs as the seat of 
the affection. 

Oppressed breath (simply) may arise either from impeded digestion, 
from particular conditions of atmosphere, or from affections of the air- 
passages. 

Panting breath rather identifies obstructions (such as thickening of the 
lining membrane,) in the windpipe and air-tubes. 

Suffocative breatli— that is, when the breath is totally arrested by re- 
cumbency — may result from extravasation (pouring out) of blood on the 
lungs, etc., from the accumulation of water, from alteration of the sub- 
stance of the lungs, or from what is termed paralysis of those organs; in 
any case it is a most urgent symptom. In all respects, it is opposed to the 
easy breathing, or to the habitual degree of ease in breathing, which char- 
acterizes the healthy state of the patient. 

Warm breath (simply)— indicates a degree of fever; if very hot, particu- 
larly if the extremities be cold, it is a positive index of general, internal 
inflammatory action, or more particularly of inflammation of the substance 
of the lungs, or of some of the adjacent intestinal parts. 

Cold breath — indicates a deficiency of vigor (superfluity of watery 
humor,) in the blood, and, consequently, sluggish, languid circulation. It 
may result, however, from obstruction which prevents the effectual pas- 
sage of the blood through the lungs. As a symptom appearing with the 
sudden suspension of pain, and with general dullness of sensation in severe 
organic inflammation, it indicates internal mortification; in any case, as 
attendant upon the last stage of a very critical disease, it is a fatal sign. 

Unequal breath — an expression which conveys its meaning — may, in 
very severe cases, result from obstructions impeding the inhalation or 
exhalation of the air, (chiefly in the windpipe and air-tubes,) or it may be 
occasioned by purely casual circumstances; as, for instance, spasmodic 
affection of the nerves connected with the respiratory apparatus. It is 
opposed to the equal breathing of health. 

Noisy respiration— ov that which is attended with unnatural sounds, — 
is subject to several modifications; as, for instance, whistling breath, 
which, in the majority of cases, indicates the result of spasm, or of accu- 
mulation of phlegm, etc., in the windpipe. Rattling breath, which may 
result from the presence of matter, blood, or phlegm, partly obstructing 
the air-tubes ; or, as a fatal sign, it is the result of paralysis of the lungs. 

Flapping breath, or that which is accompanied with an occasional sound 
as of the sharp flapping to and fro of a dry valve, indicates the presence 
of very adhesive matter, or phlegm, in delicate cells connected with the air- 
passages. 

Crackling or crepitating breath, which, as associated with inflamma- 
tion of the lungs, would be qualified by the other distinctive symptoms of 
that disease, may (particularly in aged persons) indicate deficiency of 
moisture in the lining membrane of the air-passages. 

Oppressed breathing, or oppression of the chest, will be treated of under 
the head of anxiety, (see "Pain,'' etc). 

Offensive or fetid breath— a symptom which requires no further des- 
cription, but which must be considered in due relation to other circum- 
stances—as, for instance, going too long without food, will engender it. 



INVESTIGATION OF DISEASE. 47 

The menstrual periods are sometimes attended with it. Excessive use of 
mercury, under any treatment, is another ascertainable cause. A scorbutic 
habit of body (or that in which every affection has a disposition to resolve 
itself into a greater or less degree of putresence,) is unmistakably discernible 
from this symptom, when continual and habitual. Excess of animal food 
may occasion it. Decay of the teeth, and inattention to the proper cleans- 
ing of the mouth and teeth, will almost inevitably induce it. In typhus 
it characterizes the putrid degeneracy of the disease. In affections of the 
chest it usually characterizes suppurative processes in the lungs, etc. As 
a general rule, especially in the absence of any particular conditions, such 
as have been stated — foulness of the stomach, or the presence of worms, or 
other impure substances in the intestines, may be distinguishable by 
offensive breath. 



THE DIGESTIVE FUNCTIONS, AND THE INDICATIONS 
WHICH THEY AFFORD. 

The digestive functions, as is well known, afford some of the most 
palpable indications of derangement; and as the nutritive or tributary pro- 
cess is entirely centered in this portion of the system, one very important 
deduction is dependent upon its condition; namely, the sufficient or 
insufficient degree in which the subsistence of the whole constitution is 
provided for by the processes acting upon the food, and, in the habitual 
state of the digestive process. 

Persons of habitually strong digestive powers are more likely to resist 
the injurious effects of external circumstances; such as heat, cold, infection, 
sorrow, etc., etc.; but once attacked with disease (especially inflam- 
mation,) they are prone to be very seriously affected. At the same time 
disease will be more likely to run a rapid course with such subjects, and 
to terminate promptly, than to degenerate into chronic disease. 

If the digestive process be habitually weak, we have a general indica- 
tion of precisely contrary conditions. 

THE EVACUATIONS AND THEIR INDICATIONS. 

Costiveness.— Suspended or deficient evacuations may be the effect of 
inflammatory tendency ; or of muscular debility; or of inaction of the lower 
intestines; or, again, of deficient or altered discharge of bile from the liver 
into the intestines; or of general debility of the system, and poverty of 
blood. Suspended evacuations may, however, be occasioned by mechan- 
ical obstruction of the bowels, as the lodgment of improper substances, 
etc.; whereas, deficiency of discharge may result from excessive dis- 
charges or transpirations of another kind. 

Very dark evacuations may be either associated with costiveness or 
relaxation, and in both instances they usually, when not induced by the 
nature of the food, evince an excess of bile. 

Hard evacuations are of various kinds: — as hard and large; hard and 
small (detached) ; hard and knotty, etc.; in general they exhibit a deficient 
degree of natural irritability in the lining membranes, more or less excess 
of internal heat, and deficiency of moisture. 

Relaxation, as understood, not only of less consistent, but of 
more copious evacuations, is also subject to variations in the frequency, 



48 DIGESTIVE FUNCTIONS. 

color, odor, etc., of the motion. In general, it may result from inflamma- 
tory or nervous irritability of the intestinal canal; or from the presence 
of obnoxious, irritating substances, impurities, etc.,— such as undigested 
food, worms, — therein; or from suppression of other discharges; or emo- 
tions; or, again, from a debilitated condition of the bowels, or of the entire 
system. 

If the discharge be green (of an infant), acidity is commonly exhib- 
ited; if dark, predominance of bile; if pale, deficiency of bile. 

Spontaneous discharge should be distinguished from involuntary dis- 
charge, the former being of little importance, and being a common result 
of unconsciousness (when relaxation is present) and occurring, also, 
owing to the excremental matter being completely liquefied. 

Involuntary evacuations, properly so called, and attendant upon the 
last stage of severe fevers, especially fevers of a typhoid character, are 
indicative of paralysis, and are to be looked upon with great apprehension. 

Diminished evacuations are not necessarily opposed to the lessened 
consistency, and may occur either with highly consistent or very liquid 
motions; in the latter case, however, they generally exhibit an imperfect 
expulsion of the matter to be evacuated, and, in such instances, of the 
presence of some irritative substances in the canal. If unqualified by any 
other manifestation (such as hardness, or those already stated) and espe- 
cially, if there be a constriction of the passage, the decreased quantity of 
the evacuation may be attributed to spasm. 

Straining to evacuate, is sometimes of spasmodic character, especially 
if the motion be only partial, very scanty, or totally suppressed. But 
without spasm, or especially nervous character, such straining may result 
from a greater or less degree of inflammation and its sequels, or from the 
peculiar susceptibility of the canal to irritations. 

Of painful evacuation we shall have occasion to speak under the head 
of " Pains." 

FLATULENCY— WIND IN THE STOMACH AND INTESTINES— AND ITS 

INDICATIONS. 

The generation of wind, either in the stomach or in the bowels, arises 
from the production of the elements, in the form of gases of the normal 
phlegm which is secreted from the blood. If habitual and excessive, it 
is clearly indicative of weakness or derangement (of nervous action or 
tone) in the stomach, if the wind be expelled upwards,— or in the bowels, if 
the intestines become inflated, or the wind be expelled downwards. 

Flatulent distention of the belly, occurring in children, often identifies 
an additional morbid state, characterized by the presence of worms in the 
intestinal canal. 

Flatulent, drum-like distention of the belly during the course of 
fever, betrays want of vigor which may occasion serious results. If, at 
the same time, the belly thus distended be very tender, and severe pain be 
caused by pressure, a tendency to local inflammation in clearly exhibited. 

NAUSEA AND VOMITING, AND THEIR INDICATIONS. 

1. These symptoms especially point out either original, local, or sym- 
pathetic affections of the stomach or upper portion of the digestive 
apparatus, as opposed to the bowels or intestinal canal, which constitute 
the second division of this portion of the system. If, therefore, these symp- 



50 APPETITE AND THIRST. 

peculiar heat of the hands follow a meal when we may have reason to 
apprehend a hectic or consumptive disposition. In some cases, however, 
in which excess of appetite occurs (unaccompanied with these qualifying 
conditions) especially in young persons, it may be attributed to worms 
alone — to over-rapid growth — to violent exercise and excessive perspira- 
tion (sweat,) or to any other cause which would tend to absorb or to con- 
sume the substance and nutriment of the body. 

Absence of appetite may more particularly be attributed: 

1. To organic derangement of the stomach, or simply to weakness of 
the first process of digestion. 

2. And more frequently, to overloading the stomach, or the pressure 
of injurious and indigestible substances, even in moderate or small quan- 
tities. 

3. To fever of any kind, otherwise determinable by the pulse, etc., 
except, indeed, to hectic or rheumatic fever, neither of which necessarily 
subdue the appetite. 

4. To nervous, hysterical, and hypochondriacal conditions — or to 
nervous derangement resulting from emotions, as from excessive grief, 
alarm, etc.; or to the like, resulting (without fever) from undue physical 
exertion (a rare case) when the nerves of the stomach are implicated; or 
frequently from undue mental labor or anxiety. 

Natural appetite, that is, appetite neither increased nor decreased, 
may occur, associated with hectic or rheumatic fever; when, however, it 
is generally qualified by other circumstances — in both cases, it is more 
likely to be irregular or excessive. 

Excess of appetite, as a symptom of disease, is an evidence of poorness 
of blood, frequently attended with the secretion of an acrid, irritating 
phlegm ; but, without such conditions, it may result from purely nervous 
and sympathetic irritability — as during pregnancy, or in diseases of a 
purely hysterical character — or, again, from some habitual cause of irri- 
tation, such as worms. In hectic or consumptive complaints, it indicates 
the insufficient distribution of nutriment by the tributary apparatus, that 
is, a want of proper action in the digestive function to appropriate the 
nutritive constituents of the food. Excess of appetite will, also, often 
appear associated with habitual vomiting, or continued relaxation of the 
bowels, owing to the deficient distribution of nourishment. 

THIRST AND ITS INDICATIONS. 

In the majority of cases, continued thirst indicates fever or inflam- 
mation ; but, inasmuch as it will result from any dryness of the mouth 
and throat, and from lack of moisture in the stomach (without disease,) 
we must be careful to distinguish the thirst of health. 

The thirst of health may be the consequence of any condition calcu- 
lated to absorb the moisture of the mouth, throat, gullet, and stomach— 
such as: — severe physical exertion, greatly elevated temperature, particu- 
larly in a dry state of the atmosphere, or even when the temperature is 
much depressed by the deficiency of moisture in the air, particularly if 
strong exercise be taken during the prevalence of such atmospheric con- 
ditions,— or, again, eating salt food, or eating solid food, especially heating 
food (chiefly animal) in excess, or continuing too long without food (with- 



INVESTIGATION OF DISEASE. 51 

out necessary abatement of appetite) after the return of hunger, whereby 
the saliva has been exhausted. 

When, however, there is no apparent cause for the thirst, especially if 
accompanied with increased heat, or dryness of the skin, etc., and if, upon 
investigation of other symptoms, farther indications should warrant the 
conclusion, we may infer that the thirst arises from internal heat, and is, 
consequently a symptom of fever. If, in such a case, the thirst be intense 
and insatiable (the pulse being full, hard and frequent,) the character of 
the fever is distinctly indicated — it is inflammatory ; that is, there is a 
deficiency of the watery constituent in the blood. 

Thirst may, however, arise purely from acidity; when it will be char- 
acterized by risings, and acrid sensations in the gullet, etc. 

It may, also, be associated with spasm ; when, however, it will be 
characterized by deficiency, not by excess of heat. 



THE TOXGUE AND ITS INDICATIONS. 

The tongue affords many of the most important indications associated 
with derangement of the digestive functions. 

Tongue thickly furred, dirty white, or brownish white, without either 
unusual dryness, enlargement, or redness, indicates that the derangement 
involves rather the lining membranes than the nerves of the stomach, and 
that not to a serious extent. The derangement is then identified as com- 
paratively recent, and easily cured. 

Tongue furred with slimy matter, and with vivid red tip and mar- 
gins, indicates also an affection of the lining membrane of the stomach, 
but one of a more serious and continuous character. 

Yellow tongue, also qualified by one or more of the last-stated condi- 
tions, indicates the liver as implicated. 

Clean tongue, of bright redness, naturally moist, but with the papilla? 
unnaturally prominent, indicates that the derangement affects the nerves 
of the stomach, and is of recent date. 

Dry, red, glazed tongue represents a similar affection to the last, but 
more severe, and of longer standing. 

Swollen, red tongue, but slightly charged with white fur, represents 
such a degree of nervous derangement of the digestive organs as to react 
congestively upon the brain, and implicate that organ. 

Cracked, furrowed, fissured, swollen tongue, conveys to our apprehen- 
sion the most severe degree of derangement of the nerves of the stomach. 

Swollen tongue, thinly coated white, but bright red at the tip and mar- 
gins, indicates a complication of both varieties of indigestion— viz., that 
of the lining membranes, and that of the nerves of the stomach, which is 
of old standing, and of an obstinate character. We may look for irregular 
operation of the brain, as associated with this symptom, as well as 
extreme despondency, nervous irritability, and depression of spirits and 
activity. 

Tongue indented on either side is a modification of the swollen tongue, 
already mentioned as associated with derangement of the nerves of the 
stomach, and consists of a very severe degree of tumefaction (transient 
swelling). 



52 SENSATIONS OF THE NERVES, ETC. 

Tremulous tongue, or tongue trembling when protruded, is often 
noticed amongst habitual drunkards, and distinctly indicates a complex 
variety of the nervous form of indigestion, implicating the spinal 
marrow. 

Blackish, dry , furred and tremulous tongue, is a symptom in abdomi- 
nal or putrid typhus. 



THE NERVES, BRAIN, SENSATIONS ANJD SENSES. 

This section includes the consideration of suspension, or acuteness of 
sensation, perception, consciousness, volition, motion, rest, etc. 

LOSS OF CONSCIOUSNESS, DELIRIUM, FAINTING, ETC., AND THEIR INDI- 
CATIONS. 

Loss of consciousness may be of three kinds, (as we shall have occa- 
sion to consider it.) two of which are primarily referable to the brain, 
and one to the heart, namely : Apoplexy, (considered as a symptom,) 
which consists in total suspension of the activity of the brain, and conse- 
quently, also, of nervous irritability and vitality; delirium, which con- 
sists in disturbance or irregularity in the activity of the brain ; and 
fainting, which consists of temporary suspension of the activity of the 
heart, but which, also, involves the like prostration of general nervous 
activity. 

Apoplexy, which is distinguishable by unaltered strength, or by 
increased strength of pulsation, accompanying total suspension or motion, 
or motive power, (which does not always return with consciousness.) 
indicates an organic affection of the substance of the brain more or less 
critical. 

Delirium, which is distinguishable by loss of consciousness, or more 
properly, perhaps, of connected ideas, (generally of the nature of sleep, 
without rest,) with or without frantic movements, but always with 
increased or diminished activity of the brain of an irregular nature, 
affords various indications, according to the particular conditions and 
circumstances which precede, accompany, or follow it ; or to the particu- 
lar disposition of the patient, which may serve to qualify it. 

1. When it becomes continuous, and is divested of any other symp- 
tom of derangement, and the functions of the system continue in regular 
operation, it ceases to be a symptom, assumes the individual character of 
an independent disease, and would seem to indicate a greater or less alter- 
ation of the substance of the brain. 

2. When there is a continual predisposition to the return of attacks 
of delirium, without a permanent and continual duration, qualified, 
moreover, by other symptoms of hysterical or hypochondriacal suscepti- 
bility, it is of comparatively little importance as a symptom of diseases 
which exhibit that character (hysterical, etc.) 

3. Persons of a habit of body and temperament, characterized by a 
peculiar activity, susceptibility, and excitement (easily provoked or 
aggravated) of the brain, so invariably exhibit this symptom with the 
least acceleration of circulation, and are so prone to become wholly 
abstracted by the continued activity of the brain, that we should weigh 



54 INVESTIGATION OF DISEASE. 

well the accompanying indications, which further characterize disease, 
before attaching much importance to delirium alone, in patients of such 
a descripton. 

4. If, however, there be active delirium — that is, raving, occasioned 
by suddenly increased flow of blood to the brain, with or without frantic 
action, with considerable derangement of the system, as shown by other 
symptoms, especially if this symptom occur in persons who are not sub- 
ject to a manifestation of the kind, we should first consider— whether 
there be continuous and active fever, in which case we have an indica- 
tion of the most inflammatory disposition of disease, and it remains to 
be considered whether the brain itself, or its membranes, be the primary 
seat of inflammation— or whether there has, previously, been some skin 
disease which has suddenly disappeared, or whether there are such symp- 
toms as forebode an eruption ; or whether, again, there have been evi- 
dences of inflammation, developed in some other organ, which suddenly 
subsided or disappeared. Or, if no such manifestations be present, we 
may consider the delirium as resulting from a sympathetic affection of 
the brain, of which the primary cause is seated in some other part, — such 
as the stomach or the bowels, or both, arising from the presence of irrita- 
tive matters, (as, for instance, worms, bile, etc.;) or, again,— if any such 
cause can be identified — the influence of narcotic and poisonous drugs. 

5. There is, also, another kind of delirium which appears as a very 
important symptom, especially associated with any cause of pressure on 
the brain, generally the immediate or remote result of accident, or of— 

Inflammation: — Immediate, when it appears as an attendant symp- 
tom of the actual disease, — in which case, it distinctly indicates the pres- 
ence of blood disengaged, and accumulating in the substance of the brain, 
or suffusion of extravasated blood in the enveloping membrane; remote, 
when acute organic inflammation is not present, in which case, it identi- 
fies the presence of water. 

This is what is termed drowsy delirium. It is identified by a defi- 
ciency of activity of the nerves and brain, the absence, even, (in many 
cases,) of any motion of the body, a species of dull, inanimate sleep, total 
helplessness, and complete silence, or, at most, a low, internal murmur ; 
and it is characterized by prostration of nervous action. 

Drowsy delirium, may, also, appear in nervous and typhoid fevers, 
as an indication of general debility. 

In any case, it may be considered as a more critical symptom than 
active delirium. 

Fainting — swooning — should, also, be considered with due regard to 
the disposition of the patient, and to the circumstances which qualify it. 

1. If \t he habitual, especially as the termination of violent attacks 
of palpitation of the heart, which, generally, if not invariably, lead to 
this issue, there is reason to apprehend organic derangement of the heart. 

2. If, on the other hand, it" should occur casually, after violent emo- 
tion— as joy, fear, grief, etc., or after severe loss of blood, etc., or as the 
result of casual, but very excruciating pain, or as the consequence of an 
accidental injury of no great moment, it is not to be looked upon as a 
very important symptom. 



V J? 



<l" . 



o" r 



^iritaaU 



rApp ro ha- X _ \ Sublimity. V fe^ 

kveness. / V ,-ee* 



i A* 



Contint 



Inhabi- 
tiveneis. 



[Parental 



j^etfe 36 * \ -Aequj6itf ve _\ %. 



Friend- 
ship. 



Combative- ( -o^ 



Conju?alstv. > 



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34 
Vitality- 



Alimeiitiven 



\BibaV ^ K\S #£,»■ 



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c 




The location and description of the organs as fixed by phrenologists. 



(55 



56 MOTION OR MUSCULAR ACTION, REST. 

3. If, again, it be the habitual result of mere nervous excitement, in 
persons of a highly susceptible hysterical, or hypochondriacal dispo- 
sition, — in which case, it is merely spasmodic, — it is not of great 
moment. 

4. If, however, one or more fainting fits should usher in an attack 
of fever, we have a positive indication of the subsequent nervous type 
of the disease. 



MOTION, OR MUSCULAR ACTION, REST— AND THEIR 
INDICATIONS. 

Although not in accordance with technical classification, we shall 
include under this head of 1 ' motion and rest," every circumstance, inter- 
nal as well as external, in which the motary power is called into play, or 
subdued. Wherefore, it must be premised, that motion and rest are 
either healthy and natural, or symptomatic of derangement, and, conse- 
quetly, unnatural. 

And. first, with respect to motion : — it is clear that to be healthy and 
natural, it must be subject to the will, and the consciousness ; that is, 
that until the resolution to effect a certain movement (as of the arm or 
leg) instinctively calls the proper muscle into play, that muscle should 
remain inactive (but not incapable of action.) It is, also, clear that it should 
not exceed the limit prescribed by the will, (except in so far as the phys- 
ical impulse prevents an abrupt arrest— as, for instance, if running at 
great speed, the runner should be unable to stop himself suddenly, when 
at the top of his speed upon the sudden intervention of circumstances re- 
quiring it. It is, further, evidently clear that even if the will, excited 
by sensations, (which are painful,) does prompt motion — such as change 
of position — such motion is not to be considered as a healthy movement 
properly so called. An example of this occurs in any restlessness caused 
by suffering. With respect to motion, which occurs when nature, in 
health, would have prescribed rest — as in the case of restlessness at 
night, — this is, evidently, a case in which the motion is not subject to the 
will, and, therefore, unhealthy and unnatural; because sleep is totally 
independent of volition. The active and motary condition of health, as 
the general rule for an adult male, should not continue {in spite of the 
will) more than from sixteen to eighteen hours out of the twenty-four. 
In the earliest days of infancy, it should occur during little more than the 
time required for feeding. Young persons, under twelve or fourteen 
years of age, should have a natural tendency to activity during about 
fourteen to sixteen hours out of the twenty-four. 

Secondly, with respect to rest: — If understood purely in the sense of 
muscular inactivity, during the active and conscious operation of the 
will, it is also clear, that in order to be truly denominated as healthy and 
natural, it must, likewise, be subject to the will, which has the power of 
determining its duration, and of prescribing its recommencement at any 
moment. Even if prompted or disturbed by the sensations, the will is 
yet, to a certain extent, the mediating power. As sleep is not purely a 
degree of muscular inactivity (which it does not even necessarily induce,) 
it is totally exceptional. But, even here, if the will be retained in proper 



INVESTIGATION OF DISEASE. 57 

ascendency, by being habitually exerted, it is well known that it his the 
power of determining the duration of sleep; for many persons can wake 
precisely at a given moment, after many hours' sleep, merely by having 
previously resolved to wake at such a moment. It is even admissible, that 
the will has an initiating power in inducing sleep, because sleep would 
not, in many cases, occur without a resolution to permit it; and, if it occurs 
in spite of the will, it is exceptional, because it must either be an 
unhealthy symptom in itself, or the absence of it must have been an excess 
of exertion, forced upon nature by the will-. That sleep can be induced 
even with a disposition to rest — by a mere resolution of the will — has been 
asserted, but is far more problematical. If, however, it does not occur 
when the will composes the body for it, it is again exceptional, and the 
absence of it is a symptom of derangement (not healthy). It can not, 
nevertheless, be denied that the will cannot coerce it; and if the will, 
which is refinement of nervous power, combat the irritation and irritability 
w r hich repels sleep, it becomes a mere combat between one portion of the 
nervous S3 7 stem and another, (resulting, perhaps, in fever,) both become 
more and more irritated, and each repels the other more violently. Thus, 
the very thought that one cannot sleep, and the wish to do so, makes one 
more restless. 

The sleep of persons, of all ages, should be calm, neither interrupted, 
nor of too long duration, undisturbed, evincing a placid countenance and 
no evidence of pain, uneasiness, or fantastic dreams and visions. The only 
motion which does not identify irregularity during sleep, is the occasional 
turn from side to side. The more noiseless the breathing, the more per- 
fectly healthy the sleep. The skin during sleep should be warm, but 
neither very hot, dry, nor excessively moist. 

Restlessness, therefore— that is doubly, the inability to rest, in spite 
of the will, and the muscular motion prompted by the will (under such 
conditions,) may be considered as an unhealthy and unnatural condition of 
activity or motion (either internal or external). As a symptom of fever, 
it identifies an excessive susceptibility or irregularity, and irritative 
activity of sensation. It is a symptom rather of an inflammatory than of 
a debilitated state. 

Contraction of tlie extremities towards the belly, identifies pain in those 
parts (chiefly colicky pains). 

Continual starting up in bed, indicates great oppression and anxiety, 
or simply delirium. 

Continual sinking down towards the foot of the bed, denotes great 
prostration of vital energy. 

Throwing off the clothes — when the patient Lavs himself bare, denotes 
excessive oppression and anxiety, or simply active delirium, which may, 
likewise, be identified by evident inability on the part of the patient, to 
bear the bed clothes upon the body, or when they seem to oppress him like 
heavy weights. 

Grasping at imaginary objects, may be considered as one of the most 
severe indications of utter failure of vital energy, if not of approaching 
dissolution. 



58 POSITION, SLEEP, SPASMS 

Position of the Patient— a question which is distinctly dependent 
upon the questions of motion and rest, and which evinces some very- 
important manifestations— as, for instance : 

1. Severe suffering, provoked by lying on one side, which constitutes 
inability to lie on that side, generally denotes internal derangement of 
organs, whose seat is in the opposite side. 

2. Immovable retention of one position, identifies either excessive 
weakness or stupor, according to the associated symptoms, and the previ- 
ous duration or nature of the disease. 

3. Repeated change of position— in some measure distinct from what has 
been more generally described as restlessness— if occurring on what are 
termed the "critical days" (as the seventh or fourteenth,) or anticipated 
periods of determinative issue in fevers, which run a regular course, 
(especially eruptive fevers,) may be assumed to indicate the approach of 
the crisis; or, if occurring early, in, or during the course of a fever, which 
has not been accompanied by an eruption, we may infer the necessity for 
such a development ; or, again, if unattended with the general indications 
of a forthcoming eruption, or unconnected with any period of crisis, and 
characterized either by determination of blood to important organs, or by 
deficiency or suspension of natural discharges or evacuations, this symp- 
tom may variously indicate the lodgment of oppressive matters in the 
stomach, or simply internal pain, or anxiety. 

4. The favorable indications connected with the position, consist of 
such a position as is least inconsistent with that usually assumed by the 
patient when in health, and ability of the patient equally to lie on one side 
or the other, or upon the back, which is decisive in determining the 
absence of disease of the organs of the chest (if the breath is not impeded 
or oppressed, when the head is bent backwards,) or of the intestines. 

Sleep, when unhealthy, is distinguishable by any circumstance con- 
trary to those above stated, or opposed to the habitual condition of the 
patient (in health). 

1. Or, again, when it is characterized by delirium, under the head of 
which the particular indications afforded by this symptom will be found. 

2. When it is impossible to rouse the patient, in which case fever 
being present, it is identified as of a typhoid character, or we may other- 
wise infer that there is an inflammation of the brain. This is especially 
an ill omen when it is manifested at the commencement of the fever. 

3. When the sleep is disturbed by the least noise, but relapses imme- 
diately. 

4. When it is interrupted by muscular twitches, convulsive move- 
ments, and repeated starting, or when there is grinding of the teeth dur- 
ing sleep, all of which occur associated with a high degree cf hysterical 
excitement in females, when they are not serious evidences of disease, but 
which may occur in consequence of sympathetic irritation, resulting from 
oppression or irritation of the stomach. 

Spasms and Convulsions should, according to our purpose, be classi- 
fied under the head of motion. Indeed they constitute muscular motion, 
both internal and external; but in order justly to discriminate their 



INVESTIGATION OF DISEASE. 59 

symptomatic importance, we must have clue regard to the general cir- 
cumstances, age, sex, disposition, etc., which may qualify them, for: 

1. As occurring in females of a highly susceptible or hysterical dis- 
position, or in children, they are usually provoked by such trivial causes 
(often unattended with such constitutional disturbance,) that they are 
commonly not to be considered as of great moment, and may generally be 
traced to some source of irritation of the bowels. 

2. If, however, they occur in consequence of wounds, by which 
important tendons have been seriously injured, spasms may be considered 
as highly momentous, and may result in lock-jaw, or, at all events, in 
permanent rigidity of the parts injured, or of other parts. 

3. If again, they should occur (in persons of mature years, and of 
robust habit,) as resulting from severe loss of blood, etc., they are of por- 
tentous import. In this case they are the result of exhaustion of vital 
enesgy. 

4. If, again, they appear as the effect produced by determination of 
blood to the brain, or to the spinal marrow, or are derived from the pres- 
ence of obnoxious matters or foreign bodies, they are not to be neglected. 
In the first of these cases, they are caused by super-abundance of blood, 
etc., in the second by nervous irritation. 

5. If they occur at the point of issue in typhus fever, they may 
either be critical, (terminating in convalescence,) or fatal (when the vital 
energy sinks in this last effort). 

6. If they appear associated with contagion, or the irregular develop- 
ment of eruptions or efflorescences, (as with purple rash, smallpox, etc.,) 
they are attributable to nervous irritation. 

7. They may be attributed to the presence of worms in the intestines, 
or to any other obnoxious or irritating matter, either in the stomach or 
intestines, in which case, also, they are directly occasioned by nervous 
irritation. 

8. Convulsions resulting from the pressure of extraneous matter 
(such as water) on the brain, or otherwise traceable to irritation of the 
brain primarily, may result in the highest degree of which they are sus- 
ceptible, namely epilepsy. 

Spasms, particularly if caused by tendinous injuries, may terminate 
in the highest degree of which they are susceptible, namely, permanent 
rigidity, (such as lock-jaw or the contraction of any limb, or part of a 
limb). 

10. Spasms which affect the muscles of any limb, are commonly called 
"Cramp." The distinctive feature of a spasm is gathered therefrom, 
namely, an uninterrupted muscular contraction. 

11. Convulsions consist in the alternate contraction and relaxation of 
one or more muscles. 

12. Spasms and Convulsions, internally, include such affections as 
vomiting, already separately considered, (when they affect the stomach;) 
Colic, exemplified under the head of "Pain,'' (when they affect the 
bowels,) Palpitation, considered under the head of "Pulse,'' when they 
affect the heart;) Cough, separately considered hereafter, and also under 
the head of " Breath,'' (when they affect the chest;) Retention of urine, 



60 PARALYSIS, HICCUP, TREMBLING. 

considered under the bead of "Urine," (when they affect the bladder ;) 
Hiccup or Hiccough, separately considered, (when they affect the dia- 
phragm or midriff). 

Paralysis, which may be confined to muscular power, or which may 
extend to the superior faculties of the brain, and to all power of sensation 
and perception, must be considered with due regard to every circumstance 
connected with it, in order to form a just idea of its indications. In any 
case, the brain must be considered as the seat whence this symptom, 
either directly or indirectly, springs. But it may either appear as the 
result of some external oppression, or from internal and organic affection 
of the brain and spinal marrow. 

1. If it be purely occasioned by external causes, or by causes which 
are external as regards the organic substance, as, for instance, if the 
oppression arise from congestion of an enveloping membrane, it will be 
easily distinguishable by being transitory, and consequently the more 
simply remediable. In the majority of such cases the paralysis will be 
local, leaving the superior faculties, and all other physical parts of the 
organism, unaffected. Very severe cases hold as an exception. 

2. If it be the result of internal affection of the organic substance, as 
of disengaged accumulation of blood in the substance of the brain, it will 
be continuous, and will almost invariably impair, if not destroy, the 
memory, and permanently detract from the powers of perception and 
sensation. 

Hiccup or Hiccough, an internal development of muscular action, 
must, also, be considered with due regard to the conditions and circum- 
stances of age, and of the symptoms with which it is associated. Simply 
described it is a convulsion affecting the midriff or diaphragm. 

1. If it occurs in children, and can be associated with cold, or with 
distension of the stomach, (that is, flatulency,) it is casual and of little 
moment. 

2 If, however, it should be associated with nervous fever, it indi- 
cates a malignant type. 

3. If associated with inflammatory fever, it identifies, to a certain 
degree, the tendency to inflammation of the bowels. 

Trembling is a symptom which is of various import, according to 
the circumstances and conditions under which it appears, and according 
to the disposition of the patient. 

1. For, if the patient be of a highly nervous susceptibility, and it 
cannot be traced to any of the other causes metioned, it may be attribu- 
ted to a degree of nervous excitement or irritation, which may result 
from emotions of any kind— abuse of stimulants, whether medicinally 
administered (under foolish treatment) or not, or to excess of physical 
exertion, but more frequently of mental labor. 

2. If the antecedent circumstances be characterized by loss of blood, 
or any animal fluid, it may, unquestionably, be attributed to debility, as, 
also, if it attend every attempt at exertion after severe acute disease. 

3. If it be distinctly manifested, as unconnected with other direct 
causes, at the outset of a fever, here is an unquestionable premonition 
of the subsequent neryous character of the disease. 



INVESTIGATION OF DISEASE. 61 

4. If it should appear in a person of a full habit of body, or other- 
wise, with evident distention of the bowels, and unconnected with any- 
other apparent cause, it may, with propriety, be attributed to superabun- 
dance of blood in the vessels. 



THE SENSATIONS, AND THEIR INDICATIONS. 

The sensations need not necessarily be painful to afford a distinctive 
symptomatic indication, although it be true that, as an index of disease, 
every particular or characteristic sensation is generally painful, or, at all 
events, disagreeable. The most distinct sensation, as a symptom of dis- 
ease, however, is pain, or the painful operation of a function — or absence 
of pain when there is disease which should cause pain ; but we may also 
divide these sensations into two further distinctive subdivisions, namely, 
sensations of discomfort or uneasiness, and sensations of anxiety. 

PAIN, DISCOMFORT, AND ANXIETY, AND THEIR INDICATIONS. 

Pain, as a distinguishing symptom, in whatever part or organ it may 
have its seat, is to be divided into (1) that which continues uninterrupt- 
edly, which, if persistently in the same part or parts, and continues to 
become aggravated, (until resolution takes place,) and which is further 
qualified by being aggravated by the touch, and still more by severe pres- 
sure, and temporarily by the application of heat, is the general distinctive 
indication of inflammation of the part, or parts, whence the pain orig- 
inates: (2) Pain which is chiefly developed in a particular course, or 
direction, (the course or direction of a nerve,) or which is changeable, as 
to the part in which it occurs, but which, in either case, is generally 
characterized by aggravation from apparent contact, or slight touch, and 
relieved, or not aggravated, by severe pressure, identifies pain of a nerv- 
ous character : and, (3), Pain which comes and goes in the same part, or 
parts, partakes of a contractive, or cramp-like character, is relieved by 
pressure, or warmth, or friction, is often intermittent, and always irregu- 
lar, and which is rarely continuous, and never persistently continuing to 
become aggravated, identifies pain of a spasmodic character, that is, 
spasm of the part, or parts, affected. 

1. Pain in the chest, or painful breathing, may be the result of an 
overloaded stomach and impeded digestion, or may be occasioned either 
by a rheumatic, (2) a spasmodic, or an inflammatory affection ; or by occa- 
sional determination of blood to the part of the enveloping membrane of 
the lungs. 

If it communicate a sensation of being bruised, or of a stiffness, as if 
the muscles could not bear the expansion of the chest, (3), if the pain is 
of a shifting character, or if touching and pressing the chest causes pain, 
it may be identified as of a rheumatic character. 

If it be casual stitching, as, for instance, suddenly interrupting the 
respiration, without returning regularly, or being regularly provoked by 
a similar effort in breathing, it may be considered as of a neuralgic 
character. 

If there be persistent stitching pain whenever a certain degree of expan- 
sion takes place, with a dull, heavy pain, (without progressive aggrava- 



62 SENSATIONS AND THEIR INDICATIONS. 

tion) in the intervals between such expansion, we may identify determin- 
ation of blood to the enveloping of membranes of the lungs. 

If, again, there be a continual acute pain, growing progressively 
worse and worse, and further qualified by a general and severe degree of 
fever, which has been preceded by chills, and is associated with more or 
less prostration of strength, inflammation of the membranes in question 
is clearly established. 

2. Pain in the bowels, or painful evacuation, is either of (1) a nerv- 
ous character, when it will be fugitive, returning when the attention of 
the patient is directed to it, fugitive and aggravated by apparent contact 
or by slight touch, and relieved by severe pressure ; or, (2), spasmodic, (a 
modification of the nervous,) but relieved by contact and pressure of 
every kind, by lying on the belly, and by drawing the legs up, and oth- 
erwise contracting the body, may, by continuance, become inflam- 
matory; or, (3) inflammatory, when it will be readily distinguished by 
persistency, accurate locality, progressive aggravation, and by excessive 
tenderness of touch, and still more of pressure. 

Colic, properly so called, is, strictly speaking, a spasmodic pain, but 
by long continuance may become inflammatory. 

3. Painful discharge of urine may appear as the symptom, either of 
inflammation or irritability of the passage, or of the bladder, or neck of 
the bladder, distinguishable by the locality of the pain and nature of the 
discharge; for (1) if the pain arise from inflammation of the bladder, or 
neck of the bladder, it will be associated with fever and hard pulse, and 
the pain most severely felt at the bottom of the belly and the discharge 
will, usually, be either mingled with blood, or blood will predominate 
over the urine, or the discharge of urine will be followed by that of pure 
blood, with excruciating, twinging pain ; (2) if the pain be occasioned by 
inflammation, irritation, or irritability of the passage, it will be qualified 
by a scalding sensation, (when urinating.) towards the terminal part of 
the passage, with or without discharge of matter ; (3) if the pain be 
dependent upon inflammation, irritation, or irritability of the kidneys, 
the water evacuated will be hot, and the seat of pain will be chiefly in the 
loins and small of the back ; or, (4), if the pain be occasioned by spasm of 
the bladder, or neck of the bladder, there will be continual urging to 
pass water, but total inability to effect it ; that is suspension of urine, 
with cutting, cramp-like, agonizing pain in the part, relieved, however, 
by pressure; that is, by doubling the body forward, and pressing the 
hands firmly upon the lower part of the belly. 

4. Absence or sudden suspension of pain, in severe cases of organic 
inflammation, is, in all instances, a most ominous manifestation, but it 
may indicate two distinct conditions, namely: (1) the sudden transition 
of the inflammation to another organ, (in most cases to the brain,) when 
it requires the utmost care, but is, nevertheless, not so alarming as when 
such reappearance of the disease in another quarter does not quickly 
follow; for, in this case, the change, in the majority of cases, has been 
one from inflammation to mortification, (and consequent loss of sensa- 
tion). 

5. Intermittent pain, which is also either periodical or irregular, or 
that which is very severe for a certain period, often accompanied 



INVESTIGATION OF DISEASE. 63 

by local heat or general flushes of heat, sometimes by the palpitation of 
the heart, and frequently by a degree of irritative fever during its contin- 
uance, and terminating with local or general sweat, (and that only,) and 
by an acute degree of nervous susceptibility and irritability, often aggra- 
vated by heat, or by slight contact, (the patient having, however, an 
inclination to press severely upon the part,) but which totally subsides 
during regular or irregular intervals, and which is of a nervous char- 
acter. 

6. Remittent pain, or that which becomes modified from time to time 
for certain intervals, especially at certain periods of the day, or under 
particular conditions of heat, cold, access or exclusion of air, or owing to 
palliative measures, but which never totally subsides during the intervals, 
but continues dull, heavy, and persistent, instead of being highly acute, 
pulsating, or shooting, and which is further qualified by severe feverish 
symptoms during the acute stages, which, however, also become modified, 
though never wholly subdued, during the intervals of comparative relief. 
This description of pain is generally associated with organic inflamma- 
tions, or with obstructive causes of irritation, with a strong tendency to 
organic inflammation, and identifies a tendency to chronic or continued 
inflammatory action in such parts or organs. 

7. Inflammatory pain, in its genuine distinctive character, is very 
plainly distinguishable from pain of any other nature, as for instance: 

It is always accompanied with increased heat of the particular part 
affected, (if purely local,) and then even in some cases, especially, if it be of 
long continuance, by general increased heat of the body, or alternate heat 
and chills, frequent and hard pulse, and other signs of fever. 

And if it be internal, and affecting one or more of the important 
organs, the adjacent parts, as also the whole body, (except the lower 
extremities,) will manifest greatly increased heat, and the general symp- 
toms of fever will run high, the thirst being generally considerable, and 
often intense and insatiable, (in highly inflammatory subjects). 

It will be continuous, proceeding from bad to worse, until the crisis 
or other issue. 

It will be relieved by moisture of the skin, and general or even local 
perspiration. 

It will be greatly aggravated by pressure, or even by the least touch, 
as of the clothes or bedclothes, but still more so by severe pressure, which 
is usually insupportable. 

If local, there will be redness and often swelling of the parts ; if affect- 
ing the outer membranes, particularly of the intestines, again, redness 
will often be discernible externally. 

There will be sometimes more or less strong development of the adja- 
cent vessels, which will be observed to be swollen and dark, their course 
being palpable, where, in general, they are externally imperceptible. 

There will be often more or less throbbing or pulsation in the part 
with the pain, especially in the after or suppurative stage, (although this 
symptom may also accompany nervous pain). 

If local, it will usually be much aggravated immediately by warm 
applications, such as fomentations, but will afterwards decrease, and will 
be generally relieved at first by cold applications, but in such cases the 



64 SENSATIONS AND THEIR INDICATIONS. 

pain will often return more severely, as soon as the cold application is 
removed. 

Whether local or affecting internal and important organs, it will be 
aggravated by stimulants, motion, exertion, mental or nervous excite- 
ment, fatigue, etc., and will have a tendency to grow worse towards 
night. 

If natural discharges have occasion to pass over the inflamed surfaces, 
as, for instance, of the bladder or bowels, the pain will usually become 
excruciating. 

If internal, the natural discharges will be qualified by the evacuation 
of blood, and either by being very liquid (of the excrements,) or very 
dry; in any case (of all discharges) they will be deficient in quantity, 
occur frequently, and there will be continued urging to discharge. 

The external surface, whether attending local or internal inflamma- 
tory pain, will invariably be dry until the crisis, when the pain will 
subside, with the development of moisture. 

The pain will, inseperably, prevent or disturb proper rest, (sleep; a 
condition which only applies to inflammatory pain, because pains, either 
of a nervous or spasmodic character, may be overcome by sleep, which 
frequently occurs in spite of them, especially the latter). Consequently 
extreme and inseperable restlessness, with such indications as above 
stated, identifies pain as inflammatory. 

The most perfect crisis, or resolution of inflammatory pains of any 
kind, consists in gentle, undisturbed, and placid sleep, with proper mois- 
ture of the skin. 

8. Nervous pains are of a fugitive, irregular or periodical, pulsating, 
dragging, darting character, with or without local heat during the entire 
continuance of local suffering, but then often attended with local sweat, 
(simultaneously— which never occurs of inflammatory pain,) flushes of 
heat without fever, or with temporary irritative fever, (in modified degree,) 
restlessness, depression of spirits, hysterical disposition, or fantastic ideas; 
aggravated by thinking of them, and relieved when the attention is dis- 
tracted by objects of interest, or aggravated by apparent contact, or slight 
touch, and relieved by pressure, unattended with any variations of appe- 
tite or thirst; characterized by the occurrence of involuntary motions, as 
by jerking, or the sensation of twittering (vibrating) in particular parts, 
in the latter case, frequently without external perceptibility of such 
action— by extreme restlessness and uneasiness, with or without a degree 
of irritative fever, (and often with an extremely low pulse,) by intermittency 
or periodicity, by being usually dispelled during motion, or absorbing occu- 
pation, and by a peculiarly intractable persistency, continuing to recur, in 
spite of every resource, (when they cannot be traced to a precise point or 
cause,) without, however, affecting the general health, or detracting from 
the vigor of the functions. 

9. Spas?nodic pains are of a cramp-like, contractive, and very severe 
cutting character, but they are usually of brief duration, though they may 
be of frequent recurrence. In their distinctive and peculiar qualifications 
they are totally unassociated with heat, or any other inflammatory symp-r 
torn, and are, rather, except in highly excitable subjects, habitually 
attended with depressed than over-active circulation ; but by long continu- 



INVESTIGATION OF DISEASE. 65 

ance they will frequently engender a reactionary inflammation, and assume 
all the characteristic features of inflammatory pain, sometimes becoming, 
in such cases, very severe and intractable. As affecting important organs, 
they may first accelerate, then temporarily suspend the circulation and 
breath. In their distinctive character they are relieved by stimulants, 
heat, contraction of the parts, or of the whole body (doubling up,) pressure 
and especially friction. In their excess they render expansion of the 
parts impossible. They are either local, affecting particular motary mus- 
cles, or they are internal, affecting the muscles which are connected with 
or constitute important organs. A constant and severe degree of spas- 
modic pain, affecting important organs (as, for instance, the heart or 
stomach,) is indicative of organic derangement. A casual spasmodic pain, 
however severe, is attributable chiefly to the accidental presence of irrita- 
tive matters, especially in the stomach or bowels. 

10. Pain in the back of the head usually denotes determination of 
blood to the head. 

11. Pressing pain in the forehead, accompanied with giddiness, com- 
monly implies the presence of irritative or impure substances in the 
stomach ; or, in some cases, excessive weakness : — that is, if it occur after 
a severe attack of illness, confinement to the bed, or more especially loss 
of blood, or other animal fluids. 

12. Pains particularly and persistently, occurring in the back or loins, 
may (in females,) be associated with pregnancy, or, if at due time, with 
the monthly return; but, in such cases, as in the more general definition, it 
may be held to intimate the presence of, or a tendency to piles. 

13. Pain in the front part of the stomach or bowels, occasioned by pressure, 
(although there be no actual or positive pain without pressure,) when 
occurring as associated with fever, or at the onset of fever, and further 
qualified by heat of the parts, and retching, (if of the stomach,) or straining 
(if of the bowels,)— denotes respectively inflammation of such part or 
organ as thereby typifies the fever. 

14. Stitching, or prickling pain, may denote a spasm, but more- fre- 
quently determination of blond to a part, or inflammation, especially of 
the enveloping membrane of an organic part. 

If it be occasioned by spasm— as of the stomach— it will be casivaT^ 
generally severe, sometimes even to the degree of suspending the breath, 
but passing off without return, or with a similarly casual re-turn,, in the 
majority of cases, upon the dislodgment of wind, especially belching;, 
pressure and friction will relieve it. 

If it be the result of determination of blood, such as when it occurs 
on the right or left side, (about the liver or spleen,) provoked by rapid mo- 
tion, immediately after eating, or the like conditions — or when it occurs 
without such immediate causes, and continues to be perceptible upon 
drawing a deep breath for some time without striking constitu- 
tional derangement — pressure does not always aggravate it, unless severe- 
motion does : relaxation of the parts, as by bending the body forward, 
relieves. 

If it be the decisive symptom of inflammation^ asdn, pleurisy, we may 
thereby distinguish inflammation of the pleura, (the membrane which 
covers the lungs, etc, and lines the cavity of the chest,) from inflammation 
5 



66 SENSATIONS AND THEIR INDICATIONS. 

of the substance of the lungs, especially, if there be little, if any pain, 
until the parts are expanded, as by drawing breath deeply; and its inflam- 
matory character will be distinguishable in the general derangement and 
high degree of fever, which accompanies it, with local and general 
increase of heat, (except sometimes of the extremities,) dryness of the 
skin, thirst, etc. 

Sensations of discomfort, such as the following: 

1. Restlessness has been already mentioned under the head of Motion. 

2. Giddiness, (simply) except in the cases mentioned as important, is a 
symptom of no great moment, but it often serves to determine the indi- 
viduality of disease. 

It may identify a nervous condition, generally speaking, occasioned by 
an irritation of the stomach, when we may identify the cause as an over- 
loaded stomach, with a tendency to expel the irritating substances, upward. 

In many cases, particularly as occurring in persons of a full habit of 
body, it denotes congestion of blood to the head. 

3. In persons of advanced age, or of apoplectic tendency, it may be 
looked upon as one of the unpropitious indications of imminent apoplexy. 

Sensations of heat and cold are of two kinds — those (1) with which 
there is actual heat or coldness, and those (2) which merely convey these 
sensations, the, part affected with such feeling being neither hotter nor colder 
(necessarily,) in a degree which should occasion such feeling. These are 
subject to many modifying conditions— of which we shall briefly notice the 
most important— and are generally to be held as of very great importance 
in the investigation of disease. 

Actual increase of heat, if unqualified by any particular local deter- 
mination, or by particular and local pains, denotes (1) increased activity 
•of circulation, that is, fever (simply,) more or less inflammatory, as the 
degree of heat is greater or less ; (2) local inflammation, whether of par- 
ticular parts, if purely local, or attended with general inflammatory 
action throughout the system, if the heat be general, and simply charac- 
terized by local determination and other particular identifying symptoms. 
This heat, as regards a particular spot, may or may not be externally 
apparent to another person, it is sufficient that it is internally felt by the 
patient; (3) a determination of blood to particular parts or organs, with- 
out active inflammation, when the heat, whether internal or external, is 
confined to the spot, part, or organ affected, and to those which are con- 
tiguous; (4) when inflammatory and general heat is present, it is identi- 
fied by the simultaneous frequency, hardness and strength of the pulse, 
which increases with the increase of heat t and by its conveying no unpleas- 
ant sensation on contact to a healthy person; and further, by the part of 
the healthy body thus brought into contact with it becoming so accus- 
tomed to it, after a short duration of contact, as to lose the distinct sensa- 
tion of greater heat in the sick body; or (5) in the last stage of putrid 
fever, or as an indication that fever has assumed a portentous putrid 
character, it may signify incipient decomposition, in which case, however, 
it will increase as the pulse becomes more and more feeble, it Avill convey a 
most disagreeable sensation of a burning, stinging character to the part 
of a healthy body on contact, becoming more and more disagreeable the 



INVESTIGATION OF DISEASE. 67 

longer the contact continues, and leaving the same unpleasant sensations 
for Sv>me time after the contact has ceased; this is a chemical, not an 
animal heat. 

Heat iu the front portions of the stomach, bowel3 and chest, and 
especially, if conveying a burning sensation intern illy, to the patient, 
accompanying a high degree of fever, shows a general inflammatory con- 
dition of the tributary organs of life. 

// at of the hin l>, after eating, denotes a disposition in the disease to 
become habitual, or if there be no distinct disease, a predisposition to 
hectic complaints. 

Fugitive heat is particularly associated with a nervous condition ; it is, 
therefore, more common among females, (at certain periods especially,) 
but it may occur in either sex, associated with nervous debility, irritabil- 
ity, or susceptibility. 

Coldness of the extremities, associated with a severe degree of fever, 
denotes a high degree of inflammation in one or more of the important 
organs of life, such as may impeds the thorough distribution of the blood 
throughout the system. Therefore, it is one of the distinctive features of 
inflammation of the lungs. But it may, also, denote deficient circulation 
or deficient strength of the blood, as associated with other symptoms of 
an enfeebled condition, and.assuch, itidentifiesclepression of vital energy. 
Or, again, it may be the result of spasm, either of particular parts or of a 
superior organ, (as of the heart in particular,) if associated with other 
spasmodic symptoms. 

Numbness or deadness of particular parts may (1) be indicative of 
latent and insidious gout, and if from other symptoms there be such 
further analogy as to identify this condition, it may be of much conse- 
quence; or (2) it maybe purely nervous, and then quite superficial, in 
which case it will generally be palliated by cold applications; or (3) it 
may be occasioned by temporary arrest of circulation in the parts, in 
which case there will be no contraction or rigidity, and hot applications, 
friction, or rapid motion will palliate or remove it; or (4) it may be the 
result of spasm, in which case there will generally be contraction and 
rigidity, and heat or friction will likewise relieve, but motion will be, 
commonly, arrested. 

Itching, (without the presence of any eruption,) especially if preceded 
by chill, and accompanied by heat (as associated with fever,) usually 
announces the approach of a critical sweat; or, if unattended with fever, 
commonly denotes an acrid condition of the humors. 

Chill (or the sensation of coldness without actual coldness,) is a 
purely nervous indication of irregularity. It may consist of a spasm of 
the skin. The conditions which precede, accompany, and follow it, 
must indispensably be considered, in order to form a correct judgment of 
the various important indications which it affords, and which qualify 
every fever; as for instance: 

1. Acute feveus are characterized by the single and unrepeated 
occurrence of the chill. Intermittent fevers by the more or less fre- 
quent repetition of this symptom, according as the repetition of the fever 
fits return. 

2. If the fever be of an intermittent character, and the chill be 
slight, with great predominance of heat, there is reason to anticipate that 



68 SENSATIONS AND THEIR INDICATIONS. 

the disease will run into a distinctly acute character ; but if the chill be 
severe, of long duration, and very predominant, the occurrence of heat 
being imperfectly developed, the disease exhibits a tendency to become 
sluggish and of long duration, and to assume a chronic form. 

3. Chill, which is very severe, and precedes the heat, may first be 
generally designated as identifying either violent, acute, or even inflam- 
matory fever, or, on the other hand, intermittent fever. 

4. Chill, which is imperfect, or comparatively feebly developed, and 
which alternates with heat, (that is, is successively preceding and suc- 
ceeding it,) usually identifies fever, of a nervous character, or of a rheu- 
matic, or catarrhal description. 

5. Chill (rigor, coldness attended with shivering,) . which occurs 
during the course of an acute fever, possesses many important significa- 
tions; as, for instance: If there be inflammation of any particular and 
important organ, especially of the lungs, we may anticipate suppuration 
or the still more urgent result of mortification, which will be further 
identified by subsidence of pain; or, in cases, particularly, in which 
no decided and local inflammation has existed, or in which the general 
symptoms are favorable, the approach of the crisis is identified, namely, 
the thorough development of an eruption, or, more frequently, the occur- 
rence of copious perspiration, followed by general abatement of the dis- 
ease ; or, when inflammation of one particular organ has existed, and 
any abrupt arrest has taken place, such as the irregular suppression of a 
discharge, we may anticipate a transition to other organs ; if no inflam- 
mation of any particular organ has existed, and there be evident suscep- 
tibility of any particular part, or evident tendency to determination of 
blood to such part, or obstruction to the operation of its functions, we 
may anticipate inflammation of such part; or, if none of these circum- 
stances be so combined as to warrant deductions, such as have been sug- 
gested, the chill may forebode the succession of intermittent fever. 

Sensations of anxiety : a name which is applied to a certain feel- 
ing of weight or pressure, with oppression of the breath, of which the 
seat appears to be the front part of the stomach and chest. No pains (or 
very few) are so distressing as these sensations, in which there almost 
appears to be a struggle for life, although, except in cases of organic dis- 
ease of the heart or lungs, or of inflammation of some important organ, 
or of general dropsy, they are not so immediately urgent as they appear. 

They may be the result of an accumulation of blood in the lunss, (con- 
gestion,) in which case, if the patient were of a consumptive habit, the 
symptom would be urgent. 

They may occur as a spasmodic affection of the lungs; or, again, from 
local derangement of the same organs, such as irregular reception and 
expulsion of the blood, owing, perhaps, to the obstruction occasioned by 
enlargements, (as of any important gland,) deposits of matter, etc., in 
which last case, as distinguishable by the pulse, much importance should 
be attached to them. 

Such sensations may be the result of merely sympathetic nervous irri- 
tation of the lungs, most frequently when the stomach is affected, as by 
deleterious drugs, tobacco, coffee, excess of fermented liquor, or obstruc- 



INVESTIGATION OF DISEASE. 69 

tive and indigestible substances, in which case the affection must not be 
attributed to the lungs. 

They may be occasioned, as last indirectly stated, by overcharging or 
overtaxing the powers of digestion, especially, if the stomach be weak, a 
condition easily identified in those who have been treated with copious 
use of purgatives, emetics, or even tonics, or who have been addicted to 
excesses in eating or drinking, or in young persons affected with worms; 
in such cases, if the patient has partaken of flatulent substances, or of 
very rich, heavy, or irritating food, or of mixed liquors, or has been affec- 
ted with bilious symptoms, the occasion of the anxiety is sufficiently 
apparent. 

They may be associated with inflammation of the heart, stomach, 
liver, lungs, or bowels; or with dropsy of the belly, general dropsy of the 
system, or water on the chest; or, again, with permanent or organic dis- 
ease of the heart or lungs, or with determination of blood to any of these 
organs, in the majority of which cases they are of great consequence. 

They may be purely spasmodic, in which case the apparent suffering 
of the patient will be greater than in any other, and it is not uncommon, 
even without serious disturbance of pulse, to see the patient, as if in the 
last struggle of existence, either speechless and prostrate, or occasionally 
grasping at the bystanders, and feebly expressing an apprehension of 
immediate death. Such cases, especially, occur from comparatively slight 
causes of derangement (of the stomach, in particular,) in subjects of a 
highly nervous disposition, if males, or amongst females of excessive 
hysterical susceptibility, particularly if there be actually some affection 
of the womb. Women subject to frequent miscarriages are, particularly, 
subject to be affected in this manner. Under such circumstances, these 
symptoms are of comparatively slight importance. 



THE ORGANS OF SENSE * AND THEIR, INDICATIONS. 

This section involves, to a certain extent, not only the investigation 
of the condition of the sense, which may be deranged without apparent 
derangement of its organ, but, also, of the external appearance of one 
organ itself (especially) — namely, of the eye, as well as of the sight. The 
other organs of sense — namely, the ears, nose, and palate, convey no 
such very distinct or important external manifestations, or none which 
are not included under various heads in the course of this article; and we 
shall, therefore, rest contented, in alluding to these, to treat of the senses 
which they convey — namely, hearing, smell and taste. 

The eye affords a multitude of external evidences of derangement — 
as, for instance : 

1. A dilated pupil may be engendered by sympathetic irritation of 
the brain, as associated with irritation of the stomach and bowels, partic- 
ularly from the presence of worms ; or it may indicate a local affection of 
the brain itself— as inflammation of the membranes — or water — and is 
then the result of direct pressure upon the brain ; or, again, it may result 
from total inaction, or suspended action of the bowels, in which case the 

* The sense of feeling is derived from the nerves, and is, elsewhere, separately considered. 



70 THE ORGANS OF SENSE. 

symptom would identify a sympathetic affection of the brain ; or, it may 
be associated with insensibility of the nerve, which communicates the t 
representations of the eye to the brain, in which case it need not be oth- 
erwise than a purely local symptom . 

2. A contracted pupil may be caused by great tenderness to light, when 
it consists of a convulsive effort to exclude the light from acting too 
powerfully upon the eye. 

If attended with sensibility to light, it exhibits over-due irritability 
of the nerves connected with the sight, and, consequently, an irritative 
inflammatory tendency. If attended with insensibility to light, and 
associated with fever, it is an indication of the utter prostration of the 
vital energy. 

Languid expression of the eye, occurring as a distinct and appreciable 
vymptom, may indicate (1) if associated with anxiety— overloaded stom- 
ich ; or, sometimes, the action of fermented liquor on the stomach; or of 
deleterious substances, or of heavy and indigestible food ; in sucli cases it 
forebodes vomiting, especially if cold sweat bedews the forehead ; (2) if 
associated with general debility, as the result of sudden and severe loss of 
animal fluids, or of very severe acute disease, it denotes the sinking of the 
vital energy, and often forebodes fainting. 

Squinting, or distorted sight, is always symptomatic, when it is not 
habitual, and constitutes a very important indication, in children especi- 
ally, affording a decisive index to the case, when other symptoms con- 
spire to evince the probability of acute water on the brain. Otherwise, 
it exhibits a sympathetic affection of the brain, originating in irritation 
of the stomach and bowels, especially if worms be the direct cause of 
such irritation. 

Staring expression of the eye, or fixed stare at one object, with or 
without raving, or muttering, if consciousness be absent, identifies delir- 
ium ; or even if consciousness be not absent, (in the usual acceptation of 
the phrase,) there is a degree of abstraction, amounting to momentary and 
accidental suspension of consciousness, absorbed by a fixed thought, or 
with vacancy of thought, in which case, also, it may be termed the indi* 
cation of a degree or species of delirium (in its strict sense). 

Sunken or retracted eyes denote debility. 

Protruding or prominent eyes, particularly if they be glittering, and 
characterized by suffusion of redness, combine to identify considerable 
congestion of blood in the head. 

The sight is attended with some variations of distinctive import- 
ance — as, for instance : 

1. Double sight, or half sight, either of which may exhibit a degree 
of spasm, and which may be simply associated with a hypochondriacal 
or hysterical disposition, but which may also arise from irritation of the 
stomach, especially, as the result of very stimulating food or drink ; in 
which case, however, it is usually characterized by giddiness drowsiness, 
dread of motion, talkativeness, extreme taciturnity, or excessive rest- 
lessness and excitement ; or, again, as one of the premonitory symptoms 
of imminent apoplexy. 

2. The appearance of a profusion of dark spots before the eyes, gen- 
erally conveying the idea of a slow descending movement aggregately, 
but sometimes, also, of irregular oscillation, which, even when the patient 



INVESTIGATION OF DISEASE. 71 

wanders, is often to be distinguished in some fantastical expression ; of 
dread of insects, as, in health, he or she abhors, may (according to other 
symptoms present) identify or forebode:— depression of vital energy and 
fainting, if the patient has suffered from very debilitating affections, 
such as excessive loss of blood or other animal fluids, or from very rapid 
or severe acute disease, determination of blood to the head, or a deranged 
or over-loaded stomach ; and. perhaps, in the latter case, vomiting. 

3. Obscuration of sight affords indications similar to those of dark 
spots before the eyes, as just stated. 

The taste affords very important indications in respect of its alter- 
ations — as, for instance: 

1. Foul taste may originate either in local affections of the mouth, 
teeth, throat, etc., or in irregularities of the nervous system, as occurs 
particularly amongst women of a highly susceptible, hysterical disposi- 
tion ; or, sometimes, also, without such causes, during pregnancy ; or, 
again, as associated with fever, in a tendency to putridity in the blood, 
which it, therefore, denotes to a certain extent ; or, again, if saltish and 
putrid, as occurring in persons of a consumptive constitution, or under 
circumstances likely to provoke consumption, it may originate in a sup- 
purative condition of the last-named disease. Furthermore, a sweetish, 
saline, bitter, slimy, or harsh and acrid taste, especially, if considerable 
phlegm be constantly in the throat, may be traced to the presence of an 
irritative condition of the stomach, occasioned by the presence of impure 
matters. 

2. Loss, or absence of taste, may arise from some organic, nervous 
affection ; or, again, from cold, or derangements dependent upon cold. 

The hearing may constitute a characteristic symptom, either in its 
excessive or deficient sensibility. 

1. If deficient, as associated with fevers, and, particularly, with 
typhus, this very irregularity constitutes Ei'wholesome indication. 

2. If excessive, associated with fever, we may identify either a degree 
of inflammatory action involving the brain, or, in general, too acute a 
susceptibility of the nervous system. 

3. Buzzing or ringing in the ears, as associated with inflammatory 
action, or occurring without any apparent cause, or without either of the 
other conditions here mentioned, in persons of a full habit of body, may 
be attributed to congestion of the blood in the part; or, if associated with 
cold, to that, with or without increased secretion ; or, again, to determin- 
ation of humors to the ears, when more or less deafness usually qualifies 
the case. 

The sense of smell is also qualified by two chief conditions, 
namely: (i) deficiency or loss of smell, which is attributed to nervous dis- 
turbance, or to the effect of cold (when associated with cold,) or to indi- 
gestion ; and (2) unnatural conditions of smell; as, for instance: — the 
prevalence of putrid smell in the nose, which is attributable either to 
local disease of an ulcerative and putrid character in the nose or palate, 
or to tendency to putridity in the blood or developed as an early mani- 
festation of disposition to apoplexy— or peculiar smell (which is not 
putrid, but may be very disagreeable,) and which consists of an affection 
of the olfactory aj:>paratus of a spasmodic character. 



72 COUGHS AND THEIR INDICATIONS. 



CHAPTER III. 



INVESTIGATION OF THE DISEASE-Continued. 



COUGHS, AND THEIR INDICATIONS. 

Coughs are of various significance, and point to various derange- 
ments, or seats of derangement, according to the conditions which pre- 
cede, accompany, or follow them, or by which they are immediately pro- 
voked. They constitute a series of manifestations, which should never be 
overlooked in the investigation of disease, because it is clear that whether 
associated with direct or local inflammation of the respiratory apparatus, 
and of the lungs in particular, or with sympathetic affections of these 
organs, originating in other organic causes of irritation, whether in the 
stomach and digestive process generally, or particularly in the spleen, 
liver, etc.; the presence of cough indicates, for the time being, one of 
two conditions, respecting the respiratory apparatus, namely: — either (1) 
that there is in the system some cause of irritation oppressing these 
organs, directly, or reacting upon them from other parts. 

If the affection be merely sympathetic, caused, as is very frequently 
the case, by irregularity in the process of digestion, chronic derange- 
ment of the lining membrane of the stomach, etc., or by the presence of 
any impure substance in the stomach or bowels, either received from 
without, or spontaneously engendered from within, it does not indicate 
circumstances of much consequence as regards the organs of respiration, 
and should be dealt with purely as an affection of the stomach or bowels, 
etc.; with this reservation, however, that if the increased irritation of 
the lungs, etc., be allowed to continue too long, for want of the removal of 
such provoking cause in the digestive process, it may lead to congestion 
of blood to the lungs themselves. 

If the respiratory organs themselves be clearly the seat of the affec- 
tion, it may be the product of the congestion of blood, suppuration, 
tubercles, etc., or of a purely nervous affection; or, again, of inflamma- 
tory action in the lungs, or the ramifications of the wind-pipe, or pri- 
marily of common catarrh, etc. 

The condition of perfect health, as respects the respiratory 
organs, is, therefore, in any case, inconsistent with the presence of cough ; 
for when no cause of irritation, either local or sympathetic, is present, 
there will be no cough, nor anything to impede the breath, and a deep 
inhalation may take place, the air being retained for many seconds in the 
lungs, without the slightest disposition to cough. 

If the habit of body be such as to lead to the suspicion that there is 
some latent taint in the system; or if, again, the taint be testified by 
morbid affections of the glands, skin, or bones, or by tendency, in every 
affection, to assume a sluggish, chronic character, or by continual inflam- 
matory or ulcerative affections of the eyelids or gums, every cough may 
be of momentous importance, and should lead us to investigate its cause, 



INVESTIGATION OF DISEASE. 73 

and to treat the affection, of whatever character, without delay, lest, 
while we pause, it should run on to organic affection of the lungs, and 
degenerate into consumption. 

Sho?°t, dry cough, accompanied by watering of the eyes and frequent 
fits of sneezing, in the early stage of acute fever, usually prognosticates 
measles. It may, likewise, (without such particular accompaniments) 
announce an eruption of another character. 

Cough, (generally,) painful, hacking cough, associated with acute 
fevers (other than those originating in, or associated with, cold,) may 
often be the foreboding symptom of incipient inflammation of the lungs, 
when the manifestation of crepitating (crackling) breath will frequently 
be decisive. 

Predisposition to cough, as the result of every exertion of the lungs — 
such as the accelerated breathing caused by rapid motion, or speaking, 
or laughing ; or, even as occasioned by mental or moral excitement— such 
as emotions, etc.; or, again, as the result of every derangement of the sys- 
tem, usually identifies a tendency to organic affections of the lungs. 

Chronic, dry cough, especially if associated with more or less difficulty 
in breathing, and readily provoked by the slightest causes, and accom- 
panied from time to time with stitching sensations, or pains in the chest, 
would lead to the belief that tuberculous disease had set in. 



TRANSPIRATION FROM THE SKIN, AND SWEAT, AND 
THEIR INDICATIONS. 

The more distinctive method of dividing the consideration of this 
cutaneous process, would be to consider "transpiration," properly so 
called, as a healthy, natural operation — indicative of derangement only, 
when qualified by excess or deficiency. Excess of transpiration, under 
the name of sweat, and deficiency of transpiration, under the name of 
dryness of the skin. 

1. The transpiration of health is evinced by softness, with slight 
moisture of the whole surface of the skin, in an equal degree, and without 
any roughness, crackling, extreme tension, shriveling or withering, or 
flaccid, flabby looseness of the skin, but with natural fullness and elastic- 
ity; and it consists of a continual, imperceptible, gaseous exudation. 

2. Sweat is a disturbed degree of transpiration, characterized by 
excessive discharge of humor of the skin ; it may be perfectly consistent 
with health, as the result of severe corporeal exertion; but, in relation to 
disease, sweat must be considered as of two distinct kinds: (1) that which 
accompanies the healthy determination or crisis of disease, or by which 
such healthy determination is effected, which is called critical, and (2) 
that which occurs before the critical period, which is followed by no relief, 
but rather by aggravation, or which is excessively profuse, which fore- 
bodes, or ushers in, or originates from, the peculiar operation of disease 
itself, especially characterized by the eruption of pimples (and not of a 
healthy reaction,) which is called symptomatic. 

Of the latter variety— symptomatic sweats — we may particularly 
notice (1) sweat occurring in the morning (without previous habit of the 
kind) and which, if associated with fever, identifies its hectic character; 



74 SWEATS, THE COMPLEXION. 

(2) offensive sweats, which, as associated with fever, identify putrid 
typhus; (3) sweat emitting a sour smell, which commonly characterizes 
the fever as miliary ; (4) local sweats, as, for instance, on the chest, or 
about the head, which are characteristic of determination of blood to 
those parts ; (5) cold sweats, which denote a depression of vital energy, 
and which, in the last stage of prostration, forebode dissolution; (6) tran- 
sitory sweats, as opposed to the continuous sweat of a wholesome crisis ; 
(7) symptomatic sweats may, however, be caused by a mere accessory 
mismanagement— such as want of ventilation, and excessive heat of the 
apartment— the use of feather-beds, which is much to be deprecated, 
especially in cases in which fever becomes developed — or the superfluous 
(and very mistaken) excess of covering; (8) otherwise we may generally 
attribute them either to great debility of the whole system, as associated 
with depressed pulse, etc., especially if occurring after long and debilitat- 
ing diseases, severe loss of blood or other animal fluids or other exhaust- 
ing causes, or to accumulation of noxious matters or substances in the 
stomach, when they will appear more particularly about the forehead and 
face, and will usually be cold and clammy; or, again, to overdue activity of 
the circulation, accompanied with comparative deficiency of energy in 
the functional process of the skin. 

Critical Sweat, on the other hand, is to be distinguished (l) by 
affording general relief, and by the simultaneous modification of every 
source of suffering and the subsidence of the irregularities of the pulse; 
(2) by being warm and clammy ; (:}) by being developed over the whole sur- 
face of the body simultaneously; (4) by the subsidence of all restlessness, 
nervous irritation, or mental uneasiness, and the occurrence of calm, even, 
undisturbed sleep; (5) by continuity; ((>) by the period of its development, 
in relation to the duration and course of a fever— viz., on what is termed 
the critical day of those fevers which run a regular course and usually 
resolve themselves into an issue about a given period, as on the seventh 
or fourteenth day, etc. 



THE COMPLEXION AND ITS INDICATIONS. 

Red, florid complexion, commonly identifies determination of blood to 
the head, or a full habit of body in general. 

White (cold, dead white,) complexion of young females at the critical 
age, denotes a difficulty in the sexual transition— green sickness. 

Faint-yellow complexion, usually denotes intestinal disease — disease of 
the bowels. 

Deep-yellow complexion, on the other hand, identifies jaundice, or even 
organic disease of the liver. 

Pallid complexion, with (more usually) meagreness, want of fullness 
of the skin, commonly identifies the stomach and intestinal canal as the 
seat of disorder, and may be caused by any obnoxious or impure matters 
therein— such as worms, (in particular) or associated with acidity of the 
stomach, with a drawn, sunken appearance, (especially,) it denotes spasm; 
with (more usually) puffiness of the flesh, it is associated with constitu- 
tional weakness, qualified by sluggish circulation or congestion, or excess 
of watery humor (as a constituent) in the blood, or by deficiency of blood. 



INVESTIGATION OF DISEASE. 75 

6 Patchy redness of the complexion— that is, redness as of a flush- 
spot on the cheek, denotes a hectic disposition. 

7. Sul ten and total chintz in the appearance of the complexion is 
often to be considered as a very serious manifestation. 

S. Lio'd spots, may, in advanced age, lead to an apprehension of 
apoplexy, as indicating inactive accumulations of blood upon important 
organs (with stagnant circulation); the general indication, however, 
affordeil by this manifestation, is taat of a putrescent condition of the 
blood (as associated with scorbutic habit of body). 

9. Blue, or livid complexion (habitual) — organic affection of the heart. 

o .-- _ 

SOUNDS EVINCED BY THE CHEST, AND THEIR 
INDICATIONS. 

The only varieties which have been considered susceptible of general 
investigation, or which appear appropriate for the consideration of unpro- 
fessional persons, are such as are plainly manifested by what is termed 
percussion — that is, by tapping upon the chest, etc., with the tips of the 
first two lingers of the right hand, or upon the index finger of the left hand, 
being laid flat upon the surface— and which we shall confine to the clear 
and dull sounds. Auscultation, or the act of listening i>y the application 
of the ear to the chest {immediate or by the unassisted ear— mediate, or by 
the stethoscope,) requires anatomical knowledge, and considerable experi- 
ence, to insure a correct interpretation. 

1. The clear sound— on: that which conveys the idea of an unoccupied 
cavity — is a sufficient evidence that the cavity of the chest and the lungs 
are free from any abnormal formations or accumulations of obnoxious 
matters, such as blood, matter, water, etc., and, therefore, indicates sound- 
ness. 

2. The dull or muffled sound, or that which conveys the idea of a 
cavity, the resonance of which is impeded by repletion, indicates the 
presence of accumulations, whether of blood, matter, or water, etc., and 
consequently unsoundness. The sounds elicited anteriorly, posteriorly, 
and laterally, in one half of the chest, ought to be carefully compared with 
those of the other; but, as the sound is naturally dull over the region of 
the liver, we must not expect to find it clear below the sixth rib anter- 
iorly, the eighth rib laterally, and immediately beneath the shoulder-blade 
posttriorly. 



THE VOICE AND SPEECH, AND THE IB INDICATIONS. 

J. Loss of voice — which may be occasioned by paralysis, or by simple 
spasm in the organ of voice— generally, however, indicates inflammation 
of the upper part of the wind-pipe, and if this symptom becomes perma- 
nent, or chronic, it denotes organic disease of the part. 

2. Hoarseness is likewise a symptom which originates in the upper 
part of the wind-pipe, and may consist of a temporary congestion or 
inflammation resulting from cold, or may denote organic disease of the 
part. 

3. Stammering— as associated with fevek— is a symptom of great 
moment, and which may sometimes be distinguished and foreshadowed in 



76 CRYING, LAUGHING, SNEEZING, ETC. 

the early stage of disease, by the imperfect pronunciation of particular 
voxels or syllables— in which case it should be held to forebode severe 
affection of the brain. It is a frequent premonitory symptom of apoplexy. 
4. Loss of speech is a very grave symptom when it occurs associated 
with concussion of the brain, apoplexy or typhus; or it may be associated 
with worms or other noxious matters in the intestines, or simply with 
hysterical disposition; or, again, it may be the result of spasm, in which 
case it may assume a periodicity. 



TEARFULNESS AND LAUGHTER, AND THEIR 
INDICATIONS. 

1. Copious toatering of the eyes in the early stage of fever, com- 
monly forbodes measles; or, if occurring in the course of acute fever, it 
usually denotes determination of blood to the head. 

2. Tearfulness, or weeping— provoked by the most trivial causes, is one 
of the chief manifestations of hysterical disposition, the same being the 
cause of laughing; therefore, the two symptoms are generally combined, 
and the one succeeds, or runs on into, the other. In such cases, however, 
laughter is generally the first symptom, which, becoming prolonged and 
convulsive, is converted into weeping. 

An excessive susceptibility and tearfulness, or weeping upon the 
slightest vexation, or upon fantastical grounds of vexation, is similarly 
indicative of a hysterical disposition, and is one of its chief indications. 

3. Laughter, in every case, denotes a great degree of nervous irrita- 
tion, both as regards the superior faculties and the animal functions ; if 
there be a predisposition to laughter, which is provoked by very trifling 
causes, a hysterical disposition is clearly identified, as already stated under 
the head of tearfulness ; if associated with fever, this symptom often 
forbodes convulsions or delirium. 



LOSS AND UNHEALTHY INCREASE OF FLESH, AND 
THEIR INDICATIONS. 

1. Accumulation of flesh, (fat,)* which is sudden, excessive, or other- 
wise irregular, is usually associated with organic disease of the liver, but 
may, at any rate, be very closely watched to detect the first manifestations 
of distinctive indications of disease. 

2. Emaciation, or loss of flesh, when it does not occur as the result of 
fever, or of distressing affection of the mind — such as deep and gnawing 
grief, or continued mental excitement, etc.,— may be attributed (1) to undue 
and irregular discharges of blood, etc., evacuation of water, and the like; 
(2) to disease of the lungs, or of other organs connected with the respira- 
tory apparatus; (3) and most frequently, to derangements involving the 
digestive functions, and seated either in the stomach or bowels. 

SNEEZING, YAWNING, GROANING, ETC., AND THEIR 
INDICATIONS. 

1. Sneezing is directly caused by irritation of the nerves connected 
with the lining membranes of the nose, and consists of a convulsive respi- 

* It is not unworthy of notice, that the same symptom has been identified amongst the inferior 
animals, as accompanying the earliest stage of diseases resulting from obstruction of the biliary ducte. 



INVESTIGATION OF DISEASE. 77 

ration; it may be the result of irritation in the bowels, and as such, when 
it occurs very frequently, in children, without being associated with any 
more direct cause, (as here stated,) we may infer the presence of worms, as 
the provoking cause ; or it may occur as an incipient symptom of measles, 
if associated with fever which cannot be traced to cold ; or, again, it may 
be the mere manifestation of cold in the head. 

2. Yawning is the result of a sluggish passage of blood through the 
lungs, and, if associated with fever, whether acute or intermittent, in its 
incipient stage, it identifies one of two conditions; either a spasmodic, or a 
debilitated state. 

3. Groaning may be attributable to purely mental causes, with which, 
indeed, this symptom is generally associated, otherwise it affords the same 
clue to the distinctive nature of the affection as the preceding symptom 
(yawning). 



THE SALIVA AND ITS INDICATIONS. 

The distinctive features respecting the saliva, as indicative of more or 
less derangement, are either an increased, or a deficient and diseased flow 
of this fluid, as compared with the habitual condition of health respect- 
ing it. 

2. Deficiency of Saliva, or dryness of the mouth and throat, denotes 
either (1) a deficiency of the watery humor, as a constituent of the blood 
and consequently an inflammatory or feverish condition — in which case it 
will occur as a continuous symptom, associated with extreme thrist; or (2) 
may originate purely in spasm, in which case it will occur but casually, 
and, if attended with unnatural thirst, the latter symptom will disappear 
with the direct cause, and with the resumed action of the salivary glands. 
A diseased state of the saliva, which is so frequently associated with indi- 
gestion, may be manifested in the form of a thick and tenacious, or— 
though less often— a thin and acrid fluid. 

2. Increased flow of Saliva may either be critical, as, for instance, in 
small-pox, or in sluggish nervous fevers, or in fevers generally, as occa- 
sioned by suppression of transpiration (through the skin) ; or it may be 
symptomatic, (in which case it may either identify a purely local affection 
of the salivary glands, or be associated with sympathetic disorders origina- 
ting in the stomach or intestines; such, for instance, as that deranged 
state which gives rise to the existence of worms) ; or, again, it may be 
associated with sore throat. 



THE EXPECTORATION AND ITS INDICATIONS. 

1. Expectation, which indicates a wholesome determination or crisis 
of disease, especially inflammatory diseases affecting the lungs, is technically 
termed "critical,'' and is identified by the facility with which it is detached 
and expelled, by the absence of pain associated with it, and, on the con- 
trary, by the relief which it affords, and by exhibiting a thick agglomera- 
tive consistency and yellowish color, occasionally modified by a few slight 
streaks of blood. 

2. Expectoration, which is expelled by an effort, such as repeated hawk- 
ing or coughing, or which causes more or less acute pain or soreness in the 



78 DIET AND MANNER OF LIVING. 

effort to detach it, may either denote the presence of accumulations of 
obstructive and obstructed matters, in any of the air-cells or tubes, or in 
the windpipe, or whence the discharge of expectorated matter proceeds, as 
the result of a continued irritation. 

If jelly-like, or sticky and rusty-colored, it will usually indicate inflam- 
mation of the lungs. 

If transparent, stringy, or sticky, sometimes streaked with blood, and 
expectorated with much difficulty and without relief to the patient, it com- 
monly identifies acute inflammation of the tubes of the lungs, (bronchitis); 
in which affection a change in the expectoration to that of an opaque 
yellow, or greenish- white colored substance, which is easily coughed up, 
and is followed by considerable relief, gives evidence of subsiding inflam- 
mation. 

If it be of the character of matter, or if whitish streaks are seen, or 
small whitish-yellow, sometimes globular masses, connected together by, 
orfloating amongst, sticky phlegm (continuously,) it is usually a symptom 
of suppurative (the second stage of) consumption ; again, if it consists of 
masses of substance of a brown or greenish-white color, and which flattens 
at the bottom of the vessel, into a shape resembling a piece of coin, it is 
an indication of an advanced stage of consumption. 

If it be of pure blood, it may be the result of inflammatory action, or 
of consumption; but it is, very frequently, the offspring of congestion, or 
an overcharged state of the vessels of the lungs. If a permanent symp- 
tom, (and not a critical expectoration.) it is, generally, of much import. 

If yellow, and particularly if also bitterish, affection of the liver is 
identified. 



CHAPTER IV, 



DIET AND MANNER OF LIVING. 



DIET. 

These excellent rules on diet have received the approbation of all 
classes; the self-denial imposed seems more stringent than it will prove 
on being carried into effect. Many individuals, in the authors' own 
experience, have pursued the same system of diet after they had no fur- 
ther occasion for medical assistance, thus continuing, from choice, what 
they had begun from necessity. 

These dietetic rules consist merely in the avoidance of medicinal and 
indigestible substances during treatment, both as calculated to interfere 
with the action of the medicines, and the proper functions of the alimen- 
tary system. Consequently, among liquids, the articles generally pro- 
scribed are green tea or strong black tea, coffee, malt liquors, wine, spir- 
its, and stimulants of every description ; lemonade, or other acid or alka- 
line drinks, and natural or artificial mineral waters. On the other hand 
cocoa, unspiced chocolate, toast, rice or barley-water, oatmeal gruel, sweet- 
ened with a little sugar, or raspberry or strawberry syrup, if desired; 



INVESTIGATION OF DISEASE. 79 

whey, milk and water, or pure milk not too recent from the cow, boiled 
milk, and, in some instances, butter-milk, or, in fact, any non-medicinal 
beverage is allowable. 

The diet should, however, bo accommodated to the peculiarities of 
the constitution in individuals; for instance, some persons cannot take 
the smallest quantity of milk without serious inconvenience; others 
throw out a rash after partaking offish; and, again, others loathe 
the very sight of animal food. These peculiarities should, also, be taken 
into account in the selection of the remedies. 

Of the varieties of animal food, pork, young or salted meats, and, 
amongst poultry ducks and geese, were better avoided, particularly when 
derangement of the digestive functions exist. Beef, mutton, venison, 
and most descriptions of game, if not too long kept, (high,) pigeons, 
larks, rabbits, etc., are allowable at discretion. (Refer to the Synopsis). 

Fish is a wholesome article of diet, and may, in most cases, be par- 
taken of occasionally, with the exception of the oleaginous species — such 
as eels, salmon, etc ; or shell-fish— as lobsters, etc.; and all kinds of salted, 
pickled, potted, or smoked fish. 

Eggs, when known to agree; butter, if free from rancid, or unusual 
taste; cream, plain, unseasoned custards, and curds, are also admissible 
in moderation. 

Stimulating soups, and high-seasoned, or rich-made dishes, are directly 
opposed to this regimen. Beef tea, veal, and chicken broth, etc., thick- 
ened with rice, macaroni, or sago, and seasoned merely with a little salt, 
are, of course, allowable. 

Amongst vegetables, all of a pungent, aromatic, medicinal, or indi- 
gestible description, or greened with copper, are prohibited; such as 
onions, garlic, eschalots, asparagus, radishes, horse-radish, celery, parsley, 
mint, sage, mushrooms, etc.; but others, free from such qualities, such as 
potatoes, French beans, green peas or beans, cauliflower, spinach, seakale, 
mild turnips, carrots, etc., may be used with the needful precaution of 
avoiding any particular article of diet, whether of the animal or vegetable 
kingdom, that may seem to disagree in the particular case in question. 

Lemon or orange-peel, laurel leaves, bitter almonds, peach leaves or 
kernels, fennel, anise seed, marjoram, etc., arc objectionable; acids, and the 
ordinary condiments, such as pepper, mustard, pickles, etc., and salads, 
ought either to be sparingly partaken of, or entirely abstained from, par- 
ticularly, by persons predisposed to indigestion. Salt and sugar, in mod- 
eration, are admissible. 

All kinds of light bread and biscuit, free from soda or potash, and not 
newly baked; also, simple cakes, composed of flour or meal, eggs, sugar, 
and a little good butter; or light puddings, such as bread, rice, sago, sem- 
olino, without wines, spices, or rich sauces, are admissible; but colored 
confectionery, pastry, and, in some cases, also, honey, must be rejected. 
Regularity, in the hours of meals, should be observed, and too long fast- 
ing, as well as too great quantity of food, at one time, should be avoided. 

It is not sufficiently considered that excess in eating, even wholesome 
and digestible food, is a most grievous error. The lightest diet will 
impede the operation of the digestive functions, if the stomach be over- 
loaded. It were always better to leave the table unsatisfied, than to 



80 CLOTHING AND HABITS. 

indulge in any excess in this particular. Nor should it be forgotten, that 
a craving appetite, which induces an inclination to eat excessively, is, in 
itself, an unhealthy condition, which requires to be counteracted, rather 
than to be encouraged. 

During fevers and inflammatory affections, the patient must, of 
course, be kept upon a low regimen— gruel, barley-water, etc., and, at the 
commencement of convalescence, a light pudding, with a little weak 
beef tea, or mutton or chicken broth, should form the whole of the nour- 
ishment given. Nature, however, is our best guide ; and whenever she 
takes away appetite, the necessity of not taxing the digestive functions 
must, with rare exceptions, be deemed imperative. (See Fever, and also 
Synopsis of the Kules of Diet). 



CLOTHING AND HABITS. 

Upon the first point, it were scarcely worth while entering into any 
observations, were it not simply to remark upon the impropriety of 
wearing garments impervious to air, and fitting closely to the shape, and 
the custom of exposing the extremities and chests of young children to 
the chilling atmosphere of our peculiarly variable climate, under the 
absurd idea of making them hardy. The evil consequences arising from 
thecheck given to perspiration, by the first-mentioned practice, are too well 
known to require any particular comment; but as the other is an error 
widely prevalent, I consider it my duty to mention it ; and I feel assured, 
that, if mothers would only reform this custom, and clothe their chil- 
dren in a more rational manner, they would make no slight advance 
towards the prevention of serious affections, not only during childhood, 
but in after life. Cotton, linen, and even leather, worn next to the skin, 
are generally preferable to coarse woolens. 

As regards habits, it may be briefly observed, that a regular method 
of living, avoiding ill-ventilated apartments, late hours, dissipation, 
over-study, anxiety, and other mental emotions, and taking sufficient air 
and exercise, are the best preservatives of health. 

The frequent use of hot-baths is injurious and liable to retard the 
cure under treatment. The idea that sea-bathing is almost universally 
beneficial is exceedingly erroneous ; there are many constitutions on 
which it acts prejudicially. Medical baths, either natural or artificial, 
are strictly forbidden. Bathing the whole frame daily with a sponge or 
wet towel, with cold or scarcely tepid water, and the use of the flesh-brush 
are by no means objectionable, and, indeed, frequently strongly to be 
recommended. (See Notes on the Use of the Bath.) 



CHAPTER V. 



ADMINISTRATION AND REPETITION OF HOMEOPATHIC MEDI- 
CINES. 

The method, quantity, potency, and frequency of repetition, to be 
selected and observed in the administration of the remedies, will be stated 
more explicitly as regards particular cases, in the subsequent directions 
for the treatment of each separate disease. 



ADMINISTRATION OF HOMCEOPATHIC MEDICINES. 81 

There will also be additional particulars in the remarks on internal 
and external remedies; and material assistance may be derived from 
the Repertory. Yet much will still be left to the discrimination and 
judgment of the administrator; because it is obvious, that a multiplicity 
of exceptional cases and conditions will arise, to which no general rule 
and few special regulations will apply. In instances of this description 
the particular character of each symptom distinguishable by the condi- 
tions under which it is manifested— or still more properly the assemblage 
of symptoms similarly qualified by conditions, will be the safest guide for 
the judicious selection of the remedy; and the continuance, return, sus- 
pension, aggravation, palliation, modification, or change of such particu- 
lar features of ailment, will serve to regulate the repetition, suspension, 
or change of the remedy. The same circumstances will also frequently 
guide the administrator to change the potency (strength,) when the 
remedy selected is evidently indicated, but has not been followed by adequate 
results; or, in other instances, to adopt a similar remedy, when both of 
the previous methods have equally failed. 

In pursuing such changes, great care should be taken in turning to 
the Table of Analogous Remedies, and from thence to the Repertory, and 
thereby selecting the remedy or potency whose operation assimilates 
most nearly to the aggregate features of symptoms and conditions in the 
case. 

The form of the medicine.— With respect to the form in which 
the medicines should be used, see under the head of " Remarks and Regu- 
lations respecting Internal Remedies and Doses." 

Repetition and selection.— The following are a few of the gen- 
eral rules to be observed in the domestic employment of the homoeopathic 
medicines: 

In diseases which are severe, and run their course rapidly, we must 
carefully watch the symptoms, and when we feel assured we have chosen 
the proper remedy, if no perceptible medicinal aggravation or improve- 
ment declare itself, but the disease seems to gain ground, repeat the medi- 
cine. In cases of high inflammatory action, Aconite or Belladonna, 
etc., should sometimes be repeated at intervals, varying from fifteen 
minutes to two, four, or six hours. 

If a medicinal aggravation take place, followed by improvement, we 
must let the medicine continue its action, until the improvement appears 
to cease, and the disease again makes head; if new symptoms set in, we 
must then have recourse to the medicine thereby indicated. Should, 
however, no perceptible medicinal aggravation take place, but improve- 
ment follow, we may safely await its approach to a termination, ere we 
again administer. If any symptoms remain, from the remedy first 
selected having afforded only partial relief, we must have recourse to 
some other medicine, which seems best fitted to meet them; but refrain 
from changing the remedy as long as benefit results from its employ- 
ment. 

In diseases whose symptoms are obstinate and long-continued, and 
in those which are virulent, but of short duration, as well as in those 
which partake somewhat of these features of violence, when a very 
striking improvement takes place, it will generally be found advantage- 

G 



82 ADMINISTRATION OF IIOMCEOPATHIC MEDICINES. 

ous to cease to administer the medicine as long as the improvement continues^ 
and only to repeat as soon as the slightest symptoms of activity in the 
progress of the disease reappear. But when a sudden or marked improve- 
ment, of comparatively short duration, follows the first dose of a remedy, 
and on repeating the dose, the symptoms of the complaint increase 
instead of subsiding, as they did in the first instance, it maybe concluded 
that the medicine does not answer, and that another must accordingly 
be resorted to, in the selection of which it will be necessary to choose one 
related or analogous to the remedy first prescribed. 

The distinguishing of the medicinal aggravation from that of the dis- 
ease, being a point of material consequence, we shall here give the leading 
and most usual characteristics of each. The medicinal aggravation comes 
on suddenly and without previous improvement ; the aggravation of the 
disease more gradually, and frequently following an amelioration. Lastly, 
the pulse is also a good guide, particularly in fevers and inflammations. 
Thus, when it becomes less frequent, or when, at all events, it does not 
increase in frequency, on an accession of aggravation, the aggravation is 
to be attributed to the medicinal influence; but when it does increase in 
frequency, the aggravation of symptoms must be considered as depending 
on the advance of the disease. 

We cannot attach too much importance to the necessity of carefully 
watching the effects of each dose, as, in addition to the temporary aggra- 
vation of the symptoms which sometimes set in, a development of collat- 
eral or medicinal signs occasionally takes place, particularly after fre- 
quent repetition of different remedies, in susceptible patients. By a want 
of attention, therefore, to this important point, we may incur confusion, 
and may be, unconsciously, treating a temporary medicinal disease of 
our own creation. We must, also, guard against falling into the opposite 
extreme — that of allowing the disease to gain head unchecked. 

Slight diseases are often removed by a single dose of a well-chosen 
medicine; the more severe and deeply-seated disorders are, also, frequently 
removed by a single dose of a well-selected, or specific remedy; but, in 
general cases, and, particularly those which have been long and rudely 
treated by other means, a frequent repetition is usually required. 

As a general rule, however, a given number of repetitions, more or 
less, according to the severity of the case, will serve to place the patient 
thoroughly under the influence of the medicine, after which the pause 
may be protracted, so long as the indications of progressive improvement are 
present. If, then, it becomes necessary to resume the administration, it 
will, generally, avail at remoter intervals than during the previous course. 
In complaints which are of a mild, though sluggish type, and which are 
unattended with any critical characteristics, the intervals, in the first 
period, may vary according to circumstances, from six to twelve hours. 
But in most complaints, in which constitutional or local inflammation is 
present, the intervals, in the first period, should not exceed four hours, and 
when important organs are involved, and constitutional fever runs high, 
these intervals should not, at first, exceed two hours. 

In severe acute affections, such as inflammations, fevers, etc., we may 
often repeat the same medicine in the same dose, at regular intervals, as 
long as it does good; but this rule has many exceptions, and the directions, 



ADMINISTRATION OF HOMOEOPATHIC MEDICINES. 83 

already given at the commencement of this article, should be borne in 
mind. 

In obstinate and lasting cases, by a long-continued administration of 
the same medicine, the patient often becomes less susceptible to its action ; 
in such instances, if the improvement remains stationary, or progresses 
slowly, we may gradually increase the dose, or still better, give, at suit- 
able intervals, some other remedy or remedies, of as nearly analogous 
medicinal properties, to that first administered, as possible, and then return 
to the original remedy, if needful ; if, on the other hand, decided amelior- 
ation follow each administration, we should allow a longer interval to 
elapse before repeating, by which means the system gradually recovers 
itself, and the susceptibility to medicinal influence remains unimpaired 
until the cure is completed. 

In rare cases, this susceptibility increases ; in such instances a higher 
potency should be selected— provided the remedy still appears to be appro- 
priate — and the intervals between the doses should be lengthened. This 
occasionally occurs when the medicine has been frequently repeated and 
given in solution. When the beneficial effect of a medicine is interrupted 
by any intermediary irregularity, such as attack of cold, looseness of the 
bowels, etc., some other medicine must be given for the new affection, on 
the removal of which, the medicine, which was previously acting favorably, 
must be again used. 

In the Selection of the Remedy, it is not necessary that all the 
symptoms noted should be present; at the same time care must be taken 
that there are no important symptoms uncovered by the medicine, or which 
more strongly indicate another remedy. 



REMARKS RESPECTING INTERNAL REMEDIES AND 

DOSES. 

PRELIMINARY OBSERVATIONS AS TO THE FORM OF THE MEDICINES. 

The Form in which Homoepathic Medicines are employed for internal 
administration, requires some particular notice, in order that the reader 
may have an additional opportunity of administering the medicine, with 
the medium or vehicle which may be most likely to promote its active 
operation in the case under consideration. It is well known, that the 
medicines are prepared in three distinct forms, namely : 

GLOBULES, (PILLS,) TINCTURES, AND TRITURATIONS OR POWDERS. 

1. Globules, (or pellets of sugar of milk saturated with the tinc- 
ture), are, in a great majority of cases, the only form required for domestic 
treatment, and so greatly facilitate the explicitness of the directions for 
doses, that in the first instance, all the medicines comprised in the list of 
the remedies which are quoted in this work, must be understood to be 
recommended in globules, (at the potencies, (strength) also, stated in that 
list). 

Dose.— For adults eight globules, (pills), either dry or dissolved in a 

little water (a teaspoonful). 
For infants two globules in the same manner. 

2. Tinctures might, as far as practical purposes are concerned, be 
coupled with Triturations, (powder) the latter being the form in which 
those remedies, which are insoluble, are first made, and consequently which 



84 INTERNAL REMEDIES AND DOSES. 

represents those lesser degrees of attenuation which are administered in a 
fluid form — of such remedies as do not require such pulverization to ren- 
der them soluble (or approximately so). It is this fluid form of soluble 
substance which is called the Tincture. Tinctures have, upon the whole, 
(like powders Triturations), been found better adapted to the treatment 
of acute diseases, and some forms of scrofula, ague, etc. 

Dose usually employed — For an adult, two drops to a spoonful of 
water ; or, in cases in which the substance medicating the tincture 
is precipitated (becomes thickened) by water — as, for instance, cam- 
phor, — then give two drops on a small piece of pure loaf sugar. 
For a child above two years and under twelve years old, one drop — 
constituting from two to three doses, according to the strength of 
the child. 
For an infant under two years old, one drop, similarly divided into 

six to eight doses. 
3. Triturations, as has already been explained in speaking of Tinc- 
tures, represent the lower potencies (as administered in the latter) in 
powder, of substances which are not susceptible of immediate (approx- 
imate) solution, and which require previous and repeated jyulverization, and 
extreme and minute distribution. The administration of Triturations is 
adapted to circumstances, such as those just mentioned in relation to the 
Tinctures of completely soluble substances. 

The objection to Triturations for unprofessional persons, is, that being 
in powder, we have no other means of naming a precise quantity for the 
dose, than by indicating the weight. Persons, therefore, who are in the 
habit of using them, should furnish themselves with appropriate and well- 
approved scales. 

Pose usually employed. For an adult, from half a grain to a grain 

(about what would lay on the point of a penknife blade of medium 

size). 
For a child between two and twelve years old, half a grain distributed 

as equally as possible into three portions— one of these third portions 

constituting a dose. 
For an infant under two years old, one-sixth part similarly. 

1. Previous to undertaking the treatment of any affection, it is advis- 
able that the article on the administration and repetition of the 
medicine should be carefully studied. 

2. Should the progress of the malady, notwithstanding treatment, 
without a distinct change in the nature of the symptoms, indicate a change 
of the remedies, it is advisable that the table of analogous remedies 
(see page 81) should be consulted in the selection of the new remedy. 

3. In cases in which the distinctions between the indications for dif- 
ferent medicines prescribed are so slight as to leave the least doubt on the 
mind of the administrator, as to which he should select, the decision will 
be determined by making out the list of symptoms, and referring to the 
" Repertory." 

This difficulty may frequently arise where two or more medicines are 
of closely analogous operation. 

4. Of doses for infants and children.— Where no particular 
direction is given for the treatment of young children, or children under 
the age of twelve years, it is to be understood, that the dose, in general 
cases, should be in proportion of one-third of that directed to be taken 



ADMINISTRATION OF MEDICINES. 85 

generally, or especially for an adult, as nearly as that proportion can be 
ascertained. 

The general dose for an infant, under six months of age, may be stated 
at the proportion of two globules (pills) to three teaspoonfuls of water, 
which solution should be administered by the teaspoonful at each dose. 

The general dose for an infant, between six and twenty-four months 
old, may be stated at two globules (pills) to the teaspoonful of water for 
each dose. 

Of Potencies.* — With respect to the potencies or dilutions to be 
employed, although it is by no means an essential point, still, as all the 
directions for treatment herein given, have been drawn in conformity 
with that scale, it is well that they should be in accordance with those 
quoted in the table of medicines and dilutions prescribed in this work. 

6. Of the division of doses and solution.— The doses prescribed 
in this work, are all directed to be taken in solution, as that is doubtless 
the most efficacious method of administration. But when that is not con- 
venient, or is rendered impossible by the state of the patient, the globules 
(pills) may be administered dry, by being placed on the tongue. 

When the solution of any medicine in water has to be kept more than 
three days before the whole is consumed, it is necessary to preserve the 
water from decomposition, by adding six drops of proof spirit to the two 
tablespoonfuls of solution. In very hot weather, one day should be the 
limit beyond which no solution should be kept without such infusion of 
spirit. When it is not convenient to add the proof-spirit to the solution, 
the only way of obviating deterioration is to make a fresh solution at the 
expiration of every such stated period of time. 

The best medium of solution is distilled water; the next, filtered or 
jjwe rain water; the next, water which has previously been boiled, or 
pure spring water. 

7. Of the recurrence, suspension, etc., of doses.— It were 
impossible, as has been already stated, in laying down a general rule for 
treatment, always to assign a given recurrence of the dose of any remedy, 
without being as egregiously wrong in one case, as one might be positively 
right in another. The discretion of the person who uses the medicine, 
guided by a careful study of the article on the repetition of medicines, 
must indicate the frequency of the doses, the pause, the renewal, and the 
change, according to the conditions of each particular case. 

As far as the frequency, suspension, and resumption in the exhibition 
of medicine can be reduced to a systematic scale, this has been done 
in the subjoined table, from which the patient may occasionally derive 
assistance, but to which he must not trust in the least exceptional 
instances. 

Great care must be taken in distinguishing between the scale set forth 
for acute, and that designed to direct the treatment in chronic disease. 

The constitution, temperament, and habit of body must also 
modify all set regulations in respect to the recurrence, etc., of doses. 
Highly susceptible subjects require more sparing treatment, and must be 
closely watched, to observe the earliest indications in the cessation of 
efFect, medicinal aggravation, or other exceptional conditions. 

* Potency is the term used to describe the strength of the medicine used. 



8Q TABLE OF ANALOGOUS REMEDIES. 

8. Of consecutive treatment. — It is a manifest error, in treating 
of any malady, to direct a patient positively to begin by the administra- 
tion of this or that remedy. Every malady may develop itself in a variety 
of ways. The incipient stage of the same disease, even, is scarcely ever 
identical in two cases. In all instances, the development of complaint 
must depend upon constitutional tendencies, atmospheric influences, 
external circumstances especially relating to each case, condition of the 
system of previous treatment, etc. 

All the remedies which are applicable to the treatment of any com- 
plaint within the proper province of domestic management, together with 
the symptoms which indicate the exhibition being detailed, the only way 
which an unprofessional person will avoid error, is by invariably selecting 
the remedy indicated by the symptoms that are present, and the 
circumstances which attend them, irrespective of any order of succession, 
except where (as next stated,) a particular course of medicine is directed 
to be taken in rotation. 



TABLE OF ANALOGOUS REMEDIES. 

As a general rule, however, when consecutive treatment is required, 
with medicines of analogous properties to those below stated, it will be 
found that such as are named, as operating beneficial after others, will be 
preferable for selection in such relation, to former treatment, viz : 
After Acidium-Nitricum— Calcarea, Petroleum, Pulsatilla, Sulphur. 
" Acidum-Bhosphoricum — China, Lachesis, Rhus, Veratrum. 
" Acidum- Sulphur icu m— Pulsatilla. 
u Aconite — Arnica, Arsenicum, Belladonna, Bryonia, Cannabis, 

Ipecacuanha, Spongia, Sulphur. 
** Alumina— Bryonia. 

" Antimonium Crudum — Pulsatilla, Mercurius. 
" Antimonium Tartaricum—See Tartarus-emeticus. 
" Arnica — Aconite, Ipecacuanha, Rhus, Sulphuric-acid. 
" Arsenicum— China, Ipecacuanha, Nux Vomica, Sulphur, Veratrum. 
" Belladonna— China, Conium, Dulcamara, Hepar, Lachesis, Rhus, 

Stramonium. 
" Bryonia— Alumina, Rhus. 
" Calcarea-Carbonica — Acidum-nitr., Lycopodium, Phosphorus, 

Silicea. 
" Carbo- Vegetabilis— Arsenicum, Kali, Mercurius. 
" China— Arsenicum, Belladonna, Pulsatilla, Veratrum. 
" Cuprum- Acet—CalcsLvezi, Veratrum. 
" Hep ar-Sulphuris— Acidum, Nitr., Belladonna, Mercurius,Spongia, 

Silicea. 
" Ipecacuanha— Arnica, Arsenicum, China, Coculus, Ignatia, Nux 

Vomica. 
" Lachesis— Acidum-phosph., Alumina, Arsenicum, Belladonna, 

Carbo-veg., Causticum, Conium, Dulcamara, Mercurius, Nux 

Vomica. 
" Li/copodium— Graphites, Ledum, Phosphorus, Pulsatilla, Silicea. 
" Mercurius— Acidum-nitr., Belladonna, China, Dulcamara, Hepar, 

Lachesis, Sepia, Sulphur. 



ADMINISTRATION OF MEDICINES. 87 

After Nux Vomica— Bryonia, Pulsatilla, Sulphur. 
" Opium,— Calcarea, Petroleum, Pulsatilla. 
" Phosphorus— Petroleum, Rhus. 
u Pulsatilla— Acidum-nitr., Bryonia, Sepia. 
u Bhus-Toxicodendron — Acidum-phos., Ammonium-c., Arsenicum, 

Bryonia, Calcarea, Conium, Phosphorus, Pulsatilla, Sulphur. 
" Sepia— Carbo-v., Causticum, Pulsatilla. 
'.' Silicea— Hepar, Lachesis, Lycopodium, Sepia. 
11 Sjyongia — Hepar-sulphuris, Kali-Bi., (for instance, in croup;. 
" Sulphur— Acidum-nitr., Aconitum, Belladonna, Calcarea, Cuprum, 

Mercurius, Pulsatilla, Rhus, Sepia, Silicea. 
" Tartarus-E)iieticus—BsiTytSi-c., Ipecacuanha, Pulsatilla, Sepia. 
" Veratrum— Arsenicum, Arnica, China, Cuprum, Ipecacuanha. 

9. Of Accessory or Palliative Treatment.— In cases of obsti- 
nate constipation, the use of the injection, or lavement, is allowable. The 
injection should consist of cold water, or, if that disagree, of tepid water; 
in some cases it may, also, be requisite to add a tablespoonful of sweet or 
castor oil. The quantity of water necessary for the different ages may, 
under ordinary circumstances, be stated to be a pint for an adult: f of a 
pint for a youth of ten or fifteen ; \ a pint for a child between one and five 
years of age ; and about one ounce for an infant at birth, or soon after. 

In Cases of Acute, External and Local Inflammation, or, 
more particularly,with wounds in which there is a lodgment of foreign sub- 
stances, which cannot be extracted, or where suppuration is not sufficiently 
progressive, we may have recourse to an application of the nature of a 
poultice, such as that which is described in the ensuing page 87- 

All appliances and methods, such as bleeding, cupping, leeching, blis- 
tering, etc., are strictly prohibited. 

10. Precaution to Insure a Proper Dose.— When the adminis- 
trator is not certain that the patient will adhere rigidly to the dose pre- 
scribed, or when given doses of medicines have to be sent to a distance, the 
simplest and safest expedient is to drop the globules into as much sugar 
of milk, as will envelop them securely, fold the contents together in a 
slip of clean, unglazed paper, and crush them from the outside, with the 
blade of a knife, or some other hard and even substance. 

11. When Medicines Should be Taken, etc.— The medicines 
should invariably be taken fasting, (save the understated exceptions,) and 
abstinence from food or drink for about an hour after the administration, 
is equally important. It is, also, of great consequence, to abstain from 
excessive bodily or mental exertion during treatment, and to keep perfectly 
quiet, if possible, for about an hour after the administration of medicine. 

There are exceptional cases, such as modify this rule, which may arise 
out of accidents or sudden emergencies, but the rule should be followed 
as closely as possible, even in cases of this kind. 

INDISPENSABLE RULES FOB THE PBESEBVATION 

AND MANAGEMENT OF HOMCEOPATHIC 

MEDICINES, ANTIDOTES, ETC. 

1. Keep your chest closed, or your vials in a dark, dry, clean, and cool 
place, free from odor or scent of any kind, or, if in a hot climate, in as 
regular a temperature as possible. 



88 PRESERVATION OF HOMOEOPATHIC MEDICINES, ETC. 

2. Do not change the corks, or use the same vials to contain a differ- 
ent remedy, without having previously been assured that it has been thor- 
oughly cleansed, first with boiling and then with cold water. It is better, 
at all times, to rinse a vial, which has already contained medicine, with 
spirits of wine, and to expose it, uncorked, to the action of great heat, 
before it is filled with a different medicine. The cork, or stopper, should 
be submitted to the same process. The safest way of all is, to destroy 
empty bottles. 

3. Let all the medicines be carefully marked and labeled, and abstain 
from handling two at one time. 

4. In preparing your solution for administration, be assured that the 
glass, or spoon, or other vessel in which you are about to mix it, is per- 
fectly clean. 

5. If it is necessary to prepare solutions of two or more medicines at 
one time, take care to keep them apart, and to mark them so that no 
mistake can occur. 

6. Do not use the same spoon or other vessel to administer two dif- 
ferent remedies, without having previously ascertained that it has been 
scrupulously cleaned. Porcelain spoons are preferable to any metal, on 
this account, because you are more certain of the thorough removal of any 
former medicinal substances. 

7. If you dissolve your medicines in open vessels, such as tumblers, 
take the precaution to have them well covered down during the intervals 
between the administration, and keep them in a dark, dry, clean, and 
cool place, totally free from odor or scent of any kind. 

8. Do not resort to any other medicinal agency during homoeopathic 
treatment, and abstain from any external applications, except such as 
are described homoeopathically. 

9. Avoid the use of all articles of perfumery, restoratives, cosmetics, 
and the like. Camphor, and other popular appliances for cleansing the 
mouth, etc., are strictly prohibited. The same may be said of smelling 
salts, etc. 

10. The saturated tincture of camphor, as it is used homoeopathically, 
must be kept entirely apart from any other medicines, or from any 
vessels or vehicles, such as powders, in which it is proposed to convey or 
administer other medicines. 

11. Do not change your course of treatment or your remedies, (when 
change becomes necessary,) too suddenly, or without allowing a sufficient 
pause to elapse, viz.: at least two hours, if possible, six hours, in general 
cases of a severe inflammatory nature, and in malignant fevers — and at 
least from two to three days (48 to 72 hours,) in diseases of a chronic kind. 

12. If the symptoms be so violent as to compel you to resort to imme- 
diate change after any previous treatment, administer one drop of spirits 
of camphor on a lump of sugar, or a teaspoonful of strong coffee, and 
then wait one hour, half an hour, or only a quarter of an hour, in urgent 
cases, before you proceed with further treatment. 

When, as occasionally happens with persons who are extremely suscep- 
tible to the effects of the homoeopathic remedies, an undue medicinal 
action is developed, giving rise to considerable local pain, or general con- 
stitutional disturbance, camphor is, generally speaking, the most effective 



ADMINISTRATION OF MEDICINES. 89 

antidote, particularly to the vegetable medicines. (See Table of 

Medicines, etc.) It may simply be inhaled by the nostrils, or a drop of 

Tincture of Camphor may be taken on a piece of lump sugar. Coffee, 

without milk or sugar, is also a useful antidote, provided the patient has 

not been long accustomed to its use. The same may, in a measure, be said 

of wine. 

■— ♦ ~~-_ 

SYSTEMATIC TABLE, 

FORMING A SUMMARY OF THE RULES FOR THE ADMINISTRATION AND 
REPETITION OF THE MEDICINES. 

In summing up the general regulations for the administration and 
repetition of medicines, the following particulars may be mentioned: 

OF ACUTE DISEASE, NOT CRITICAL.— GENERAL INITIATORY REMARKS. 

In acute diseases, not critical, when, after the lapse of four, or at 
the most, six hours, no amendment results, another remedy should gener- 
ally be selected, or the general state of the patient and the nature of the 
disease should be re-investigated. When, on the other hand, in the 
course of an hour or two, symptoms of improvement ensue — such as moist 
skin, a clear state of the intellectual faculties, a happier frame of mind, or 
a gentle and undisturbed slumber, no repetition or change of medicine 
must be thought of until a cessation of the improved condition of the 
patient becomes manifest. 

In acute diseases of a severe and critical kind, however— such as 
severe inflammatory complaints, cholera, croup, nervous fevers, asthmatic 
affections, etc., the repetition of the dose sometimes becomes necessary 
every five, ten, or fifteen minutes— or, at all events, at intervals of from 
one to three hours, subject to the like conditions. 

1. That there are two distinct periods in the course of treatment: — 
the first period, or that in which the medicine is more rapidly repeated to 
establish a medicinal ascendency over the disease; and the second period, 
or that in which the treatment is resumed and continued to complete the 
cure, or, until change of treatment. 

That these two periods are advantageously divided by a pause, during 
which the medicine may be suffered to exhaust its action, and the varia- 
tion of symptoms, etc., be observed. 

That during the first period, in the treatment of acute disease, which 
is not of immediately critical character, the intervals between doses 
should extend over from two to four, or even six hours, according to the 
severity of the symptoms. 

That, as a general rule, a course of two, three, or four doses, according 
to the length of the intervals, will constitute the first period; the greatest 
number of doses agreeing with the shortest intervals. 

That the pause, at the conclusion of the first period in the treatment 
of such diseases, should extend over from four to twelve hours, according 
as the progress of the disease has been checked by the previous treatment 
or not. 

2. That the disease continuing to make head after the pause, whether 
modified or not, (if no suspension or change should appear desirable in 
conformity with the exceptions below stated), the same treatment should 
be resumed during the second period. 



90 CHRONIC DISEASE. 

That during the second period in the treatment of acute disease, which 
is not of immediately critical character, the interval between doses should 
extend over from four to eight, or even twelve hours, according to the 
severity of the symptoms. 

That, as a general rule, one, two, or three doses, according to the 
length of the intervals, will constitute the second period; the greatest 
number of doses agreeing with the shortest intervals. 

3. That, in the event of no alteration, or, at most, a merely tempo- 
rary mitigation of the smyptoms, by the remedy or remedies administered 
during the first pe? , iod, another remedy must be selected as closely anal- 
ogous as possible to the symptoms present. 

4. That, after the completion of the secoiid period, in the event of the 
re-appearance of symptoms, which have yielded to the use of the remedy 
or remedies previously administered, the same remedy or remedies shall 
be administered at still more extended intervals. 

That, in this after-treatment, the intervals between doses shall extend 
over from 12 to 48 hours. 

CRITICAL CASES OF ACUTE DISEASE. 

1. That critical cases of acute disease— such, for instance, as of cholera, 
croup, or severe inflammatory disorders, which are excessively rapid in 
their issue, are not susceptible of the general rules applied to acute 
diseases. 

That the majority of these are individually exceptional. 

That, in their critical acceptation, they are only susceptible of one 
period of treatment. 

That, in cases of this nature, such remedies as Arsenicum, Caprum, 
Digitalis, Lachesis, Sambacus, Hepar, Spongia, and Veratrum, 
may be administered at intervals, varying from five to thirty minutes, 
according to the urgency of the symptoms, until beneficial reaction takes 
place. 

That the evident (and progressive) decline of the vital principle, not- 
withstanding treatment, may, in such instances, warrant the change of the 
remedy, if there be any hope that the change may produce the desired 
reaction. 

That, otherwise, cases of this nature are susceptible of the same excep- 
tional conditions, as have been reserved for the previous class of com- 
plaints. 

OF CHRONIC DISEASE. — GENERAL INITIATORY REMARKS. 

In chronic diseases of a severe and obstinate kind, it is often very 
advisable to administer a dose of the remedy selected daily, the first thing 
in the morning (fasting) for a period of from four to eight days ; or, in 
short, until such time as one or more symptoms become developed, which 
the patient had not experienced before commencing to take the remedy. 
When the remedy has been properly selected, the change in the patient's 
state will commonly occur within or shortly after the periods just named. 
Should no medicinal manifestations of any kind become apparent, 
another remedy may be selected, from two to four days after the last dose 
of the previous remedy has been taken. 

In chronic diseases, sulphur * is very often the most appropriate 
remedy to begin with, if no other is better indicated, and particularly if 

* See, also, the article on "Ebadicative Treatment." 



ADMINISTRATION OF MEDICINES. 91 

the patient has previously been affected with any skin disease. 
As soon as the symptoms developed by Sulphur have entirely 
subsided, a new medicine must be administered in accordance with the 
remaining symptoms (if any); but not for a longer period than from four 
to eight days. If improvement then sets in, the new remedy need not 
be repeated until the favorable change ceases to become progressively 
manifest. But, if no improvement ensues, although the remedy seems 
to be correctly chosen, Sulphur may again be resorted to, for from two to 
four days, and so on. It is frequently necessary to fall back upon Sul- 
phur several times in this manner during a protracted course of treat- 
ment. It should be remembered. 

1. That there are two distinct periods in the course of treatment ; the 
Urst period in which the medicine is more rapidly repeated to establish a 
medicinal ascendency over the disease: and the second period, or that in 
which the treatment is resumed and continued to complete the cure, or 
till change of treatment. 

These two periods are advantageously divided by a pause, during 
which the medicine may be suffered to exhaust its action and the varia- 
tion of symptoms, etc., be observed. 

During the first period in the treatment of chronic disease, the inter- 
vals between doses should extend to about twelve hours, and, as a gen- 
eral rule, a course of twelve doses will constitute the first period. 

The pause at the conclusion of the first period in the treatment of 
chronic diseases, should extend, for the vegetable remedies, generally, 
over from three to six days, according to the severity of the case, and the 
effect produced ; and for such remedies as Staphysagria, Conium, etc., 
over from four to eight days; for the mineral remedies, generally, over 
from six to ten days; and for such remedies as Calcarea, Hepar-sulphuris, 
Graphites, Silicea, Stannum, Sulphur, Zinc, etc., from eight to twelve 
days. 

2. That the disease continuing to make head after the pause, whether 
modified or not, (if no suspension or change should appear desirable, in 
conformity with the exceptions below stated,) the same treatment should 
be pursued during the second period. 

During the second period in the treatment of chronic disease, the inter- 
vals between doses should extend over from twenty-four to seventy-two 
hours, according to the severity of the case. 

As a general rule, two, four, or six doses should constitute the second 
period, according to the length of intervals — the greatest number of doses 
agreeing with the shortest intervals between doses. 

3. That in the event, or mere temporary mitigation of the symptoms, 
by the remedy or remedies administered during the first period, another 
remedy must be selected, as closely analogous in its properties as possible 
to the symptoms present, for further treatment. 

That, after the completion of the second period, in the event of the 
reappearance of symptoms, which have yielded to the use of the remedy 
or remedies previously employed, the same remedy or remedies shall be 
administered at still more extended intervals. 



92 EXTERNAL REMEDIES. 

That, in this after-treatment, the intervals between doses shall extend 
over from two to six days. 

CONDITIONS CREATING EXCEPTION TO THE FOREGOING RULES, 
RESPECTING CHRONIC DISEASE. 

1. That the repetition of any medicine be suspended. 

Upon the intermediate appearance of symptoms involving a complica- 
tion not covered by the previous treatment. 

Or, again, as soon as a positive degree of improvement becomes appa- 
rent. 

To be renewed and recontinued upon the first indication that the 
natural and original disease is regaining its ascendency, from which we 
may judge that the medicine has exhausted its active agency. 

2. That another remedy must be selected as closely analogous in its 
action as possible to the symptoms present. 

Upon the intermediate appearance of another symptom or symptoms, 
involving a complication not covered by the previous treatment. 

If no change takes place, and tlie disease continues to gain ground pro- 
gressively, notwithstanding the administration of ten or twelve doses. 

„> 

MEM ARKS AND REGULATIONS RESPECTING EXTER- 
NAL REMEDIES AND APPLICATIONS. 

Any remedy, which is prescribed for internal administration as Ho- 
moeopathic to a local affection, may be applied to the parts as a lotion, 
either by dissolving the globules in water, or by using the tincture to 
mingle with the water. 

External Application of the Nature of a Poultice.— The 
simplest and best application which can be used in cases requiring externa] 
treatment of this nature, to forward and encourage suppuration, or for 
any other reason, consists solely of a piece of lint saturated with cold 
water, applied to the parts, and kept constantly wet, the whole being care- 
fully covered with oiled silk, so as to exclude the air. 

All medicated poultices should be avoided. 

External Application of the Nature of Fomentation.— x\s 
a palliative application, pending the salutary action of internal treatment, 
in cases in which local irritation and tension are excessive, it is allowable 
to bathe the parts with water moderately hot, by means of a piece of flannel ; 
or to expose the parts to the action of the steam rising from boiling water 
poured into an open vessel. In cases of sore throat, in which the obstruc- 
tion and burning sensation in the nostrils is excessively distressing, the 
patient may similarly inhale the steam of boiling water. Hop poultices, 
and bread and milk poultices are good. 

Tincture of Arnica.— This useful medicine, when employed as a 
lotion to wounds, should always be discontinued upon the appearance of 
any eruption, etc. Individuals, of what is ordinarily designated as an 
inflammatory habit, or who have very irritable skins, and are liable to be 
affected with erysipelas, must be very cautious how they use it, and must 
modify their treatment accordingly, and abstain from the application upon 
the earliest appearance of medicinal irritation or erysipelatous swelling 
or redness. Such patients should invariably dilute the tincture with two- 
thirds more of water (in proportion) than is indicated in the directions, 



ADMINISTRATION OF MEDICINES. 93 

which occur in various parts of this work, when they have occasion to 
employ it; and, should this precaution not suffice to exempt them from 
excessive medicinal aggravation, they should have recourse to calendula- 
officinalis as a substitute. 

General proportion of the lotion Tincture of Arnica 1 part, to water 6 parts. 

Or for very susceptible subjects Tincture of Arnica 1 part, to water 12 parts. 

For the eye, or as a gargle for the gums, after dental 

treatment Tincture of Arnica 1 part, to water 20 parts. 

For an infant under six months old Tincture of Arnica 1 part, to water 32 parts. 

For an infant over six months and under two years . . .. T. inct ure of Arnica 1 part, to water 20 parts. 

Tincture of Calendula-Officinalis may be employed in the treat- 
ment of wounds of every description, by those who, from constitutional 
causes, are unable to employ Arnica externally, without subjecting them- 
selves to the inconveniences generated by the character of that remedy. 
Calendula has, moreover, an important advantage over Arnica in very 
severe incised or lacerated wounds, where there are indications of a serious 
scar being otherwise left by the cut. It is also preferable in all severe 
wounds which cannot heal without previous suppuration. 

General proportions of the lotion — Tincture of Calendula one part, to 
water six parts. (For infants and children the same as Arnica.) 

Tincture of Jlhus-Toxicodendron is more especially adapted to 
the treatment of Sprains, for the milder forms of which it is a specific 
remedy 

General proportions of the lotion — Tincture of Rhus-tox., one part, to 
water six parts. (For infants and children the same as Arnica.) 

Tincture of Aconite.— Aconite has been used externally with great 
success for local inflammation arising from check of perspiration, (or from 
other causes,) in conformity with its well-known characteristic properties. 
Care must be taken to distinguish such cases of inflammation, usually 
extending to the membrane which invests the bone, and affecting joints 
in particular, from erysipelatous inflammation, to which it frequently 
bears a striking resemblance. The sudden appearance of symptoms of 
this nature in young persons, who are particularly liable to accidents 
arising out of carelessness, ecc, and who, at the same time, have no pre- 
disposition to erysipelas, may be a strong ground of assurance in respect 
to the character of such inflammatory action, which may further be 
explained by a brief inquiry into the previous circumstances. In such 
cases, the external application of a lotion, composed of diluted Tincture 
of Aconite (simultaneously with the internal administration of the same 
remedy,) by means of a linen rag saturated therewith, and applied to the 
parts, will speedily subdue the symptoms, and preclude more serious con- 
sequences. 

General proportions of the lotion — for a person of adult age, Tincture 
of Aconite, ten drops to a wineglassful of water. For a child under 
twelve years of age, Tincture of Aconite, six drops to a wineglassful 
of water. 

Tincture of Cantharia or Cantharides — The peculiar property 
which Cantharis, or Spanish Blistering Fly, possesses of creating a severe 
burning pain, followed by the effusion of watery fluid beneath the scarf 
skin, bears so close an analogy to the effects of a burn or scald, with 
the formation of vesication or blisters, that we can readily conceive it 
well adapted, according to the homoeopathic law, to be an admirable 
remedy for injuries of the like description, or attended with similar symp- 



94 EXTERNAL APPLICATIONS. 

toms. Cantharis is, in fact, specific as an external remedy, in the treat- 
ment of burns or scalds, and is by far the most efficacious, if applied imme- 
diately after the injury has been inflicted (otherwise see Causticum,) and 
before the application of cold water, Acetate of Lead, or similar expedients 
have been adopted. 

Cantharis is, however, objectionable for persons whose constitutional 
peculiarity renders them susceptible of erysipelatous tumefaction of the 
skin, in the place of blisters, from the effect of a burn or scald. In these 
cases, Urtica-dioica is specific. In some instances, although very rarely, 
the external application of Cantharis may produce deranged action in the 
urinary organs, (exemplified by suppression of water) ; in such cases the 
mischief is readily counteracted by the internal administration of one 
drop of Tincture of Camphor on a lump of sugar. The lotion should gen- 
erally consist of the tincture at the second dilution and water, wherewith 
a linen rag is to be saturated, the linen being so wound around the parts 
as to exclude the air, and the moistening repeated as often as it becomes 
dry. 

General proportions — three drops of the Tincture of Cantharides, 2d, to 
every teaspoon ful of water. 

Tincture of Urtica-Dioica, or TJrtica-TJrens, should be used in 
preference to tincture of Cantharides by those in whom a burn or scald is 
apt to produce erysipelatous swelling in the place of blistering. But this 
is the only case in which Cantharides is superseded by Urtica. 

General proportion of the lotion Tincture of Urtica-dioica 1 part, to water 10 parts. 

For an infant under six months old . . . . Tincture of Urtica-dioica 1 part, to water 20 parts. 
For an infant over six months and under 

two years Tincture of Urtica-dioica 1 part, to water 15 parts. 

Proof Spirits of Wine, — In mild cases of burns or scalds, if Spirits 
of Wine can be procured immediately, (otherwise, see Causticum,) speedy 
relief may often be obtained therefrom, and after-suffering avoided. 
Apply it warm to the parts (as hot as the patient can bear it,) the injured 
part having meanwhile been exposed to the heat of the fire. 

Causticum or Lime Water, as already intimated under the head 
of Cantharis and Spirits of Wine, is a preferable remedy to either of the 
foregoing, when an hour or two may chance to have elapsed before the use 
of any remedial application. The Causticum wash is, also, of much service 
in more serious burns, and in those of long standing. 

General proportions of the lotion — to every teaspoonful of water, add 
six drops of the Tincture of Causticum, and apply frequently to the 
parts by means of a piece of linen rag saturated therewith. 

Raw Cotton, (excepting when the suppuration is excessive, anfl the 
weather hot, for which case see Soap,) is highly useful as an external 
application to burns or scalds of a serious nature, and more especially 
when an injury extends over a large surface. The method of use is as 
follows : Puncture any blister which may have arisen, bathe the sore 
well with tepid water, and then cover the parts with carded cotton or 
wadding in three layers— removing the outer laytr only, and substituting 
a fresh one— when suppuration sets in. 

The Soap Plaster {Pure, white, hard Soap). This application is 
more particularly serviceable in cases of burns, where not only the outer 



ADMINISTRATION OF MEDICINES 95 

or scarf skin, but also the inner, or true skin, has been destroyed. In 
serious cases, which have previously been treated with the lotion of Can- 
tharides, or Urtica-dioica, and in which the inflammation and pain have 
yielded to these remedies, but which are too severe (owing to the injuries 
inflicted on the tnie skin and adjacent muscles) to heal without suppuration, 
the soap plaster is a very useful accessory. It should be made and applied 
as follows: Moisten the soap with tepid water, and make a thick lather 
or paste, and spread it upon linen ; then puncture any blisters which may 
appear on the exposed surface, and remove all loose skin. After these 
precautions, apply the plaster to the parts, and secure it by means of a 
bandage, being careful that the whole of the injured surface is covered 
with the plaster. As a general rule, the plaster may remain undisturbed 
for twenty-four hours, when it should be gently removed and changed; 
but there are many exceptional cases, and the feelings of the patient 
should guide us in the removal and change of the plaster, whenever a 
return of pain is complained of. This course of application should be con- 
tinued until the injured parts are completely healed. 

The application of the plaster will always be attended with increased 
pain at first; but this must not deter us from the employment of it, as it 
will soon be followed by marked improvement. 

Flour — May be used as a substitute for cotton or the soap-plaster, 
when neither of the latter can be obtained at the moment. The method 
of application is simply to sprinkle flour copiously over the injured 
parts, after having taken the precautions directed to be observed under 
the heads of cotton and soap plaster. When it becomes necessary to remove 
the dry paste formed by the incrustation of the flour, this should be gently 
effected by first moistening and loosening it, by means of poultices (as 
directed under the head of external applications of the nature of a poultice.) 

Tincture of Arsenicum (considerably weakened with water) is a 
good application to bedsores, and as a local resource, in many cases, of 
malignant ulceration. 

General proportions of the lotion — to one wineglassful of water, ten 
drops of the Tincture. 

Tincture of Carbo-veaetabilis, in similar cases, as directed for the 
affection in question. 

General proportions of the lotion — to two tablespoonfuls of water, 
twenty drops of the Tincture. 

Tincture of Cinchona (concentrated). See "Bed-sores," after 
typhus, etc. 

General proportions of the lotion— to a wineglassful of water, fifty 
drops of the Tincture. 



REMARKS AXD REGULATIOXS RESPECTING THE BATH 

The bath may be divided, according to modern appliances, into eight 
varieties, viz:— the hot and cold salt-water bath, the hot and cold fresh- 
water bath, the tepid, the shower, the vapor, and the medicated baths. 
Of these we shall here consider the two first-named only, viz ■ 
the hot fresh water bath. 

Except as respects new-born infants, for whom a third variety is 
necessary, namely: 



96 REMARKS RESPECTING THE BATH. 

THE COLD SALT WATER, AND THE COLD FRESH WATER BATH. 

All the other varieties, especially medicated baths, are commonly 
prohibited, except for infants. 

The consideration of the bath is a matter of essential importance to 
health, and has been acknowledged as such, from the remotest antiquity, 
and in every climate. It is almost as much a necessity of existence as 
food and clothing. It involves what is a primary essential, cleanliness; 
but like all generalities, it is subject to exceptional modifications arising 
out of the condition of the system, or the temporary state of the body ; 
such, for instance, as the presence of an eruption, or rash, or the exuda- 
tion of perspiration after violent and prolonged exercise, both of which 
would render the bath obnoxious for the time. But for persons who are 
free from any morbid manifestation, which may render the free use of 
cold water objectionable, nothing, perhaps, will tend so much to brace 
the nervous and muscular construction of the frame, and to preserve the 
sturdy physical power of youth in advanced age, as the regular observ- 
ances of the bath. 

GENERAL EXCEPTIONAL CONDITIONS UNDER WHICH COLD BATHING 
SHOULD BE AVOIDED. 

When (as is sometimes the case) it is found to induce constitutional 
disturbance, or is invariably followed by headache, etc., of the same 
character. 

When it is followed by lasting chilliness, instead of the glow, which 
indicates its healthy action. 

There are comparatively few instances in which the cold fresh ivater 
bath disagrees with persons in good health ; in such instances, however, 
when they occur, the use of a sponge or wet towel must be substituted 
for the bath, and should be followed with brisk friction. 

When any inflammatory action is present, or when from exertion or 
from any other cause, the skin is moist and the pores are open, the Cold 
Bath should be avoided. 

During the presence of headache, other than headache arising from 
irregularities of digestion or nervous causes. 

Immediately, or within one hour after a meal. 

Before any meal has been partaken of, or, in other words, upon first 
getting up in the morning. 

Generally — with a dedining temperature, as, for instance, late in the 
evening, when the temperature of the water will not have declined 
equally with that of the atmosphere. 

When the atmospheric temperature is not sufficiently high, as com- 
pared with that of the water ; or. in other words, when the water feels 
zoarm and the air cold. 

Generally — during the prevalence of cold east winds. 

GENERAL CONDITIONS FNDER WHICH COLD BATHING IS BENEFICIAL. 

When the temperature of the water, relatively to that of the atmos- 
phere, is as nearly as possible that which it would reach and maintain, 
by being constantly exposed to the action of the same atmospheric tem- 
perature. 

When it is always followed by a glow. 



SEA BATHING. 97 

Iii affections of a purely nervous character. 

In the majority of affections resulting from debility of the digestive 
functions. 

During an ascending temperature, that is to say, in the earlier part of 
the day, generally, about tio~> or three hoars after the first meal, and at an 
equal distance from the second. 

"When the water is cold compared with the air, but not so cold as to 
produce a shock or numbness. 

In this climate, from the end of June to the middle of September, 
may be stated as the best season for out-door bathing. 

In-door bathing may be continued throughout the year with great 
advantage, with the precaution that the thermometer in the apartment 
stand at from 50° to G0° of Fahrenheit, and that the water be exposed to 
this atmospheric temperature at least six hours (when that is possible,) or 
be raised to from 45° to 55°, if below it. 

The swimming bath, or bath in which (if not in open water) there is 
room to exercise the limbs, is preferable. 

GENERAL PRECAUTIONS TO BE OBSERVED IN BATHING. 

Do not bathe the lower extremities first. The immersion should be 
complete at once. 

This need not be effected by plunging, when, as is not unfrequently 
the case, such a method is found to induce headache or temporary deaf- 
ness. 

Diving, which is a v^ery common amusement, is very often prejudicial 
without sufficient attention being paid to the fact. In general, you should 
abstain from diving. 

Never leap into deep water, feet foremost and in an erect position. The 
best method is to drop into it, the body and limbs being bent together. 

Do not stand still or remain motionless in the water. 

Do not remain too long in the water. Five minutes is quite long 
enough to derive all the advantages of the bath. 

Never remain so long as to become thoroughly chilled. 

Leave the bath upon the first appearance of cramp. 

Apply a coarse towel briskly, all over the body, as soon as you leave 
the water, and take pains to dry yourself as thoroughly and as expeditiously 
as possible. 

Dress as soon as you are thoroughly dry. 

The bath should be followed by a brisk walk, but not sufficient to heat 
you. 

THE SALT WATER BATII, OR SEA BATHING. 

There has been a popular notion that sea-bathing is always preferable 
to fresh water bathing. Nothing can be a greater mistake, and there are 
a far greater number of exceptions to the proper use of the former than 
to that of the latter. It is indeed true, that the question of temperature 
is far less important in respect to sea-bathing, except, indeed, towards 
the fall of the year, when the temperature of the atmosphere, in our 
climate, becomes considerably depressed, and when, in conformity with 
one of the " general exceptional conditions'' above stated, it were advisable 
for those, even with whom sea-bathing generally agrees, to discontinue 
it 



98 FRESH WATER BATHING. 

But it is a matter of experience, that there are a great number. of con- 
stitutional exceptions. And it is quite as important that all those with 
whom sea-bathing is found habitually to disagree, should abstain from 
what, at certain seasons and in certain places, may be a great indulgence. 

There are instances in which sea-bathing produces a species of nau- 
sea similar to that of sea-sickness, in persons who are totally exempt from 
this inconvenience on ship-board. This, then, is clearly a constitutional 
exception. 

In brief, however, it maybe laid down as a rule, that when sea-bathing 
habitually induces any kind of constitutional disturbance, it should be 
avoided. 

* THE FRESH WATER BATH. 

The instances in which fresh water bathing disagrees, may almost be 
summed up under the head of the " General Exceptional Conditions v 
above stated. The cases of constitutional exception are far less numerous 
than those which occur with respect to sea-bathing, and there are fewer 
cases still in which persons who cannot bear fresh water can tolerate the 
sea-bath. When, however, they occur, they should indicate the course of 
the patient. 

TEMPERATURE OF THE BATH FOR INFANTS. 

The warm bath, which is requisite for the treatment of newly-born 
or very young infants, should never exceed 9S degrees of Fahrenheit in 
heat. It should, in general, range from 92 to 9S degrees, according to the 
effect produced on the child. When the bath is used as a remedial agent, 
it is important to main tain the temperature at which the immersion had 
taken place; and it will, therefore, be desirable on all occasions to have a 
thermometer within, so as to detect and regulate any variations. 

The cold bath should be, as nearly as possible, of the temperature at 
which the atmosphere would place or keep it. It is, therefore, desirable 
that cold spring water, which has not been exposed to the action of the 
air, for four hours at least, should be avoided in hot weather, when the 
atmospheric temperature would have materially increased the heat of it. 

Exceptions to the use of the cold bath. — In almost all cases the use of 
the cold bath, with new-born or very young infants, is reprehensible. 



PREVENTIVE AND ERADICATIVE TREATMENT. 

It is too true that the every-day practitioner suffers himself to be too 
completely engrossed by the actual condition of disease to investigate or 
to provide against its accessibility. The duty, however, of every man who 
deals with his profession, as a noble and humane science, is rather to point 
out the method of preventing the occurrence of active disease, and 
eradicating (if possible) the latent and slumbering defects of constitution, 
which may be described as dormant disease, than to confine his attention 
solely to the treatment of its active manifestation. 

This great and humane purpose should characterize the philosophy of 
every medical creed or denomination, and should ennoble, if it may not 
consecrate any system. 



PREVENTIVE TREATMENT OF DISEASE. 99 

By the term "eradication," I wish to be understood to allude to the 
method of modifying or removing such unhealthy conditions of the system, 
as necessarily predispose the subject upon whom they operate to particular 
developments of active organic disease. 

I would first, however, be understood to confine myself, here, to such 
general hints as may, with due consideration of the regulations hereafter 
laid down for the treatment of each disease as it occurs, enable the non- 
professional reader to form some idea of the mode in which the rule is capable 
of being applied in the majority of individual cases, because it is obvious 
that this subject alone might require the whole space of more than one of 
such volumes as this, ere it was considered in detail. 

I would also hint that the rule is so distinct and positive, that the 
appropriate preventive treatment of any disease may be readily in- 
ferred from the distinction of the medicines which are specific (that is 
of positively analogous properties) in its treatment. 

PREVENTIVE TREATMENT GENERALLY. 

In respect to the prevention of disease, men, of all medical creeds, 
who have devoted their time and toil to the consideration of the subject, 
hold opinions which are necessarily in accordance to'a certain point; that- 
is, as regards the modification or removal of the external and excitiny causes 
of disease, such as local or general climate, and the substitution of clean- 
liness, pure air, drainage, etc. There is, however, a limit to the concur- 
rence of opinion, even on some of these points. We are further agreed as 
regards some of those causes which proceed from irregularities of living, 
from excesses, and, also, from improper or insufficient food. 

Amongst these accessory measures, which are essential to the pre- 
vention of disease, I would, therefore, particularly, draw the reader's atten- 
tion to the following:— involving, first, thosa which concern the person 
immediately; and, secondly, those which concern the locality immediately, 
and the person indirectly. 

Those which concern the person, immediately, amongst others, are: 

1. Exercise, in proper relation to the habits of the individual, to his 
strength and capabilities of physical exertion, the state of the weather, 
the method of taking exercise, whether active or passive (the latter being 
rather a modification of the accession of pure air than an application of 
exercise, properly so called,) and the circumstances of climate— involving 
the degree of altitude, or depression of temperature, the time of the day. 
(theevening being very adverse to health, especially, in districts in which 
thick vapor, lying close to the ground, is observable at and after sunset, 
marshes, etc.,) and the nature of the atmosphere at the time— whether 
unduly charged with, or deficient of, moisture; or, again, whether any par- 
ticular wind prevail, which is known to be charged with noxious exhala- 
tions, as the Sirocco of Southern Europe, etc. 

2. Cleanliness of person and habitation, which is subject to no excep- 
tional condition, but those of rare occurrence, which render it impossible. 
This action may, also, involve the free use of (cold) water in ablution, 
except in particular cases. 

3. Ventilation, partly applicable to the person, and partly to the local- 
ity, by which I understand the admission, and free circulation of pure air, 
without the action of a direct current, or draught, and the avoidance of 




(100) 



PREVENTIVE TREATMENT. 101 

closely confined apartments, sedulously closed against the external atmos- 
phere. In ninety-nine cases out of a hundred, such exclusion would 
repulse, more probably, a restorative of health, than an aggravant of dis- 
ease. For nature is more surely in accordance with the requirements of 
human life, than any artificial means; and science should be rendered not 
a repellant, but an assistant of nature. 

4. Apparel, by which should be understood all coverings— which 
should be as light as possible, consistently with weather, climate, and par- 
ticular susceptibilities, or habits. The action of the skin is one of the 
most important functions of life, inasmuch as, if irregularly performed, it 
reacts upon all, or any of the organs most intimately connected with exist- 
ence. Over-clothing, or covering, on the one hand, therefore, may pro- 
mote an irregular excess of action, which will result in continued 
relaxation of the function, and consequent exhaustion; whereas, expos- 
ure, on the other hand, may occasion a repression and suspension of action 
which will, inevitably, recoil upon the superior organs. The strict consid- 
eration of this question is, more especially, imperative in climates in 
which the transitions of temperature are sudden or very considerable. 

5. Aliments— by which is here understood both fool and drink — 
should, in every case, be modified, in relative proportion, according to the 
climate, and to exceptional conditions arising out of the particular degree 
of strength or weakness of digestion, which characterizes particular persons, 
or to any casual circumstances which may modify, alter, or deteriorate 
the digestive functions, and, consequently, operate upon the appetite. The 
American native, or the habitual inhabitant of a temperate climate, 
removing into a tropical zone, should decrease (if not totally eschew) the 
admixture of animal food; or, if removing into an arctic, or very cold cli- 
mate, might, with due regard to condition (especially whether salt or 
fresh) of such animal food, advantageously increase its proportion ; the 
habitual use of very salt, or otherwise highly seasoned food, is always uni- 
formly prejudicial; he should, also, diminish the proportion of stimulating 
ingredients, as the heat of the climate is increased ; under the same condi- 
tions he should strictly abstain from the use of stimulating liquor, or, if 
that has previously been habitual, he should d3crease it gradually, until 
very moderate indulgence (if any) remains; and he should be very careful 
not to overload the stomach with either food or drink of any kind. It is 
very important that the American, removing into a tropical climate, 
should neither eat nor drink more than what is absolutely necessary— inas- 
much as every disease to which the inhabitants of temperate zones are 
subject, between the tropics, not only assumes complications, particularly, 
implicating the organs of digestion, but very frequently springs, either 
remotely (by predisposition thus occasioned,) or immediately, from impe- 
ded, or overtaxed digestion. The person of weak digestion should care- 
fully abstain from all indigestible or stimulating articles of food— should 
select the plainest diet— feed to supply the necessities alone, and not to 
gratify the palate— should eat but little at a time, and not at all, as the 
time of rest approaches — should avoid all stimulating food or drink, a* d 
should never attempt to force an appetite. Regularity is indispensable to 
health. 

6. The Habits of Living.— Regularity is a great preservative in 
this respect, including the just appropriation of the period of rest, as indi- 



102 ADMINISTRATION OF MEDICINES, ETC. 

cated by the secession of light and the dormancy of nature, generally, and, 
consequently, early hours, both in resting and rising, and a sufficient, but 
not excessive proportion of rest. The relations of night and day constitute 
the best directions for the equable adjustment of the due proportion of 
rest. The summer of temperate zones indicates a less proportion than 
the winter, as, also, the tropical night and day indicate a greater equality 
in the disposition of time. (See also "Rest," under ''Investigation of 
Disease.") Excessive disposition to rest, (indolence,) is as injurious, on the 
one hand, as excessive duration of mental or bodily activity is on the other, 
and the regular return of both conditions, at corresponding and stated hours, 
is important. Regularity of habits, also includes regularity in the period of 
eating, or the hours of meals, which is no less important than the former. 
The art of dividing time in every way is a powerful preservative. 

The preventive measures, which involve locality, amongst others, are : 

1. Drainage— If the locality be subject to periodical, irregular, or 
casual saturation, or flooding of water; that is, if it be nearly on a level 
with some adjacent surface of water, such as lakes, rivers with sluggish 
current, or the sea ; the generally applicable methods of preventing the 
exhalation of noxious vapors, and the consequent impregnation of the 
atmosphere with miasma, injurious to life are (1) to create, artificially, 
where practicable, such channels as shall lower the general level of the 
water, or comparatively elevate the general surface of the soil, and which 
shall prevent the stagnation of waters; and (2) so to disturb the surface of 
the soil, as by furrowing, plowing, etc., that the exhalations shall be rapidly 
emitted, and thereby be subject to dilution and dispersion, as soon as they 
transpire. 

Or. again, and especially to towns and crowded districts, in which the 
accumulation of decomposing or decomposed animal and vegetable matter 
must necessarily be great, to create so free a vent, by means of proper sub- 
terraneous canals, and by the removal of all filth, etc., (exposed to the 
action of the atmosphere,) that any such matters shall be rapidly dis- 
charged, into such currents as shall remove impurities rapidly, or into such 
remote receptacles as shall secure the absorption, dilution, or dispersion of 
all noxious vapors, before they can impregnate the habitual atmosphere 
of the inhabitants. Therefore, every dwelling, to be wholesome, should be 
accessible to the free passage of natural currents of air, and should be 
provided with an ample and wholesome supply of water, and an easy dis- 
charge for all refuse deposits * 

2. Modifications of climate, by clearing, tillage, and every other result 
and accompaniment of industry, which thereby produces a doubly benefi- 
cial result, (1) by removing the susceptibility of the inhabitant to disease, 
and (2) by removing the cause which too frequently generates disease, viz: 
the unhealthy exhalation of the soil. 

3. The choice of habitation, as to site, which should be removed as 
much as possible from particular geological influences ; from localities in 



* Vested interests, stolid indifference, and an indolent disinclination to listen to the voice of reason, 
too often oppose a formidable barrier to the removal of crying nuisances". If there were any one act of 
despotic government interference, more capable of defence than another, it would be one which was 
directed towards effectual sanitary improvement. 



PREVENTIVE RESOURCES. 103 

which the water is impregnated with mineral substances, such as lead, 
iron, etc., from particular (local) and injurious currents of air, as in certain 
valleys; from the midst of woodland (and a sufficient clearage should be 
effected); from the adjacency of stagnant waters, and, lastly, above the 
level of the mist or vapor, which consist doubly of the precipitated and 
continued exhalation from the soil, and which is readily distinguishable, 
in marshy districts, especially, by the dense white fog, which lies like a 
separate atmosphere, at an elevation of a few feet above the flat soil, after 
sunset. 

This subject has lately attracted much attention in the more populous 
countries, and is, therefore, of particular import to the colonist who may 
have to select the site of his own habitation. 

HOMCEOPATIIIC MEDICINAL PREVENTIVE RESOURCES. 

No medicine, unless its action upon the human organs be analogous 
to disease, can be really, truly, and invariably preventive. The preventive 
measures, as regards the employment of medicinal agents, consist, in the 
repeated administration, usually in somewhat large doses, at intervals 
approximately of twelve hours, of one or more of such remedies, (for alter- 
nation is occasionally requisite,) as most closely assimilate in their specific 
action, and according to the indications stated for their selection in the 
case of each particular disease, or which, in combination, by alternate 
administration, most completely embrace the distinctive characteristic 
features of disease, when it assumes an epidemic, or even a local preva- 
lence. The first point is, therefore, to refer to the article hereinafter 
devoted to the treatment of such particular disease, whereby, to ascertain 
the principal remedies quoted, whether any, either singly or in combina- 
tion, (by alternate administration,) are described as direct specifics, and 
then compare that remedy with all the symptoms, by aid of the "Eeper- 
tory." 

If, under the head of the particular disease, one or more remedies, 
under certain circumstances, and qualified by the presence of certain 
symptoms, are announced direct specifics, they will, doubtless, when early 
employed, be the unerring preventives or modifiers of the disease. Such, 
for instance, as vaccination against smallpox, which should be repeated, if 
many years had elapsed since the former operation, or which should not 
fail to be resorted to by those who have not been previously vaccinated: 
Bellaloxna against Scarlet Fever, China and Lobelia (chiefly) against 
Marsh Intermittent Fevers; Mercurius-Corrosivus against Dysentery, 
especially red Dysentery ; Bryonia and Rhus-Toxicodendron and Arsenicum, 
against some varieties of typhus; Cuprum-Aceticum, Camphor and Verat- 
rum, against Cholera and Diarrhoea, respectively, or against excessive and 
sudden relaxation, with spasmodic pains and cramps, when the diseases just 
named are prevalent; Aconitumand Pulsatilla, against measles; Aconitum, 
Belladonna and Hyoscyamus, in cases and particular localities, in which 
inflammatory fever, with prominent affection of the brain, becomes 
prevalent, and similarly occurs amongst numbers of persons at once. 
Bryonia, in cases and particular localities, in which inflammatory 
fever, with prominent derangement of the stomach, appears. Carbo- 
veg., etc., against scurvy, (see also "Eradicative Treatment.") Sabina 
and Secale, etc., against imminent miscarriage, (see also "Eradicative 



104 ADMINISTRATION OF MEDICINES, ETC. 

Treatment," for cases in which this casualty becomes habitual). 
Camphor against severe colds, (influenza,) when they are what is 
termed going through the house. In fact, every remedy, as applied to the 
treatment of a particular disease, after it has set in under a particular 
aspect, is equally applicable to the preservation, when the current com- 
plaint bears a similar stamp. 

The Doses of preventive remedies should usually be repeated at inter- 
vals of about twelve hours, until a degree of medicinal action has set in, 
when the course may be considered complete; but the action thus excited 
must be watched, lest it should occur that the prevailing disease (in a 
modified degree) has supervened. 

eradicative treatment. 

No cure can be complete, where there is a latent constitutional taint, 
without proper eradicative treatment. Scrofula, in one shape or 
another, or complicated with other diseases, may be considered as the pre- 
disposing cause of susceptibility to the recurrence of every disease, that is, 
as the great parent of disease, and the most common source of the malig- 
nity and fatality of other diseases, when not itself the fell destroyer. 

Eradicative treatment is applicable to the removal or subjugation of 
defects in constitution, habit of body, or temperament, which operate con- 
tinually, not only as the predisposing causes of every prevalent disorder, 
but also as the complicating accompaniment of every disease; or, on the other 
hand, which resolve or threaten to resolve, themselves into organic decay, 
by attacking one or more of the important organs of life, especially. 
Eradicative treatment is also applicable to the extirpation of those slow, 
latent, or occasionally more active chronic diseases which are gradually 
sapping the constitution, and which would otherwise finally result in 
general disorganization, but which have not hitherto permanently destroyed 
the functions of any important organ of life. 

The space, which is necessarily confined in a work of this kind, will 
not admit of great detail, nor, indeed, could a whole volume, such as this, 
exhaust the subject, if compressed within the narrowest compass. We 
have the intention, therefore, of confining our remarks to such general 
relations, as may afford some idea of the mode in which the treatment is 
conducted, subject to the regulations severally laid down under the head 
of each disease (in the subsequent parts of this work,) or, as it would then 
appear, in the character of a symptom, development, or manifestation of 
a more deeply-seated diseased condition— in conformity with the nature 
of the parent disease. 

The reasons for suspecting, and the grounds for ascertaining the exis- 
tence of such parent disease, will be gathered from the article on "The 
Investigation of the Patient," particularly if due regard be paid to par- 
entage (including near relations — uncles or aunts); to the part or organ 
most susceptible to the action of morbid influences, transitions of climate, 
the nature of the locality generally inhabited, the diseases which most 
frequently affect the patient, and the inveterate or peculiar or dangerous 
Form, which all maladies affecting the patient, assume. Of these, the 
question of parentage and near (blood) relations involve the most impor- 
tant and weighty considerations, as thence we may derive the origin of 
scrofulous habits of body, in all their varieties of combination, compli- 
cation, and development. 



ERADICATIVE TREATMENT. 105 

Indeed, we may not improperly attribute every family defect of con- 
stitution, or every manifestation of a latent constitutional taint, which 
appears with greater or less intensity in several, or pre-eminently in one* 
of the members of a family, to an unwholesome or scrofulous inheritance. 
Thus to Scrofula we may attribute, amongst other derangements, Rickets, 
or enlargements and curvatures of the bones, and decay or exfoliation ->f 
the bones, resulting from comparatively trivial circumstances; chronic 
disease of the skin, or extreme susceptibility to the development of mor- 
bid appearances of the skin, of an endless variety, or especially to erup- 
tions of the nature of tetters, to ringworm, etc ; imperfect construction 
of the brain; and imbecility, or prevalence of susceptibility to derange- 
ments of the mind, especially if complicated with glandular swellings or 
their cicatrices; torpid, or usually painless ulcerations, frequently char- 
acterized by a degree of putrescence, and commonly discharging a thin, 
watery, corrosive fluid; or which, if somewhat quickly dried up in one 
part, are usually developed in some other; affections of the lining mem- 
branes, in general (as of the stomach and bowels, air passage, etc.); 
habitual or long continued discharges of thin, watery fluid from any 
parts, as the result even of very slight causes of irritation, manifesting a 
deficiency of vigor in the membranes, to which may also be appended 
obstinate or continuous whites, and chronic discharges from the ears; 
chronic inflammatory affections of the eyes and eyelids, qualified by dis- 
charge of very adhesive gum, and continual adhesion of the lids in the 
morning, by excessive susceptibility to the action of currents of air, or 
to irritation by reading, by excessive or even continual flow of tears, 
or susceptibility to watery eyes, by excessive sensibility of light; or, 
again, habitual susceptibility to styes; chronic inflammatory and sup- 
purative affections, or chronic enlargements or indurations, of gland- 
ular parts in general: as, for instance, of the neck and under the 
jaw, the groin, the armpits, etc.; or abscesses; chronic enlargement 
and habitual hardness of the belly; the prevalence of water on the 
brain, water on the chest, dropsy of the belly, or general dropsy in more 
than one member of any family; the like of what is called tubercular 
consumption, or of organic affection of the mesentery, or of unaccount- 
able emaciation and gradual decline; worms, when they are evidently 
generated in consequence, not of casual circumstances, but of an inherited 
defect of constitution. 

The Accessory Means adapted to the eradication or modification of 
scrofula, are, amongst others: 

1. Diet— the most important consideration of all— which should be 
always as nourishing, in relation to its bulk, as much compressed or 
reduced in bulk,aslightandeasyof digestionandas regularly administered 
as possible — sometimes frequently, but in small quantities at a time. An 



* Parents (or a parent) possessing the semblance of sound health, may yet carry the germs of scro- 
fula in the system, and consequently be capable of transmitting the disease to the offspring; hence the 
necessity for inquiry irto the health of blood relations. Again, although there may not be any hered- 
itary taint in the family of cither parent, the capability of giving a scrofulous constitution to the off- 
spring m:»y be acquired by too early or too late a contraction of marriage, by disproportioned marriages, 
(as to relative age*,) by parental excesses, etc , and by any cause which may tend to injure the constitu- 
tion of one or both parents— as improper or insuffinent food, impure air, etc. Lastly, the germ of 
bcrofnla may be transmitted to an infant by the milk of a scrofulous, or otherwise diseased nurse. 



106 ADMINISTRATION OF MEDICINES, ETC. 

equal proportion of animal and vegetable food, or vegetable food pre- 
pared with a fair proportion of the pure gravy of sound and wholesome 
meat. Roasted meat in preference to any other — especially mutton and 
beef. Eggs, when found to agree, lightly boiled (soft), and eaten with a 
fair proportion of good, home-made, stale, wheaten bread, but not in com- 
bination with other ingredients. Sometimes milk (when it does not dis- 
agree, as is sometimes the case in particular instances.) Of beverages, 
water is the only fluid which is universally safe. Stimulants, of all kinds, 
should usually be strictly avoided. 

2. Air is second only to diet, in the treatment of scrofulous habits; 
pure country air, in a healthy, dry, rather elevated situation, not exposed 
to the prevalence of bleak winds ; free access and circulation of air within 
doors, in all apartments inhabited, and, particularly in the sleeping 
room ; as great a proportion of the day time as possible, without severe 
fatigue, particularly in fine or favorable weather, should be spent in the 
open air. 

3. Exercise should be as free and unrestrained as is consistent]with 
the avoidance of excessive fatigue, or any of its consequences, and with 
due precaution that check of perspiration does not occur; no person 
should remain uncovered, or even still, for some time after strong exer 
cise; proper protection of the skin from the arrest of transpiration and 
gentle motion are indispensable; nor should strong exercise in the open 
air be resorted to in extreme conditions of temperature, and especially 
when there is great moisture in the ground, and, consequently, much 
exhalation. But when exercise cannot, owing to extremely unfavorable 
weather, be consistently obtained out of doors, it should be sought in 
doors. With these, and other like precautions, active sports, appropriate 
gymnastic or calisthenic exercises, and every such occupation as calls the 
muscles and sinews into play, will go far to promote a vigorous operation 
of all the organic functions. 

4. Water, used not only in the sense of ablution, or cleansing, but 
for the purpose of promoting a healthy action of the skin. The cold fresh 
water bath should be used daily, (in the absence of particular reasons for 
abstaining) either in doors or out of doors, according to circumstances, 
with due regard to the precautions mentioned under the head of the 
" bath,'' and to the habitual temperature of the body, (which at the time 
of bathing should, if possible, neither be above nor below the natural 
standard,) and with careful observance of the process of brisk friction 
afterwards, and of avoiding permanent chill. Washing and rubbing the 
body, especially, the chest, stomach, and neck, daily, first with a coarse, 
wet towel, and then with a coarse, dry one, will frequently form a good 
substitute for the bath. 

5. Cleanliness of person, dwelling, clothing, bed clothes, etc., is 
imperative. If it be possible, the clothes, both of the person and bedding, 
should be frequently changed ; the bed itself, even, should be frequently 
emptied, purified, and replaced, feather beds being wholly objectionable; 
and the greatest precaution should be observed against the use of damp 
apparel or bedding. 

6. Habits of Regularity, mental, moral, and physical, should be 
strictly observed ; excesses of all kinds are prejudicial; mental or moral 



ERADICATIVE RESOURCES. 107 

excitement should be as much as possible avoided; the habitual observ- 
ance of duties, as tending to obviate irregular habits, on the one hand, 
and evil consequences, on the other, is not to be overlooked ; a proper 
degree of mental and physical occupation, without either undue physical 
exhaustion or excessive mental application, and, above all, in a method- 
ical and regular manner, is indispensable; a proper proportion, without 
excess, of rest, or without indulging an indolent disposition, is to be 
enforced. (See %t Investigation of the Disease,'' part "Rest.") 

Regular hours, and hours consistent with the natural division of 
night and day, should be observed, and the contrary strictly avoided; 
gloomy thoughts should, as much as possible, be dispelled by averting 
the attention to interesting occupations, but not by recourse to excite- 
ment ; frequent change of scene is often very advantageous to those who 
have means to procure it, but this should be understood of changes which 
do not occasion great excitement. 

HOMOEOPATHIC MEDICINAL ERADICATIVE RESOURCES. 

In cases in which an inherent defect of constitution either provokes 
the development of particular diseases, or appears in complication with 
them, we not uncommonly find that remedies which, in every respect, 
correspond with the symptoms, and which would, under other circum- 
stances, operate as specifics, are repeatedly andministered without the 
least apparent effect. The reconsideration of the symptoms having more 
than once confirmed our selection, we should turn our attention to more 
deeply-seated causes which are present to thwart us. It is obvious, that 
the presence of inherent constitutional defects may occasion external 
appearances in disease, which are especially susceptible of erroneous infer- 
ences, and, therefore, without this very important clue, the special direc- 
tions for the treatment of any particular disease may frequently tend to 
discourage the unprofessional reader. 

In every case of disease, therefore, in which a remedy, after repeated 
reconsideration and ineffectual administration, is still apparently homoe- 
opathic, or analogous to the manifestations present, I would beg of the 
reader to investigate very closely all details of parentage, antecedent cir- 
cumstances, etc., (as above stated,) in order to ascertain the indication of 
inherent taint, whether strikingly apparent, or extremely remote and 
obscure, and, as far as in him lies, to make a judicious selection from 
eradicative remedies, such as Sulphur, which is, especially appro- 
priate when there are chronic affections of the skin; Calcarea-carb, when, 
the glands, in general, are particularly affected ; Mercurius, when the 
boxes are prominently involved, unless this be traced, immediately, to 
abuse of mercury, in which case, Nitric-acid will be particularly useful, 
or, perhaps, Hepar-snlphuris may be required; or, again, Mercurius, when 
the salivary glands are, especially, involved, saving under the excep- 
tional condition just named ; Carbo-vey., against what are termed scorbutic 
complications; Sabina and Secale occasionally, generally, however, with 
an occasional course of Sulphur against predisposition to miscarriage. 
These are only to be considered as a few general suggestions ; but I would 
further add, with respect to 

Suljrfiur, that repeated occasions in which I, in common with 
many other homoeopathic practitioners, have employed this medicament 



108 ADMINISTRATION OF MEDICINES, ETC. 

under the circumstances above detailed, and when the remedies seemingly 
appropriate to the external evidences of disease had signally failed, have 
confirmed its pre-eminent utility. Very often, after the patient had been 
submitted to a few doses of Sulphur, the dormant susceptibility of the 
system becomes awakened, and a subsequent return to the particular 
and appropriate remedy which had hitherto failed, has been attended 
with the most decided benefit. In cases in which the constitutional taint 
is deeply seated, or very virulent, a long course of such alternations 
becomes necessary, continually returning to one or more doses of Sulphur, 
when the effect of other remedies becomes less apparent, and again 
employing the intermediary remedies, or those appropriate to special 
indications as before, if still required. In many cases, it is either highly 
beneficial or absolutely necessary, in treating chronic diseases of all kinds, 
to commence with aconsecutive courseofSulphurinsingledaily doses, con- 
tinuing for a week or ten days, or until a more or less distinct degree of 
medical action has set in ; then pausing for about four days to watch the 
subsidence of such medicinal action, or to detect any particular symptoms 
requiring an intermediary remedy, or, sometimes suspending treatment 
for several days, or even weeks. 

These variations of treatment must be subject to the discretion and 
judgment of the administrator, because no two ewes are strictly analogous, 
and, therefore, a rule would be merely one of many exceptions. So long, 
however, as greater activity of the skin, etc., is manifest after a course of 
Sulphur, it will be advisable to pause in the administration. If there be 
intermediary and distinct symptoms, not appertaining to Sulphur, but 
identifying a special remedy, it should be given till such particular symp- 
toms are subdued. Or, so long as general improvement makes steady 
progress, however slow, it will be advisable to abstain from repeating the 
doses of Sulphur, resuming the administration, however, immediately 
the malady becomes stationary or retrogressive. If acute or active disease 
has supervened, and yielded under the influence of intermediary or 
special treatment, we are not to consider the cure complete, but should 
return to extended courses of Sulphur at remote intervals. By persever- 
ing in such treatment, the most obstinate chronic diseases, short of actual 
organic decay, are overcome; and even if actual organic decay has set in, 
we have frequently found means to arrest its progress, and to prolong 
existence, and even comparative health, for a surprising length of time. 

The Doses.— As a general rule, the recurrence of the administration 
should take place once in twenty-four hours, namely: the first thing in 
the morning, fasting. The quantity should be sufficient to develop slight 
medicinal action, which is usually essential to the eradication of deeply- 
seated disease, but avoid the error of plunging into extremes. Eight pills 
daily. 

General conditions and injunctions respecting eradicative treatment. 
It is natural that the vigor of animal, as of vegetable life, is in the ascend- 
ant in the spring, and in the decline at the fall ; it, therefore, follows that 
the spring will be the season, in which eradicative resources, backed by 
the greater buoyancy of the vital energy, will be most successful. I 
would also strongly enjoin every person who has occasion to undertake 
the treatment of disease, characterized by conditions of the nature above 



RULES FOR DIET. 109 

detailed, above all things not to be discouraged, but, so long as all circum- 
stances correspond to identify the accuracy of his treatment, to persevere 
steadfastly, assured that, especially if the patient does not lose ground, he 
is pursuing a course towards ultimate success. 

"When a mother has given birth to one or more sickly children, she 
ought to undergo a course of constitutional treatment forthwith, even 
though she may again have fallen into the pregnant state. In the latter 
case, however, somewhat more than ordinary caution is required in 
Avatching the progress of treatment. 



SYXOPSIS OF THE RULES FOR DIET, UNDER TREAT- 
MENT. 

ALIMENTS ALLOWED. 

Soup or broth (in special cases of illness or indisposition) made from 
the lean of beef, veal, or mutton; to which may be added well-boiled 
sago, tapioca, vermicelli, rice, semolina or macaroni, pearl-barley, and 
sometimes carrots, young peas, or cauliflower, seasoned merely with a 
little salt. 

Meats and animal products. Mutton, beef, lean pork of good quality; 
in a few exceptional cases, in which it is known not to disagree, (poultry 
rarely, except in particular cases,) pigeons, larks, rabbits, (venison, and 
game in general, may, if tender, in most cases, be partaken of in moder- 
ation, but never when high,) plainly cooked and roasted, stewed or 
steamed in preference to boiled; further, soft-boiled eggs, good fresh but- 
ter and curds. 

Fish (occasionally). Soles, whiting, smelts, trout, cod, haddock, mul- 
let, perch, turbot, oysters and flounders, boiled, in preference to fried; 
when cooked in the latter manner, the white must alone be partaken of, 
and the outer, or fried portions rejected. 

Vegetables. Potatoes, brocoli, green peas, cauliflower, spinach, mild 
turnips, carrots, parsnips, French beans, beans, seakale, vegetable marrow 
stewed lettuce, well cooked, and prepared with the gravy of meat, where 
required, instead of butter. 

Condiments. Salt and sugar in moderation. 

Bread. All kinds of light bread, not newly-baked; and biscuit, free 
from soda, potash, and the like ingredients. 

Liyht puddiwjs, such as those made from vermicelli, semolina, corn 
starch, sago, arrow-root, rice; macaroni (without cheese,) simple cakes, 
composed of flour or meal, eggs, sugar, and a little (jood butter. 

Fruit. Baked, stewed, or preserved apples and pears ; also gooseber- 
ries, raspberries, grapes, or any other fruit not of an acid quality, fully 
ripe, preserved, or in the form of jelly, may occasionally be partaken 
of. 

Bcceraye. Water, toast-water, sometimes milk, milk and water, cocoa, 
chocolate (unspiced), arrow-root or gruel, made thin, barley-water, sugar 
and water, rice-water, and weak black tea, in cases where it has long been 
taken habitually, and has not been productive of injurious effects. 

Salt should be used in great moderation. 



110 ADMINISTRATION OF MEDICINES, ETC. 

ALIMENTS PROHIBITED. 

Soups. Turtle, mock-turtle, ox-tail, giblet, mulligatawny, and all rich 
and seasoned soups. 

Meats. Pork, (except in instances named as allowable,) bacon, calf's 
head, veal, turkey, duck, goose, sausages, kidney, liver, tripe, and every 
kind of fat meat. 

Fish. Crab, lobster, and shellfish in general ; and almost all other fish 
not specified amongst the aliments allowed, as likewise all kinds of salted, 
smoked, potted or pickled fish. 

Vegetables. Cucumbers, celery, onions, radishes, parsley, horse-radish, 
leeks, thyme, garlic, asparagus, and every description of pickles, salads, 
and raw vegetables, or vegetables greened with copper. 

Rich or high seasoned made dishes. 

Pastry of all kinds, whether boiled, baked or fried. 

Spices, aromatics, and artificial sauces of all kinds, as also the ordinary 
condiments, mustard and vinegar, must be used in moderation. 

Cheese. 

Chestnuts, filberts, walnuts, almonds, raisins, and indeed the entire 
complement of a dessert, except what has been mentioned amongst the 
aliments allowed, under Fruit. 

The above regulations are subject to considerable modifications in par- 
ticular cases, both as regards the aliments allowed, and those which are 
prohibited. When it is necessary to make a very material alteration in the 
diet and habits of a patient, it ought, in general, to be done gradually and 
cautiously. Regularity in the hours of meals should be observed; and too 
long fasting, as well as too great a quantity of food at one time, should be 
avoided. 

o 

ACCLIMATION, OR ACCLIMATIZATION. 

The process by which an individual or a species, on being removed to a 
different climate, becomes modified in constitution, and adapted to the 
changed conditions. The two words, however, are not strictly synonymous. 
Acclimation is generally used in speaking of particular individuals, and 
more especially of those belonging to the human species, and refers to the 
alterations which the system undergoes spontaneously in a foreign climate, 
by which it at last becomes no longer subject to the maladies peculiar to 
new comers. Acclimatization, on the contrary, expresses the artificial care 
by which man succeeds in naturalizing, under his own supervision, a 
species of animals or vegetables of exotic origin. Man inhabits all 
the zones, and nearly every region of the earth, and has been 
enabled, in repeated migrations, to change the place of his habitations, and 
to occupy new countries. The human species is, therefore, regarded as 
cosmopolitan; and yet, two facts are important to notice, in this respect. 
First, most of the great migrations, historic or traditional, have been made 
in tVe direction of longitude, and not in that of latitude; the migrating 
tribes instinctively, or intentionally, keeping nearly within the same par- 
allels of latitude, and consequently not suffering very great alterations of 
temperature, nor meeting in their new homes with a flora and fauna very 
dissimilar to those of their native country. Secondly, at the present day, 
although an individual may migrate, either westward or eastward, as a 



ACCLIMATION, OR ACCLIMATIZATION. 



Ill 



general rule, without suffering from the change, a removal into a different 
latitude is almost always accompanied with peculiar clangers during the 
first few years of residence in the new locality. The most marked instance 
of this kind is, when a person from the temperate zone visits, for the first 
time, to a tropical or subtropical region. The dangers that first beset him 
are fevers, which are so marked in type, and so ready to attack newly 
arrived immigrants, that they are sometimes called the " strangers' " fever. 
The yellow fever of the West Indies and southern United States, and the 
coast fever of Western Africa, are well known examples of these affections. 
They are not absolutely restricted to new comers, the natives being also 
subjected to them, but the recent immigrant is so much more likely to be 
affected, and is attacked by the disease in so much larger proportion, it is 
evident that his system has in it something which offers a peculiar attrac- 
tion for the febrile poison, and which does not exist, at least to the same 
extent, in that of the native or old resident. After passing through a 
period of general ill health and debility, extending over some years, and 
perhaps one or more severe attacks of illness, the immigrant approximates 
in his appearance and habit of body, to the older denizens of the place, and 
is no longer peculiarly liable to disorders, which affected him on his arrival. 
He is then said to be acclimated. No doubt, part of the immunity enjoyed 
by old settlers, in a tropical or subtropical climate, is due to the fact that 
they have learned prudence, in regard to exposure, and have come to regu- 
late, habitually, the mode of life to correspond with the climate of the 
country. Recent immigrants often neglect these essential precautions 
because they have not found them necessary in a temperate climate ; and 
it is only after repeated experience of their value, that they come to adopt 
them habitually, and as a constant protection. 

Posterior View of the Heart, Lungs, 
Trachea, and Larynx. 



1. 

2, 3. 
4. 

5, G. 
7, K, 9. 

10, 11. 
12, 12. 

13. 
Ik 
15. 
18. 
1G. 

17. 
19. 
20. 
21. 
24. 
22, 23. 

25, 2G. 
27. 



Epiglottis cartilage. 

Arytenoid muscles. 

Trachea, with its mu- 
cous f 'Hides. 

High i and left bronchi. 

Right lobes of the 
lungs. 

Left no. 

Their base. 

Heart. 

Aorta. 

Left subclavian artery. 

Right do. 

Left primitive carotid 
do. 

Right do. do 

Vena cava desce 1 dens. 

Bight vena innominate. 

Bight subclavian vein. 

Left do. 

Bight and left jugular 
veins. 

Pulmonary do. 

Pulmonary artery bi- 
furcating as it enters 
the left lung. 




112 BRAIN AND SPINAL CORD. 

SECTION OF THE HEAD AND NECK. 

The opposite cut shows the head and part of the spinal cord cut through 
the centre, showing the relative position of all the parts as they are placed 
in a healthy person of normal development, the left eye being cut around 
showing it in its natural position. 

The skull, composed of a number of bones and covered by the scalp above, 
contains the brain , traversing which may be seen the arteries (ribbed lines), 
which carry blood to the various portions of the brain. Above is the Cere- 
brum, occupying the entire upper portion of the skull. In this part of the 
brain is the seat of all knowledge, and the size of this part as compared with 
the lower orders of animate life, constitutes one of the most important physi- 
cal differences between man and the lower animals. In the lower back portion 
of the skull is the Cerebellum, in the centre of which in the illustration is 
the letter D. This is the seat of our animal life, instincts and passions, and 
is in man smaller in comparison than in many of the lower animals. 

Extending down from the brain inside of the back-bone (spinal column) 
is the spinal cord, which has its origin in the Medulla oblongata, inside the 
skull and in front of the Cerebellum, and extends the entire length of the 
back-bone ; the spinal cord is really in some sense an extended portion of 
a part of the brain, and from it branches out at different points through 
little holes (foramens) in the bone a large number of the nerves that supply 
various parts of the body. 

Inflammation of the brain and spinal cord in an intense acute degree is 
what we know as Spotted Fever, or Cerebro Spinal Meningitis. The 
large fan-shaped muscle bearing the numbers 10, 11, 26, is that which enables 
us to use the tongue so freely and for such varied uses— would they were 
always good. Downward and rather below the base of the tongue is seen 
the Trachea, commonly called the "windpipe;" letters Y, Z, Z, distin- 
guish it ; and back of this next the spinal column or back-bone is the 
(Esophagus, " Gullet " or food-passage to the stomach. In the lower part of 
the cut may be seen a portion of the aortic arch or large artery, that carries 
the blood from the heart ; also, some of the arteries which carry the blood to 
the head. The Eye is beautifully shown with its surrounding blood-vessels 
and larger nerves and muscles. And at K is the location of disease of the 
bone present in many cases of severe Nasal Catarrh. 




SECTION OF THE IIEAD AND NECK. 



JPART SECOND. 

DISEASES OF THE BRAIN, THE SPINAL CORD, 
AND THE NERVOUS SYSTEM, GENERALLY. 



CHAPTER VI. 

MENINGITIS CEREBRO-SPINALIS. 



SPOTTED FEVER— CEREBROSPINAL MENINGITIS. 

This disease has appeared in various parts of the United States and 
Europe, as an epidemic. It is of a most serious, and often, malignant 
character. The symptoms are not constant, but vary in each epidemic; 
indeed, the variation is so great, that of the reports of some thirty physi- 
cians, which we have consulted, we find no two alike. Our own experience 
in this disease, is confined to three cases of undoubted spotted fever, two 
of which recovered, the third coming into our hands after the disease had 
continued five days, and the patient was then dying. We will, therefore, 
in view of our own inexperience, transcribe the symptoms, as given by 
Professor Felix Niemeyer, of Berlin, in his exhaustive report of the epi- 
demic in the Grand Duchy of Baden, 1865, and. after that, the symptoms 
as given by Dr. Bushrod TV. James, of Philadelphia, as he observed them 
with his very extensive opportunities in the United States. 

Symptoms, by Niemeyer: "Without any other precursory symp- 
toms, the patient is at once attacked with a chill, attended with violent 
headache and vomiting. The headache speedily increases in intensity, 
the patient becomes exceedingly restless, tosses about, the pupils remain 
contracted, the sensual consciousness remains unembarrassed. The pulse 
rises to eighty or one hundred beats per minute.. At the end of the first, 
or on the second day, much less frequently at a later period, we notice 
that the head is somewhat drawn backwards; the patient continues to 
complain of violent headache, and the pain spreads from the head to the 
back of the neck, and to the back. The restlessness becomes excessive, 
the thoughts of the patient become confused, the pupils remain con- 
tracted, the abdomen caves in, the bowels are constipated. The frequency 
of the pulsations and respirations now increase to about one hundred and 
twenty, of the former, and upwards of seventy of the latter, per minute; 

8 " 3 



114 SPOTTED FEVER. 

the bodily temperature continues moderately low. In the course of the 
third and fourth day, the tetanic spasms of the posterior cervical and dor- 
sal muscles become more and more prominent, and patients are, some- 
times, attacked with lock-jaw. Opisthotonus (bending backward) super- 
venes with an extraordinary degree of intensity ; the consciousness is 
gone, but the patient still continues to toss about in bed, the pupils still 
continue contracted, the bowels constipated, the abdomen sunken; the 
urine is discharged involuntarily, or else the bladder remains distended, 
and the urine has to be drawn off with a catheter. The patient now 
lapses into a profound stupor, (unnatural sleep,) the moaning breathing is 
accompanied by a rahl (rattle,) and death takes place with the phenom- 
ena of an acute oedema of the lungs (collection of a liquid serum in the 
lungs, so as to fill them up)." (I dislike Niemeyer's use of the word oede- 
ma, here.) " This picture of the disease is, sometimes modified by the 
occurrence of a short preliminary stage, which is marked by slight pains 
in the head and back, or by the breaking out of herpatic vesicles (erup- 
tion of blisters,) or of scattered, dark-colored, roseola (red) spots on the 
first, second, or third day of the disease, or else the above described symp- 
toms develop themselves in a much shorter period, which circumstance 
constitutes one of the most important modifications of the disease; so that 
the consciousness vanishes, even on the first day of the attack, and a vio- 
lent tetanic spasm (spasm with unyielding stiffness) of the back of the 
neck, and back, begins; or, finally, may set in with such violence that a 
fatal termination of the disease is reached, even on the first or second 
day. This cursory picture of cerebro-spinal meningitis, and of the gen- 
eral course of the disease, applies, indeed, to most, but not by any means, 
to all cases of the epidemic. This picture does not comprehend phenom- 
ena that occur in a variety of cases, such as: deafness in one or both ears, 
diplopia (double vision) from a diseased condition of the optic nerves, 
ptosis (palsy of the upper eyelid), softening and destruction of the cornea 
(front coating of the eye), and, finally, paralysis of the facial nerves and 
of the extremities, either on both or only one side of the body.'' 

Symptoms as quoted by B. W. James, M. D., from experience and a 
careful study of the disease, as it has appeared in the American epidem- 
icsi In many of the epidemics, prostration appears to have been a very 
prominent symptom : 

" It sometimes sets in, with such a sudden violence, that persons who 
were afflicted with heart disease, dropped down dead in the street, incon- 
sequence of the sudden shock. This happened in a number of cases. 
Many persons died twenty-four or forty-eight hours after being seized with 
the chill. Persons overtasked with labor would very often die in four- 
teen to sixteen hours from the chill. The general features of the disease 
were: vertigo, with headache; diarrhoea, sometimes of a very prostrating 
character; in other cases, diarrhoea alternating with constipation; mod- 
erate fever; flashes of heat, mingled with creeping chills, piercing pain 
through the head, soreness and stiffness of the upper portion of the spine, 
with aching pains in the spine, or tingling soreness and tenderness of the 
skin, severe muscular pains, numbness of the limbs, with partial paral- 
ysis; spasmodic twitchings of the muscular system, sometimes amounting 
to tetanic convulsions, with lock-jaw; the consciousness not much affec- 



THE BRAIN AND NERVOUS SYSTEM. Ho 

ted, except when the disease is at its bight, when a more or less active 
delirium, and, finally, coma and death set in. In most cases the eye 
looked injected and red, and the hearing was impaired; the pulse had a 
moderate frequency, generally, about one hundred per minute, the tongue 
remained moist, and in the course of the disease, became covered with a 
dark, brownish fur; the breathing was somewhat accelerated and inter- 
rupted by moaning inspirations; during the tetanic spasms, the expira- 
tions had a hissing sound, the air seeming to be forced out with an effort, 
the skin has a peculiar bluish pallor in this disease, owing to the general 
turgescence of the venous system; the spots which have given to this dis- 
ease its name, spotted fevek, broke out on different parts of the body, 
generally however, on the chest, abdomen, an I thighs ; sometimes the 
skin had a mottled appearance, or the spots looked like measle spots, or 
had a rose colored-tint. One hour the patient will seem quite well, and 
the next the most alarming symptoms may be present." 

Treatment. — Give, as soon as the nature of the attack is known, a 
good, full sweat; the hemlock sweats, of easy application, where hemlock 
branches are obtainable, are always efficacious. Two teaspoonfuls of best 
alcohol to four of water ; one teaspoonful of this solution every half hour, 
until there is a decided abatement of the symptoms. In cases threaten- 
ing immediate dissolution, the dose may be doubled for a short time. 

ALLOPATHIC TREATMENT.— This disease is an essential fever, 
attended with inflammation of the membranes of the brain and spinal 
cord; hence its name. It is popularly called spotted fever. The disease is 
very fatal, in some epidemics reaching as high as four-fifths of all the cases, 
in other epidemics, not over one-fourth of the cases die. 

The bowels should at once be unloaded, but beyond that, purgation 
should not be practiced. Ice, in bladders, may be applied to the head and 
spine, if agreeable to the patient, otherwise they should not be used. The 
cold or warm wet pack, according to the degree of fever, should be used 
once a day. If the temperature is one hundred and four degrees, or over, 
the pack should be cold If not so high as this, cool sponging of the skin 
will suffice. When the pack is used, the patient is to be wrapped in a 
sheet wrung out of water, and then enveloped in blankets. In about an 
hour, free sweating occurs. The pack is then removed, the patient wiped 
dry and placed in bed. 

Opium should always be given to the extent of relieving pain. This is 
the most useful known remedy in this disease. The physician will obtain 
the best results by the hypodermic use of morphia. When effusion has 
taken place, and there is stupor and insensibility, the usefulness of Opium 
is at an end. Ergot is the remedy calculated to diminish the congestion of 
the cord, an I should be given in large doses; a teaspoonful of the fluid 
extract, every six hours, is a good rule. In the beginning of the disease, 
Quinine is useful in controlling the fever and inflammation. If, however, 
a single large dose — twenty grains— is not followed by benefit, it should 
not be repeated, unless malarial diseases exist. In the cases having high 
fever, the Fluid Extract of Oelseminum, given in five-drop doses, two or 
three hoars apart, will be found useful in moderating the action of the 
heart, and producing a general calm. 

Ice, acid drinks, cold tea, and lemonade, should be freely allowed to 



116 SPOTTED FEVER. 

relieve thirst. Milk, eggs, and nourishing broths should be given in suffi- 
cient variety and quantity to maintain, as far as possible, the strength of the 
patient. In case food is not taken, from vomiting or other cause, nourishment 
should be given by injecting into the rectum; half a pint of strong beef 
tea with two or three tablespoonf uls of rich cream, or a half teacup each 
of beef essence and milk, can be given two or three times in the twenty- 
four hours. The injected nourishment should be caused to be retained 
by pressure upon the anus with a napkin or towel. Stimulants should be 
avoided until the symptoms denote that the vital forces are beginning to 
fail, and just in proportion to this failure, are they demanded. Their bene- 
ficial effect is shown by a fuller, stronger, and more regular pulse and 
reduced febrile and nervous excitement. A tablespoonful of whisky or 
brandy, from one to three hours apart, is a good rule, varied according to 
the judgment of your physician. 

In Spinal Meningitis (inflammation of the membrane of the spinal 
cord,) the principles of treatment are the same as is given for acute Men- 
ingitis-Cerebral. The disease generally proves fatal within a week. 

HOMOEOPATHIC TREATMENT.— Gelsemimim, if indicated and used 
at the very beginning of the disease, will never disappoint us. It is 
indicated by the following symptoms : Severe chill, followed by conges- 
tion of the brain and spinal cord, dark red cheeks, dilated pupils, very- 
little, if any thirst, perfect loss of strength, especially of the legs, with 
staggering gait, impeded speech, icy-cold hands and feet, pulse very weak, 
if perceptible, difficult and weak breathing, nausea and vomiting, eyelids 
close in spite of all the patient can do to prevent it; sweating relieves 
inability to direct the movements of the limbs with accuracy, the men- 
tal powers remain active. 

Dose : Six pills dissolved in a tablespoonful of water, of which give 
two teaspoonfuls every fifteen to thirty minutes, until there is 
improvement and sweat, or the symptoms indicate some other of 
the remedies here mentioned, in preference to this. 

Belladonna is indicated by stupefying, stunning headache, from 
the neck into the head, with heat and pulsations in it ; inclined to bend 
the head backward, even before spasmodic action is shown in any other 
part of the body; it relieves the pain; spasmodic bending the head back- 
ward ; convulsive shaking, distortion by spasm of the face and lips, grind- 
ing of the teeth, inclination to bite, the urine retained, or involuntary 
discharge, heat of the upper part of the body and coldness of the extrem- 
ities, hightened sensibility of all the senses, renewal of the spasm by 
touch or light. 

Dose: Six pills, as just directed for Gelsemimim. 

Cicuta Vir, Vertigo, with reeling, moaning, and howling ; grind- 
ing of the teeth, double vision, pupils dilated or contracted ; dumb, deaf, 
great difficulty in breathing or swallowing, ashy paleness or bluish puffed 
face, cramp in the muscles of the back of the neck, with inability to move 
the head after it has been turned in any direction, trembling of the 
limbs, convulsions with cries, pressing together of the jaws, numbness 
and distortion of the limbs, forcible and involuntary bending of the 
body backward; violent, sudden jerks through the head, arms, and legs; 
after fits, insensibility and immobility ; pain in the stomach, with vom- 
iting, abdomen painfully puffed. 



THE BRAIN AND NERVOUS SYSTEM. 117 

Dose : Eight pills or two drops of the medicine in a little water, every 
twenty minutes to one hour. 

Hyoscyanius. Head heavy and violent pains, alternating with 
pains in the nape of the neck; constricting, stupefying headache, sensa- 
tion as if the brain were shaken and loose ; dimness of eyes, fearful 
grinding of teeth, lock-jaw, palsy of tongue, vomiting, involuntary stool, 
and urine; spasm of breast with arrest of breathing; sensation on bend- 
ing the neck as if the muscles were too short ; twisting of the neck to one 
side; stiffness of arms and legs, jerking of hands and feet, spasms 
resembling epilepsy ; great sensitiveness of the skin ; sores on the body, 
that have a tendency to gangrenous destruction ; pulse small, quick, 
intermitting. 

Dose : As directed for Cicuta Vir. 

Vcratrum Viride, Ojrium, Nux Vom., Arsenicum and Digita- 
lis, are well approved remedies. 



HYPEK2EMIA OF THE BRAIN. 

EXCESS OF BLOOD IN THE BRAIN — CONGESTION OF THE BRAIN. 

By Hyperaemia of the Brain is generally understood an excess of blood 
in the arteries and veins (blood vessels) of the brain; or, in other words, 
more blood in the brain than is natural in a condition of perfect health. 
This unhealthy increase of the volume of blood may be occasioned by 
three distinct causes. In the first place, the flow of the blood from the 
brain, being natural, a larger quantity of blood returns to the brain. In 
the next place, the flow of blood from the brain may be diminished by 
some disease of the blood vessels, or their surroundings, while the amount 
carried to the brain by other vessels, not so diseased, may be natural in 
amount. Finally, the cause may be located in the brain itself, the brain 
substance (cerebral parenchyma, may become hardened or wasted away 
{atrophied) or softened; or the capillaries (very small ends of the vessels) 
may become enlarged. 

This diseased condition of the brain is confined either to a limited 
locality, or extends throughout the whole brain. It is scarcely ever pos- 
sible to establish, during the life of the patient, a sure diagnosis regarding 
the exact seat and the extent of the hyperaemia, for the reason that conges- 
tions of very limited extent frequently excite much more striking symp- 
toms, than more extensive congestions. So far as treatment is concerned, 
such a diagnosis is scarcely ever of much importance. 

The most important terminations of this engorged condition of the 
brain, which impart to it a higher significance, in practice, are: sudden 
death from paralysis of the brain, in consequence of excessive pressure of 
the blood; dilation (widening) of the vessels, especially the capillaries, by 
which the tendency to congestion is increased, exudation and extravasation 
(or throwing out, and collection of blood in some of the cavities, or collec- 
tion beneath some of the covering membranes.) 

TnE Causes of cerebral hyperemia are various and important, in a 
practical point of view, since, in most cases, they determine the choice in 
the selection of the proper remedy. These causes are of two kinds: 



118 CONGESTION OF THE BRAIN. 

Causes.— First, those which affect the brain directly, and second, indi- 
rect causes, by which, through the operation of influences that are partially 
unknown to us, the brain becomes involved in an affection more or less 
remote from itself. Among- the direct causes affecting the brain, the most 
prominent are: concussions of the head by a fall, blow, or like accident; 
continued, persevering, and excessive mental exertions; emotional excite- 
ment, such as joy, grief, anger, disappointment, chagrin, etc.; exposure to 
excessive heat of the sun {sunstroke,) or to artificial heat; likewise to 
excessive cold ; more particularly, if the influence of cold is suddenly fol- 
lowed by the action of intense heat. 

In the second class of causes, we may range, according to circum- 
stances, almost all kincb of febrile (fever) affections, since almost all of 
them may be associated with this condition of the brain ; in this place we 
must content ourselves with mentioning diseases where almost always 
congestions of the brain are present; they are: erysipelas of the face; 
diphtheria; mumps; inflammatory diseases of the eyes and ears ; difficul- 
ties during teething. Among the more or less chronic affections that 
may be mentioned in this connection, as casual circumstances, the most 
prominent in the list of those that impede the How of blood from the 
brain, are: defects of the heart, right side, and tumors (morbid growths) 
on the neck. In the list of those that occasion a general increase in the 
impulse of the circulation, are: diseases of the heart, left side, suppres- 
sion of habitual losses of blood (such as menses or piles). In this last 
list, we likewise include those cases caused by the abuse of alcohol, in all 
its varied forms, or of other narcotic substances— such as opium. 

Without doubt there, also, exists a tendency to congestion of the 
brain; in which case, they may be excited by any perceptible change 
from a condition of health. This tendency is identical with the so-called 
apoplectic habit, but cannot be recognized, with any certainty, before its 
occurrence, by definite diagnostic signs, but has to be determined, in most 
cases, by the occurrence of the actual fact; it is a certain fact, that it is not 
alone indicated, as is popularly believed, by a thickset frame, and a short, 
thick neck. On the other hand, the idea of a probable occurrence of hyper- 
emia of the brain, suggests itself before it happens, in the case of indi- 
viduals, who, while consuming quantities of nourishing food, do not take 
bodily exercise in a corresponding ratio, and in whom this mode of living 
develops a condition that may justly be termed plethora, or excessive 
fiesh. We have already stated, that the frequent repetition of attacks of 
this nature leads to a dilation (widening) of the blood vessels, which 
increases the disposition to renewed attacks. 

Generally speaking, you can safely predict a favorable termination in 
this disease, since a fatal result need not be apprehended, unless some 
other complicating disease should supervene. In one respect, it depends 
upon the age of the patient; while, in persons of middle age, the danger is 
not very serious; it is, on the contrary, much greater in the case of children 
and old people. In the case of children, death takes place very fre- 
quently in consequence of the paralysis of the brain, occasioned by the 
excess of blood in that organ; in old people, the vessels are generally so 
fragile that they easily tear, and their contents are discharged upon the 
brain. The apparent violence of the disease is no adequate guide by which 



THE BRAIN AND NERVOUS SYSTEM. 119 

to judge of the danger likely to result from it, but the more frequently the 
trouble occurs, the more dangerous it becomes. When it depends upon 
pre-existing derangements, the prognosis depends almost exclusively upon 
the character of these derangements. 

The symptoms by which hyperemia manifests itself, vary according 
as one or another locality of the brain is the seat of the affection, and 
according as the pressure upon the brain is more or less violent. The 
head feels heavy, confus3d, or as if encircled by a tight bund; the head- 
ache, which is scarcely ever wanting, is almost always throbbing, and is 
made worse by stooping, unusual exercise, and every mental effort; buz- 
zing in the ears, sensitiveness of the eyes, even seeing sparks and obstruc- 
tion or obscuration of sight, aie generally present. 

Vertigo (giddiness, dizziness,) is seldom wanting. If arising from 
hyperemia, a characteristic sign is to become aggravated by stooping, 
but more especially by looking up. Generally, the patient feels drowsy 
without being able to sleep, or else the sleep is anxious, disturbed, full of 
dreams. Feels very languid, and his gait is rendered insecure by want 
of firmness in the lower limbs. The pulse may continue natural, and 
there may be no fever present. This mildest form may be combined with 
constant restlessness and gloomy ideas; sleep is disturbed by anxious 
dreams, which, in the more violent cases, do not altogether disappear while 
the patient is awake; they even assume the character of hallucinations, 
and if the trouble continues without being checked, a permanent mental 
derangement will not unfrequently result. Palpitation of the heart, ill 
humor, distrust, total indisposition to work, and fitful mood are almost 
always present. This form of hyperemia mostly befalls individuals, 
who, while enjoying good cheer, take but little bodily exercise, but per- 
form a large amount of mental labor. 

The foregoing symptoms arc almost characteristic, also, of hyper- 
emia, consequent upon suppression of certain forms of loss of blood. 

The trouble is much more dangerous, if it. sets in as an acute disease, 
and, although violent at first, continues to increase in intensity, until it 
terminates in death. In such cases, the face looks dark-red, the eyes are 
streaked with red, the blood vessels of the head and neck pulsate vio- 
lently ; the pupils of the eyes look smaller, all the senses are very sensi- 
tive, the headache is maddening, sometimes driving the patient to sui- 
cide. Delirium is apt to follow. This type of the disease is most common 
after stt n stroll, and not unfrequently is an accompaniment of mental 
derangement, of which, indeed, it may frequently be said to be the cause. 
Not unfrequently the above described symptoms are suddenly followed 
by all the signs of apoplexy, regarding which the diagnosis cannot be 
established with any certainty, until the rapid course and sudden disap- 
pearance of the symptoms of paralysis have satisfied one that no pouring 
out of blood (extravasation) can have taken place, since the fluid could 
not have been reabsorbed so soon. In this category belong, most likely, 
all the cases that are said to have been cured so rapidly. This disease 
never exists during an epileptic attack, in which the course of the attack 
alone gives perfect certainty concerning its true nature. 

Among children, hyperemia is an almost habitual accompaniment 
of all fevers, and not unfrequently conceal the symptoms of the truo dis- 



120 CONGESTION OF THE BRAIN. 

ease, for the reason that the course of the hyperemia is marked by the 
more violent symptoms. In every considerable congestion of the brain 
convulsions of some kind almost always occur; they are accompanied by 
drowsiness, even to the extent of sopor (sound but unnatural sleep), delir- 
ium, excessive restlessness, and anxiety and vomiting, in nearly all cases. 
However threatening such a condition may seem at first sight, in most 
cases it passes off speedily, and without leaving a trace behind, so that 
the congestion seldom lasts longer than thirty-six hours, and generally 
abates after the lapse of twelve hours. 

Treatment.— In the acute form of the disease, applications of cold 
or ice water to the head, and keeping the extremities warm, is excellent. 
In the chronic form, resort to frequent bathing and rubbing, and plenty 
of healthy outdoor exercise. 

ALLOPATHIC TREATMENT.— Active congestion of the brain, not 
sufficient to produce apoplexy or sudden coma (insensibility), is denoted 
by the following symptoms: Pain in the head, sometimes intense, not 
limited to any special part, with a sense of fullness, bursting, or weight 
and throbbing. The head is hot, and the carotid, and other arteries of 
the neck and head, pulsating violently. The face is flushed, the eyes 
injected; there is intolerance of light. The mind is confused, and con- 
sciousness may be suspended; there is dizziness, ringing in the ears, and 
difficulty in speech. If paralysis and insensibility exists, the trouble is 
greater than simple congestion — there is apoplexy from extravasation of 
blood. 

These symptoms (signs) are, also, those of the beginning of inflamma- 
tion of the membranes of the brain, and a discrimination cannot, at once, 
be made. The treatment is the same. The intensity of the congestion 
determines the prominence of the symptoms. 

Intense congestion calls for blood-letting, promptly, at the hands of a 
surgeon, as necessary in preventing apoplexy and sudden death, hemorrh- 
age upon the brain, watery effusion, or inflammation. Blood-letting gives 
relief, by weakening the action of the heart, and diminishing the quantity 
of blood sent to the head. If the congestion is not sufficient to call for 
bleeding, either general or by wet cups, applied to the back of the neck, 
relief may be obtained by ice to the head, hot foot-baths, made stimulating 
by the addition of mustard or red pepper, and an active purgative; one or 
two tablespoonf uls of Epsom Salts dissolved in water, is as good a physic 
as any for the purpose, in domestic practice. The after-treatment will 
have reference to the removal of the causes, if possible; they are, aside 
from enlargement of the heart and sunstroke, principally some form of 
using alcoholic stimulants, and over-stimulating food, excessive mental or 
emotional activity, and anger. If the patient is strong, or robust, the diet 
should be less hearty, and a cathartic of a smaller dose of salts, or a Seidlitz 
powder, taken occasionally. Let all the habits of life be governed by the 
word moderation. 

Passive Congestion of the Brain is caused by some obstruction to 
the return of the blood from the head, through the veins, except it may be 
caused by weakened arterial circulation. The trouble is distinguished by 
drowsiness, dullness of mind and perceptions, and sometimes by convul- 
sions, in children. Active delirium, throbbing arteries, and increased heat, 



THE BRAIN AND NERVOUS SYSTEM. 121 

are wanting. Passive congestion may lead to watery effusion or extrava- 
sation of blood upon the brain. When caused by disease of the heart, or 
by tumors pressing upon the veins, and so producing the congestion, treat- 
ment has reference to a removal of the obstruction. See treatment of 
diseases of the heart. 

For the treatment, or removal of tumors, the skill of a surgeon is 
necessary. To overcome enfeebled circulation, everything which produces 
exhaustion is to be avoided, and its force increased, and the blood enriched 
by nutritious food and tonics. Citrate of Iron and Quinine, one dram, 
dissolved in four ounces of simple syrup. Dose, a teaspoonful. Or the 
Soluble Citrate of Iron, dissolved in Sherry Wine, one dram to eight 
ounces. Dose, a teaspoonful, are good tonics taken before each meal. 

HOMEOPATHIC TREATMENT.— Belladonna. In plethoric persons, 
disposed to rush of blood to the head, red, almost purple face, dilated 
pupils, nervous agitation, sensitiveness to all unusual sounds and motions, 
especially any sudden jar, as of the bed or floor, delirium, constant or inter- 
mittent mutterings, and, if present a disposition to perspire, will be found 
reliable indications for Bell. 

Dose: Six or eight pills, or two drops of the remedy, in a little water, 
once in one to twenty-four hours, as the urgency of the case may 
demand. Study article on dose and repetition, in the previous pages. 

Aconite. If the trouble is the result of violent emotions, such as 
fright or mortified feelings. This remedy is also very useful in alternation 
with Bell., incases of acute hypersemia among women and children, at 
times where the latter remedy is indicated, but the symptoms show, also, 
a high fever and excited condition of the heart. 

Dose: As for Bell., and also subject to the same considerations. 

Opium is a more useful remedy in this disease than either of the 
others already mentioned, provided the trouble has not been produced by 
this remedy in some of its forms. Its use is indicated by continued sopor, 
(sleep) with insensibility of all the senses, dark redness of the face, with 
paleness and coldness of the rest of the body, slow pulse, slow breathing. 

Dose : As f or Bell. 

Tobacco is one of tw r o drugs which frequently cause this disease. Do 
not take or give it in any form. If this so-called innocent habit is one of 
your failings, be firm, shake off the demon you see so surely destroying 
your life, and quit, forever, the habit which is costing you so dearly. 

Nux Vomica. When the disease is caused by a sedentary mode of 
life, or excessive mental labor, and more especially in the commencement, 
when caused by frequent use of spirituous liquors, attended with constipa- 
tion or irritation of the kidneys, Nux is a good remedy. 

Dose: Six pills every evening. 

Arnica. When the derangement is the result of a concussion, fall, or 
blow on the head, etc., use Arnica freely. 

Veratrum Viride. When Bell, is indicated apparently, but after 
being given for twenty-four hours, a dose every half hour, or hour, has 
produced no change for the better, you will find a change to Veratrum 
Viride a good one ; it has been used extensively in ihis affection, both in 
general and hospital practice, with the best results. It is best given in a 
low potency. 



J22 LACK OF BLOOD TO THE BRAIN. 

Dose: Eight pills in three lablespoonfuls of "water, to be given a 
teaspoonful every two to four hours. 

Sunstroke in hyperemia from the heat of the sun, applications of ice 
or cold water to the head, along the back, and to the extremities, is indis- 
pensable to re-awaken the paralyzed reaction of the organism, but this 
should not be an entirely constant application, but should have short inter- 
ruptions at intervals. 



ANMM1A OF THE BRAIN.— LACK OF BLOOD TO 
THE BBAIN. 

Anaemia of the Brain is not, as generally considered, a separate affec- 
tion, but rather a symptom of, or an affection caused by, some other disease. 
Anaemia of the brain either consists in a diminished volume of blood in 
the brain, or in a supply of blood to the brain, destitute of red globules. 
In the former case, it is caused by constriction or compression of the arter- 
ies through which the blood courses towards the brain, or by any other 
circumstances, in consequence of which the space within the skull is nar- 
rowed. In the second case, all the causes of anaemia must be considered; 
whereas, the deficiency of blood, consequent upon sanguinous losses, will 
have to be counted, since it is not only the decrease in the quantity of the 
blood, but, also, in the quality, that determines the anaemia. 

Then, again, there is no doubt but that changes of a spasmodic nature 
may induce a sudden decrease of the volume of blood to the brain; a 
greater or less degree, we have observed, in consequence of powerful men- 
tal emotion or excitement. 

The symptoms of anaemia of the brain differ a good deal, according as 
it develops itself more or less rapidly. If it develops quite rapidly, we 
have a most pefect image of syncope (fainting or swooning,) unconscious 
ncss, voluntary muscular movements are suspended, most generally, 
amid slight convulsions, and both the breathing and the pulse, are slower. 
This condition is most prominently seen, during metrorrhagia (hemor- 
rhage from the womb) in confinement; or from some other morbid dis- 
charge of blood. Evidently such accidents are attended with great 
danger to life. If the anaemia sets in more slowly, symptoms of stimula- 
tion always precede the sinking of the activity of the brain. Here, as 
well as in excess of blood in the brain, we have violent headache, great 
irritability of the organs of sense, buzzing in the ears, dimness of sight, 
vertigo (dizziness); and it is only from the course, and a careful study 
of the causes of disease, that we are able to obtain light regarding their 
cause. 

It is characteristic of most cases of anaemia of the brain, that the 
symptoms either abate or disappear in the horizontal position, and that 
the partaking of food or stimulating substances, cause an improvement. 

The course and duration of this disorder depends, of course, upon the 
aggravating causes. AVhat is certain, is, that the appearance of anaemia 
of the brain is always a very bad symptom, especially in the case of chil- 
dren. 

ALLOPATHIC TREATMENT. When this condition exists in the 
whole of the biain, it is associated with, or depends upon, general anaemia 
or impoverishment of the blood of the whole system. There are also 



THE BRAIN AND NERVOUS SYSTEM. 123 

present, as a rule, the headache, dizziness, and other symptoms of 
exhaustion and weakness. This anaemia of the brain, is that of a lack oi 
the quality of blood, and not a lack of quantity. The essential element 
in which the blood is deficient, in these cases, and all cases of general 
anaemia, is iron, which enters so largely into the composition of the red 
globules. The proper treatment, therefore, is to introduce into the blood, 
through the stomach, blood making materials. Nutritious food is most 
important, and should consist largely of fresh, rarely cooked, lean meat, 
as, beef and mutton, milk and eggs. 

The medicinal treatment should consist of Iron and vegetable tonics. 
The Citrate of Iron and Quinim fulfills the indication and may be given 
in doses of two to five grains, three times a day, before meals. It should 
be dissolved in water or syrup. This, with Cod Liver Oil and good food, 
will restore the health and the proper amount of blood to the brain. The 
Cod Liver Oil should be given, at first, in doses of a teaspoonful, increased 
to a tablespoon ful. If cream can be obtained it is equally as beneficial. 

If the nervous debility should be great. Strychnine and Phosphorus, in 
addition to the above, will be most useful. The pills of Phosphorus or 
Phosphide Zinc and Nux Vomica will answer very well, and, as they are 
sugar-coated will be preferred by many. 

Dose: One or two pills, three times a day. 

The Citrate of Iron and Strychnine is a pleasant preparation and can 
be given in three grain closes, dissolved in syrup, three times a day and 
will generally suffice alone. Quinine should also be given in one or two 
grain doses, in pill or powder, or some other bitter tonic, as Tincture of 
Hark, or Gentian. 

The Elixir of Quinine, Iron and Strychnine, also meets the needs of 
these cases, and ca:i be used in doses of a teaspoonful at each meal. 

The electric current, known as Galvnnism, is immediately useful. The 
poles of the battery should be applied to the mastoid processes (behind each 
ear) or upon the forehead and nape of the neck. 

In partial anaemia of the brain, caused by embolism, as occurs in that 
form of apoplexy, time is the necessary element in its removal, by tho 
establishment of the collateral circulation. There can be no doubt, how- 
ever, in many cases, of the benefit of Strychnine in doses of about one- 
thirtieth of a grain, and the judicious employment of Galvanism, though 
much harm may also be done by their improper use. 

HOMOEOPATHIC TREATS E NT. We must content ourselves with 
mentioning only a few remedies, known to be most prominent for anae- 
mia of the brain, when manifesting itself as an independent, and more 
particularly in the form of an acute disease. 

Ipecac, as a remedy, is particularly suitable for children, after rapid 
losses of animal fluids, if the symptoms of convulsions are present, 
together with more or less stupor. 

Pose: Eight pills, or four drops of solution, in three tablespoonfulsof 
water. Give a teaspoonful every two or three hours. 

Scenic Cormttinn is particularly useful in the hemorrhage from the 
womb of parturient females; here it acts in a two-fold direction, against 
the hemorrhage itself, and against the symptoms arising from the brain 



124 APOPLEXY. 

and spinal marrow ; upon both of these organs it acts in a very marked 
manner. 

Dose : As for Ipec. 

Cuprum is only suitable where the whole process is developed slow- 
ly, and is more especially characterized where there is some spasmodic 
phenomena, such as some mental excitement. 

Dose : A small powder, or eight pills, in water, as directed for Ipec. 

HOME REMEDIES. Ammonia or Camphor applied to the nose, or 
even a little cold water applied to the face, will often arouse from syncope 
arising from anaemia of the brain . 



APOPLEXY. 

Apoplexy is a sudden loss of consciousness, beginning at the brain, 
depending upon hemorrhage upon the brain, congestion or embolism (a 
small clot from the heart lodged in an artery of the brain). 

Characteristics. — Sudden or gradual loss of consciousness, sensa- 
tion, and motion, with greater or less disturbance of the pulse and res- 
piration. 

It is extremely difficult to distinguish clearly between the different 
varieties, the external symptoms not always bearing a uniform relation 
to the internal injury; thus all the indications of serous apoplexy may 
declare themselves from sanguineus extravasation ; and it is not always 
possible to decide, in apoplexy, whether effusion, or simple congestion of 
the vessels of the brain, has taken place. 

Premonitory Symptoms. — Continued inclination to somnolence; 
heavy, profound sleep, with snoring respiration; nightmare, grinding of 
the teeth, shocks or cramps, extreme drowsiness, or a general feeling of 
heaviness, or disinclination to the least exertion; frequent yawning and 
fatigue after the slightest exercise. A sense of weight and fullness, and 
pains in different parts of the head, sometimes very deep-seated. Head- 
ache and megrim, or giddiness and fainting; pulsation of the arteries of 
the temples and neck, with swelling of the veins of the head and fore- 
head; disturbance of the functions of the brain, evinced by the loss of 
memory, irritability of temper, or mildness and indifference, despondency 
and weeping; irritation of the membranes covering the eye, dimness of 
vision, specks or motes before the eyes, or flashes of fire, or sparks, during 
darkness; acuteness of vision, or double vision; sometimes, also, the 
words in a line appear to run into one another; difficulty of opening or 
closing the eyes ; noises, humming, singing, etc., in the "ears; dullness of 
hearing; dryness of the nostrils, pinched appearance of the nose, with 
false perception of an unpleasant odor; sneezing, and slight bleeding of 
the nose ; stammering, and indistinct pronunciation ; difficulty of swal- 
lowing ; numbness or torpor , or pricking sensation in the extremities, with 
inarticulate speech, and occasional partial attacks of paralysis in the face, 
(distorting the features,) or in some of the muscles of the limbs; pains in 
the joints ; weak or unsteady mode of progression ; difficulty of passing 
water, etc. 



THE BRAIN AND NERVOUS SYSTEM. 125 

Confirmed Attack. Symptoms.— The attack itself is commonly 
ushered in by either of the following groups of symptoms: 

The patient suddenly falls to the ground, and is instantaneously 
deprived of sense and motion. The limbs are relaxed and perfectly 
motionless, or the whole of one side is rigidly contracted, whilst the other 
is relaxed and powerless; in some instances one limb (such as an arm) is 
alone implicated. The speech is either entirely suppressed, or a few 
inarticulate sounds are all that can be uttered ; the countenance is flushed 
or livid and puffed, and there is foaming at the mouth, with contortion 
towards the affected side. The respiration is slow, impeded, and usually 
accompanied by a rough, harsh snoring. The pulse varies, but is usually 
weak at the commencement, and fuller and stronger, but slower, as reaction 
sets in. In other cases, again, the patient is suddenly seized with partial 
■paralysis, comprising either an arm or leg, or the whole of one side of the 
body, attended with loss of the power of utterance, and pale, sallow, or 
livid and bloated countenance. In the course of a few hours, all, or the 
greater part of the symptoms mentioned under the first variety of apo- 
plexy, are prone to follow. 

Issue and Results.— When, in either form of the disease, recovery i3 
about to take place, consciousness gradually dawns upon the patient; he 
begins to recognize persons and objects around him, answers when spoken 
to, or makes signs for writing materials, in order to express his wants on 
paper, when the power of speech is still denied him. 

But when a fatal termination is to be apprehended, the breathing 
becomes more and more oppressed, the face becomes pallid, and a cold, 
clammy sweat bedews the brow; the act of swallowing is rendered dim- 
cult or impracticable, the teeth become clenched, the eyes dim and glazed, 
and the evacuations are passed involuntarily. 

Predisposing Causes.— Chronic derangement of the primary organs 
of digestion, and, in some cases, disease of the heart, are the principal 
predisposing causes of apoplexy. The conformation of the frame isrlso 
considered to predispose persons to attacks of apoplexy. Old age is more 
subject to this disease than the robust or mature periods of life. Particu- 
lar seasons, such as the equinoxes, (the transition from winter to summer, 
and from autumn to winter,) increase the predisposition to attacks of 
apoplexy. Sudden changes of the barometric conditions of the atmosphere 
are, also, known to operate as predisponents. 

Exciting Causes.— The exciting causes of apoplexy are intemperance 
in eating and drinking; mental emotions; obstructed circulation, arising 
from tight articles of dress around the neck or waist, or from prolonged 
stoonincr, or keeping the head in a dependent position; intense study ; blows 
on the head ; the use of opiates ; baths at too high a temperature; violent 
vomiting, or strong muscular efforts; the suppression of habitual dis- 
charges; exposure to the rays of the sun; extremes of temperature; 
accidental loss of blood, or excessive bleeding. 

ALLOPATHIC TPvEATJIENT of apoplexy will have reference to the 
period of the attack, and to its prevention. If an attack has occurred, the 
patient is to be placed in a cool, well aired room, with the head raised and 
cold applications made. If the head is hot, and the arteries throbbing, and 



126 APOPLEXY. 

the face flushed, ice should be applied to the head, and hot foot-baths, with 
mustard plasters, to the feet and legs. The dress about the chest and 
neck loosened to permit the free return of blood from the head. 

If the stomach is full, a vomit (emetic) should be given ; but not other- 
wise. A tablespoonf ul of mustard, in water, is as good as any. An emetic 
which produces straining should not be given. 

There is, generally, an advantage in an active cathartic. For this 
purpose three drops of Croton Oil is the best cathartic, on account of the 
briskness and quickness of its action. It can be given in a little syrup or 
glycerine. If free purgation does not occur in four hours, the dose should 
be repeated. The action of the physic can be hastened by injtction of soap 
suds having a little salt added; one pint is the usual size for an injection. 
If the pulse is small or feeble, or the patient weak, a cathartic should not 
be given; but if it is known that the bowels have been constipated, they 
should be moved by an injection. 

If the patient is below middle life, the condition is probably active 
congestion, particularly if the symptoms characteristic of this condition 
obtain, such as flushed face, congested eyes, throbbing of the carotids and 
other arteries of the head and neck, and a hard, resisting pulse, the life of 
the patient may depend on the immediate abstraction of blood. 

When paralysis exists, the apoplexy depends upon extravasation of 
blood from the rupture of an artery within the skull, or upon embolism 
(plugging of an artery in the brain, by a small clot from the heart,) bleed- 
ing should not be resorted to. In the latter case it can do no good, and in 
the former may do positive harm, by so weakening the patient that he 
cannot survive long enough for the clot of blood to be absorbed. 

If the patient regains consciousness, and paralysis of one side of the 
body (hemiplegia) remains, there is a clot. Cooling washes should be 
applied to the head, the bowels kept open, and the food nutritious, but 
unstimulating. Recovery will depend upon the absorption of the clot by 
the efforts of nature. Paralysis will be treated under that disease. 

HOMCEOPATHIf! TREATMENT.— Homoeopathy possesses many reme- 
dies, by means of which it is frequently possible to ward off an impending 
attack of apoplexy. 

In order to better facilitate the selection of the appropriate medicines, 
inasmuch as the immediately exciting cause frequently serves to modify 
the course to be adopted, the subjoined table of medicines, especially 
appropriate for the treatment of cases distinctly traced to particular causes, 
has been pre-attached to the distinctive indications afforded for each medi- 
cine, separately, further on in this article. 

But it is, at the same time, necessary to caution the reader against 
holding the cause as paramount to the particular indications present, for 
the cause is ever the subordinate reason for selection. But when any one 
of the remedies named as appropriate for the treatment of cases traceable 
to particular causes, is, also, found upon reference to particular and dis- 
tinctive indications, to correspond with the requirements of the case, we 
have thus ascertained a double reason for being assured that the selection 
is correct. 



THE BRAIN AND NERVOUS SYSTEM. 127 

INDICATIONS AFFORDI'D BY PARTICULAR CAUSES, DURING THE PRES- 
ENCE OF PREMONITORY SYMPTOMS. 

When the attack is directly traced to a chill, select from: * Acoxi- 
tum, Opium, Nux-vomica, and Mercurius. 

When the attack is traceable to a sudden fright, select either: *Aco- 
nitum, or Ot'iUM, or both, alternately. 

When concentrated grief is ascertained to be the exciting cause, 
select from : * Ignatia and Lachesis. 

When sedentary habits, or over-application to study, is distin- 
guished as the exciting cause, select: " :: " Nux-vomica or Belladonna. 

When the attack is directly traced to a fit of passion, select from : 
* Acmitum, Bryonia and Nux-vomica. 

When excessive joy is distinguished as the exciting cause, select 
from : * Coffea and Opium. 

When the attack is directly traced to over-indulgence in vinous 
and spirituous liquors, select from : * Xux-vomica, Opium, Lachesis and 
Pulsatilla. 

When DERANGEMENT, from overloading the STOMAcn, is recognized 
as the exciting cause, select from:* Pulsatilla, Ipecacuanha and 
Nux-vomica. 

When exposure to the sun, or a hot bath (too hot), is distin- 
guished as the exciting cause, select from: * Belladonna and Aconite, 
or both, alternately. 

When the attack is directly traced to suppression of an habitual 
evacuation of blood, select from : * Nux-vomica and Pulsatilla. 

Aconituni is required in all cases where there are evident symptoms 
of fullness of the vessels, determination of blood to the head, character- 
ized by redness and fullness of the face, distention of the veins of the 
forehead, quick, full pulse, restlessness, and anxiety. 

Dose: Of a solution of six pills to two tablespoonfuls of water, give a 
teaspoonful every hour, until amelioration or change; but if, after 
three doses have been given, the improvement does not become 
speedily progressive, proceed with the next medicine. 

Belladonna is of essential service when the symptoms of congestion 
do not speedily or thoroughly yield to Aconite, or should only ;i partial 
degree of amelioration have taken place, in which case, this remedy 
should be administered four hours after the last dose of the foregoing— 
or, further, should the following symptoms present themselves: redness 
and bloated ness of the face, injection of the conjunctiva (the mucous 
membrane which lines the eyelids, and covers the front of the eyeball), 
violent beating of the arteries of the neck and temples, noises in the ears, 
darting pains in the head, with violent pressure at the forehead, increased 
by movement, the least noise or bright light, double vision, and almost 
all the symptoms relative to the eyes already mentioned ; dryness of the 
nose, with unpleasant smell and bleeding of the nose; fiery redness of the 

* The selection from one or more of the medicines thus enumerated, must, however, as already 
observed, depend upon the correspondence between the symptoms of the case, and those hereinafter 
enumerated in connection with such of thepe medicines, separately. But if the indications for two or 
more medicines be bo closely identical as not to be decisive between them — whereas both are not appli- 
cable to the treatment of caaes arising from the same cause— then this discrepancy will bo decisive 
between them, if Ike cause be dearly ascertained. 



128 APOPLEXY. 

throat; difficulty of swallowing; slight attacks of paralytic weakness or 
heaviness in the limbs. 

Dose : Of a solution of six pills to two tablespoon fuls of water, give a 

teaspoonful (or two pills dry on the tongue) every three hours, until 

improvement or change. 

Nnx-vomica is particularly suited to cases in which the apoplexy 
threatens individuals of sedentary habits; or addicted to the use of ardent 
spirits, or too great an indulgence in the pleasures of the table, or in 
those who have long been affected with indigestion, either bilious or 
nervous ; and have, consequently, more or less of the rheumatic or gouty 
constitutional tendency; and, also, when the following symptoms present 
themselves: headache, deep-seated or frontal, but more especially at 
the right side, and giddiness, confusion, and humming in the ears ; nausea, 
and inclination to vomit; turgescence of the superficial vessels of the face 
or redness only of one cheek ; drowsiness; feeling of languor, with great 
disinclination to exertion, either mental or bodily ; cramps of the limbs, 
especially at night, and weakness in the joints; constipation and diffi- 
culty in passing water ; irritability of temper, aggravation of the symp- 
toms in the morning, or after a meal, and also in the open air ; bilious, 
sanguine, or nervous temperament. 

Dose : A solution of six pills, as directed for Belladonna. 

Opium is a most important remedy in almost all severe attacks, but 
particularly in old people, when we find the following symptoms: 
marked congestion to the head, indicated by stupor, giddiness, heaviness 
in the head, and violent pressure in the forehead ; singing in the ears and 
hardness of hearing ; sleeplessness, or agitating dreams, or frequent and 
almost overpowering drowsiness during the day ; redness of the face, and 
constipation; pulse slow but full. 

Dose : Of a solution of six pills to two tablespoonfuls of water, give a 
teaspoonful (or two pills dry on the tongue) every two hours, until 
improvement or change. 

Ignatia is, also, indicated by many of the symptoms mentioned 
under the head of Nux-vomica, but it is chiefly called for when depress- 
ing emotions (particularly severe, and protracted grief) have been the 
exciting cause, and when the person affected is of a nervous tempera- 
ment. 

Dose: Six pills in two tablespoonfuls of water, a teaspoonful every 
two hours, until improvement or change. 

HOME TREATMENT — As there is liability of apoplexy recurring, 
after recovery from an attack, all possible precautions should be observed. 
The individual should avoid violent bodily exertion, or strong mental 
labor, venereal excitement, the use of alcohol in any form, the stooping 
posture, and tight neck cloths. The head should be well elevated at sleep, 
and every morning the head bathed in cold water. When dizziness, head- 
ache, with throbbing of the arteries occur, a brisk cathartic should be 
taken. The rule of life, as stated in the treatment of acute congestion, is 
moderation. 

Head symptoms are sufficiently common, without being followed by 
apoplexy, so that those who experience them need not become unhappy 
from fear of apoplexy, especially if they have never had the disease. 



BRAIN. 



129 



UNDER SURFACE OF THE BRAIN. 

The under surface of the Brain as it rests on base or under surface of skull. 

a, a. The halves of the Cerebrum, the upper surfaces of which are seen 
in the cut. 

6, b. The Cerebellum ; the principal seat and origin of nearly all the 
nerves of sensation and motion, and by many anatomists believed to be the 
seat of the sexual instinct. 

d. The Medulla oblongata is the enlarged upper end of the spinal cord ; 
it is about an inch and a quarter in length by three-fourths of an inch in 
breadth at its widest part, and one-half inch in thickness. 

e. The lower end where it joins the cord is ealled Medulla spinalis. 

1, 1. The origins of the olfactory nerves are indicated by this number on 
the right and 
left sides of 
the cut; these 
extend out- 
ward, and are 
distributed 
on the inner 
surf ice of the 
rose and give 
us the sense 
of smell. 

2, 2. Repre- 
sent the optic 
nerves, which, 
extended to 
the eyes, give 
us the sense 
of sight. 

3, 3. Nerves 
that move the 
ball of the eye. 
The Trifacial 
nerve i n d i - 
cated by 5, 5, 
and known to 
anatomists as 
the trigemi- 
nus or fifth 
pair, is the 
largest of the 
nerves issuing 
from the cra- 
nium ; it is 
also peculiar 
in that it is 

unlike other cranial nerves, performing more than one duty. It is a nerve of 
special sense, that of taste ; of common sensation for the head and face, and 
of motion, as it controls the motions of the muscles of mastication, and is 
widely distributed over the head and face and to the various muscles 
thereof; indeed, if it was not for this nerve's help, our smiles and frowns 
would l)e very much alike. 

The Facial nerve indicated by 7 is the motor nerve of all the muscles of ex- 
pression in the face ; just try to make all the faces you can, and you will learn 
a little of the great variety of work over which it has supreme command. 

The Auditory nerve, by means of which we examine sound, is indicated 
by 8, 8. This is a most important member of the nerve system, and is 
sometimes the seat of disease, causing deafness more or less marked. 9, 9. 
The Glosso Pharyngeal. 10, 10. Pneumogastric nerve is both a nerve of 
motion and sensation. It governs the voice and breathing, the heart and 
stomach, and is very often overworked in the careless pushing American. 

9 




130 THE BRAIN AND NERVOUS SYSTEM. 

PARALYSIS. 

By paralysis, we understand a suspension of nervous action. It dif- 
fers in character according as one or another, or all the nerve trunks 
are attacked. And its symptoms must vary, just as the functions of the 
nerves vary The name paralysis, implies the complete cessation of the 
action, both of the nerves of sense of feeling, and of the nerves of motion. 
If only one set of nerves are affected, it is called incomplete paralysis, or 
paresis; one side of the body affected is called hemiplagia. If the upper 
extremities of one side, and the lower extremities of the other, are the 
seat of disease, we call it transverse paralysis. 

The causes of paralysis are various. Diseases of the brain and spinal 
cord, are the principal causes. Of these apoplexy, inflammation, and 
softening of the brain, are most prominent. There are many other influ- 
ences to which paralysis may be traced, as their result. The main causes 
of this class are : excessive exertions of the parts to which the paralyzed 
nerve is distributed, in which list must appear cases resulting from con- 
vulsions, continued and excessive pains, swellings, neuralgia, ligatures, a 
stroke of lightning, rheumatism, hysteria, gout, pregnancy, violent acute 
diseases, among which contagious and miasmatic diseases occupy a front 
rank, such as scarlatina, measles, variola, typhus, dysentery, and finally, 
poisoning by animal, vegetable, and more particularly, by mineral poi- 
sons. 

The Symptoms of paralysis may readily be understood. There can 
only be doubt, when the paralyzed part is not accessible to our vision. 
The prognosis depends on the nature of the exciting causes, and upon the 
possibility of removing them. If from disease of the brain, or spinal 
cord, a cure is not impossible, but doubtful. If from some acute disease, 
there is very little doubt of an ultimate cure. That the prognosis is ren- 
dered much more doubtful by an advanced age, an enfeebled constitution, 
and an extension of the paralytic phenomena over a large surface, is but 
natural to expect. 

ALLOPATHIC TREATMENT.— Paralysis. There are no diseases, the 
treatment of which ought more certainly to be directed by a judicious 
person, than the treatment of the several forms of paralysis. 

The treatment, as a matter of necessity, will have reference to the 
diseased conditions causing the paralysis, the state of the system, and 
any independent affections which may be co-existing. Treatment is not 
to be addressed to the inability to make muscular movements directly, but 
to the cause and associate affections. The nature of the causes must, 
therefore, when possible, be determined with positiveness. Among the 
questions to be settled before intelligent treatment can be begun, are: Is 
the cause of paralysis inflammatory, or is there a structural change of 
tissue (lesion,) and where is this lesion or inflammation situated? Is it 
in the course of a nerve within the skull or spinal canal? If it is a lesion, 
what is its nature and extent? Is it the result of poison, as lead or arsenic, 
copper or mercury? Or, are all these causes absent, and is the paralysis 
functional? What influence do co-existing diseases have on the paralysis? 
Is the system well nourished, or is there debility or anaemia? The treat- 
ment will vary according to the conclusions arrived at in answer to the 
above questions, and the result will, therefore, depend upon the correct- 



PARALYSIS. 131 

ness of the conclusions, and the judgment with which the indications are 
carried out. There are cases in which the structural changes (lesions) 
are such as are beyond hope of repair ; in such cases the complete success 
of treatment cannot be hoped for. 

That part of the treatment having reference directly to the paralysis 
or to the paralyzed parts, and calculated to restore their function, promote 
the circulation in them and their healthy nutrition are chiefly Electricity, 
passive motion, (moving or exercising the paralyzed part by the hands of 
the patient or others,) active exercise under the direction of the will, rub- 
bing, shampooing, and stimulating applications. Strychnia is also given 
internally for this purpose. 

It must be borne in mind, that these measures cannot be effectual and 
may be injuries, so long as the paralysis is maintained by the conditions 
which caused it. 

The general treatment having reference to the causes of the paralysis 
is considered under their respective heads as apoplexy, as a cause of hemi- 
plegia (paralysis of one side of the body) and myeletis (inflammation of 
the spinal cord) as the cause of paraplegia, (paralysis of the lower half of 
the body.) 

The chief remedies are Strychnine and Electricity, but their use 
should be delayed until the acute stage of the causing disease has passed, 
though later on, both these agents are useful in restoring the circulation 
to the brain in cases of thrombosis (obstruction of the circulation in the 
brain by inflammation of an artery) or to embolism (obstruction of the 
circulation in the brain, caused by a plug lodging in an artery) and 
to promote the absorption of a clot in case of hemorrhage in the brain. 
For this end, very mild Galvanism (the direct electric current,) should be 
used. One pole should be placed upon the nape of the neck and the other 
upon the forehead, or upon each mastoid process. Strong currents may 
do serious mischief. But sufficient time having elapsed for the immedi- 
ate effects of the brain disease to subside, its judicious use will be beneficial. 
If there is headache or dizziness, the greatest care will be necessary, and 
in all probability, Electricity should be discontinued. 

It is also important to remember, that part of the paralyzing effects 
of these causing conditions is temporary, and may be the result of shock, 
contusion, or congestion, which are temporary. Even paralysis depend- 
ing upon no appreciable lesion (functional) is, for a time, stationary, before 
improvement begins. Besides, paralyzed parts do not, of themselves, 
resume their healthy action, even after the conditions causing the paraly- 
sis are removed, so that it will not do to trust to nature alone, but appro- 
priate efforts must be made to restore healthy action. 

It is a serious error to begin treatment addressed directly to the 
paralysis, while that condition is maintained by the primary causes, fur- 
ther than to maintain the nutrition of the paralyzed muscles, by main- 
taining the circulation in them. It is a serious error to overlook the fact 
that after the paralysis has existed some time, that recovery will not take 
place spontaneously. After paralysis has existed so long that degenera, 
tive changes have taken place in the muscles or nerves, recovery cannot 
take place. 

So long as contractions take place upon passing the electric current 



132 THE BRAIN AND NEKVOTJS SYSTEM. 

through the paralyzed muscles, they have not yet reached a condition 
that renders them hopeless. If pain is produced upon passing the elec- 
tric current through the paralyzed part, but no contractions are produced, 
the case is less hopeful than as if both contraction and pain were pro- 
duced. 

The former is called electro-muscular contractility, and the latter elec- . 
tro-muscular sensibility. When both are lacking, the case may be said to 
be hopeless 

Electricity, — As before stated, the constant current may be applied 
to the brain for the purpose of improving the circulation and its nutrition 
(if the case is hemiplegia.) To the muscles, usually, the induced (or 
faradic) is used. This will prevent wasting and loss of function from 
disease; but, as a rule, that current should be used which produces the 
the greatest number of contractions and the least amount of pain. If the 
temperature of the paralyzed part is lowered and the muscles weak and 
flabby, great benefit, in all these particulars, will follow the use of the 
faradic current. Large, well-moistened electrodes should be used, one 
being placed over the motor nerve affected, and the other over the belly 
of the muscle. Every affected muscle should be farad ized at each sit- 
ting. 

The same principle will govern the use of electricity in all forms of 
paralysis. In facial paralysis, one pole should be placed on the. mastoid 
process, and with the other stroke the face. 

Pain is an evil, and the current should not be stronger than neces- 
sary to produce contractions. Nor should its application be made to one 
muscle long enough to tire it. From ten to twenty minutes is long 
enough for an electric sitting, nor should any muscle be subjected to the 
electric current for more than five minutes, nor oftener than every day 
or every other day. 

In infantile paralysis the most decidedly beneficial results are obtained 
from electricity. The electrical treatment should be begun early, but after 
all inflammation has subsided. So long as the electro-muscular contrac- 
tility continues, especially, if the joints have not become changed, the 
spinal cord and the nerve plexuses, as well as the paralyzed muscles, 
should be subject to faradization or galvanization. 

Strychnine, — Continuous with the use of electricity, Strychnine 
should be given. It is most useful in hemiplegia, when the muscles are 
completely relaxed; when they are rigid, it is not to be given. After the 
acute symptoms disappear, Strychnine is useful in promoting the nutri- 
tion of the affected nerves or nerve centers, as well as by kindling the 
contractile power of the muscles, whether the paralysis be hemiplegic, 
paraplegic, or of a local character. 

The most effectual method of administering Strychnine in paralysis, 
is by hypodermic injection. One thirty-second of a grain a day, by hypo- 
dermic injection, has a better effect than the same or a greater quantity 
three times a day by the mouth. A good formula is: Take of Sulphate of 
Strychnine one and a half grains, Distilled Water one ounce. Mix. Apply 
heat to effect a solution ; ten drops contain one thirty -second of a grain, 
and can be given once a day, by hypodermic injection, to an adult. In 
infantile paralysis one drop of this solution, diluted by five drops of IHs- 



PARALYSIS. 133 

tilled Water, and given once a day, is very beneficial, if the muscles have 
not lost their electro-contractility. It promotes the capillary circulation 
and the growth and power of the muscles. 

In making the injection, it is best to throw the solution into the 
muscle itself, taking the paralyzed muscles each in turn. To do this dex- 
trously requires the skill of a physician. 

Cases of paraplegia, in the early stages, should doubtless be treated 
with Ergot and Belladonna. A teaspoonful of the Fluid Extract of Ergot 
and ten drops of the Fluid Extract of Belladonna should be given three 
times a day, but after three or four weeks have passed, they should give 
place to electricity and Strychnine. 

In paralysis of the insane, there is scarcely any hope of permanent 
improvement from treatment, much less for a cure. These patients 
should be removed to insane hospitals. The treatment consists, for the 
most part, of palliative measures, and a regulation of the diet, with a 
view of retarding the progress of the disease, and contributing, as far as 
possible, to the comfort of the patient, during the continuance of the 
malady. 

HOMEOPATHIC TREATMENT.— Paralytic attacks, being almost with- 
out any exception, secondary affections, are results following some other 
disease, or injury. It is evident that in treating them it is of the utmost 
importance to learn the first, or primary cause of the present affection. 
It is not always possible to do this, but when the cause is once known, 
the treatment should be directed to its removal. If it is the result of dis- 
ease, look for the treatment under the name of that disorder. If from 
some external cause, study and remove that. 

The treatment by Homoeopathic means always includes the searching 
out of the cause of the paralysis — which is always a symptom, or the 
result of a previous condition of disease or injury— and treating the 
malady from that point of observation, as far as it is practicable. 

Electricity is the sheet-anchor, in all schools of medicine, for the 
treatment of this disease, and it is for this reason that all Homoeopaths 
point to it with pride. As it is beyond successful contradiction that the 
cures it does so very frequently produce are in full accord with what they 
have demonstrated to be nature's law of cure. The use of this remedial 
agent is so fully and plainly given by my co-author, Dr. Bean, in the Allo- 
pathic Treatment of this disease, that I shall be content to refer my read- 
ers to that part of his work ; indeed, the whole of his treatment is so fully 
in accord with our experience and practice— except in the matter of dose, 
— that we will only add that the annexed are a few paralytic conditions 
and remedies, proven to be the best for that condition ; a further study 
may be made by means of the Repertory. Causticum, while not sup- 
posed to be able to produce a cure alone, is still one of the most substantial 
helps in almost all forms of paralysis. When caused by suppressed 
eruptions and ulcers, Caust., Ars., Sul. After excessive bodily 
exertions, lihus-tox., Ars., Canst. After rheumatism, Caust., Fcr., 
Bry., Cliina, Am., Rhus-t. After apoplexy, Bell., Nux., Caust., 
Am. 

HOME REMEDIES.— Passive motion, in cases of complete paralysis is 
important, i. e., movements of the paralyzed limbs by the Jiands of the 



134 THE BRAIN AND NERVOUS SYSTEM. 

attendants or the patient. It aids the circulation and nutrition, and 
maintains them in a state of preparation to respond to the force of the 
will. 

Friction of the surface of the paralyzed limbs, kneading the muscles, 
with a deep pressure, and shampooing, are useful in maintaining nutri- 
tion, and should be employed with perseverance. 

Persistent voluntary motion, in all cases of incomplete paralysis, is 
very important. There is reason to believe that, in some cases, paralysis 
continues at a certain point, until it becomes incurable, when persever- 
ing exercise, with other treatment, would have resulted in improvement 
or recovery. With this view, gymnastic exercises are to be enforced. The 
simplicity of this method does not prevent its being of great benefit. 



INFLAMMATION OF THE BRAIN. 

BRAIN FEVER, PHRENITIS, MENINGITIS, MENINGITIS CEREBRALE. 

The Causes are sometimes veiled in obscurity; at others they are 
known to be the effect of excessive mental exertions, or the use of alco- 
holic drinks, or the effect of heat, or sometimes of cold, and other like 
causes, as mentioned under " Hyperemia of the Brain." 

Symptoms. — An attack of this disease may take place either gradu- 
ally, or very suddenly; generally the former. The premonitory symp- 
toms are, at first, depression of spirits, impaired appetite, mental uneasi- 
ness, and confusion of ideas, especially when in the recumbent posture, 
debility, and sometimes ringing in the ears, and blindness. These are 
succeeded, in most instances, by a more or less severe chill, and constant 
headache, which are soon followed by severe fever, hot and dry skin, 
flushed face, red eyes, or a haggard, anxious, fearful expression of them ; 
the pulse is quick, rapid, and forcible. The intensity of the headache 
increases, as also the ringing in the ears, sometimes changing to a 
humming or rumbling sound; the senses become morbidly acute, 
as known by the sensitiveness or restlessness as shown on exposure 
to either light or sound. The pupils of the eyes are constantly con- 
tracted, the patient is extremely restless or wakeful, with more or less 
delirium. They frequently imagine that some one designs to injure them 
and cannot bear restraint or contradiction, and the delirium is sometimes 
of a furious, raving nature. 

The head is remarkably hot, while the extremities are cold. The 
tongue is furred white, red at its edges, dry, pointed, and the papillae ele- 
vated; the bowels are obstinately constipated, and nausea and vomiting 
are common. Breathing is accelerated and laborious, seldom hurried, as 
in fevers, but irregular and with frequent sighs. Generally there will 
be spasmodic movements of the muscles and of the tendons. The urine 
is scanty and of deep color. 

As the disease advances, a change occurs in the symptoms,* the pre- 
vious delirium changes for a stupor which gradually passes into coma. 
The formerly contracted pupils are now dilated, and there is less sensi- 
bility to the light, the eye loses its brightness; sometimes there is 



INFLAMMATION OF THE BRAIN. 135 

squinting, and the countenance is vacant or idiotic; picking at the 
bedclothes or grasping in the air are almost always present at this stage. 
The hearing is much diminished, and, indeed, all the senses are very 
much blunted; the limbs become perfectly relaxed, the pulse is slow, 
sluggish, and irregular or intermittent, the respiration is deep, slow, and 
often stertorous (noisy, loud); the urine is very scanty, if passed at all, 
and the faeces are involuntarily discharged. Convulsions or paralytic 
attacks often ensue. 

Finally, the pulse becomes hurried, small, and unequal, the counte- 
nance pale and sunken, the skin has a cold and clammy perspiration 
upon it, the urine flows without any knowledge, the coma becomes more 
profound and death terminates the scene. 

It must be remembered, that these symptoms vary, being very mild with 
some, and extremely violent with others, depending upon the degree of 
strength of the system, the severity of the cause, and other attending 
circumstances. 

Some care is necessary in discriminating inflammation of the brain 
from fever of some other form; the headache of brain fever is more con- 
stant than that of fever, and appears to be confined to no particular spot. 
The sleep in this disease is disturbed with bad dreams and sudden starting 
or waking in fear, and with children a scream on awakening. 

The Prognosis is generally doubtful. Much depends upon the cause 
of the attack; if it be produced accidentally by blows, etc., it is more 
favorable than when owing to some constitutional disease or difficulty. 
The milder the symptoms the more certain is a favorable termination, 
but we should not be discouraged and despair, even in the worst cases. 

ALLOPATHIC TREATMENT of acute meningitis, cerebral, (inflamma- 
tion of the membranes of the brain). In the first stage of the disease, the 
object of treatment will be, to diminish the active congestion, and to limit 
the inflammation and its products. The hair is to be cut close to the head, 
and cold applied by means of a sack or bladder of pounded ice, or constant 
washing with cold water; the head should also be raised. An active 
cathartic is to be given : One drop of Croton Oil in Syrup or Glycerine, is 
appropriate, or twenty grains of Calomel, in a tablespoonful of Castor Oil, 
may be given. Owing to the urgency of the case, and the extreme danger 
to life, if the patient is robust, and the arteries of the head and neck beat- 
ing violently, in short, if the congestion is intense, blood-letting should be 
resorted to, preferably by wet cups to the nape of the neck, than general 
bleeding. The treatment, in this stage, is the same as in the condition 
called active congestion. These measures are only proper in the beginning 
of the disease, as exhaustion is one cause of death in cases of meningitis, 
which do not die quickly. Food should be of the blandest kind, and taken 
cold. The restlessness and excitement should be relieved by Chloral Hy- 
drate and Bromide of Potassium. Take of Chloral Hydrate eight scruples, 
Elixir of Bromide of Potassium four ounces, water four ounces. Mix. 

Dose: One to two dessertspoonfuls, in syrup or sweetened water, from 
two to four hours apart, until relief is obtained. 

Opium is beneficial in relieving pain, and accomplishes as much as any 
other remedy, in controlling the inflammation. 

Dose: A grain to a grain and a half, in powder or pill, two or more 
hours apart, until pain is relieved. 



lo6 THE BRAIN AND NERVOUS SYSTEM. 

After the stage of active congestion is over, the indications for treat- 
ment are to support the powers of life, and to promote the absorption of 
the products of inflammation (lymph and serum). The former indication 
is to be met, as far as possible, with nutritious, easily-digested food, of 
which meat essences and extracts, the preparations of milk, and milk 
beaten with eggs, form the principal part. 

Should the drowsiness and insensibility become so profound as to pre- 
vent sufficient food being given by the mouth to support life, as is fre- 
quently the case, half a pint of these strong liquid forms of food should be 
given, by injections into the rectum, two or three times a day, in addition 
to the amount taken by the mouth, and their retention effected by firm 
pressure upon the anus with a napkin. The absorption of the lymph will 
be aided by giving Iodide of Potassium. Take of the Saturated Solution of 
Iodide of Potassium one ounce, aid give five drops in sweetened water, 
flavored with Essence of Peppermint, two or three times a day. Strict 
attention should be given to the bowels, that they do not become consti- 
pated. If the bladder is not emptied by nature's efforts, the water should 
be regularly drawn, twice a day, with a catheter. For this the help of a 
physician is necessary. 

Vomiting, during any period of the disease, should be met by a fly 
blister to the nape of the neck, and a mustard plaster to the stomach. 
The following mixture is as commonly successful as any internal remedy: 
Take of Carbolic Acid ten grains, Simple Syrup one once. Mix, and give 
a teaspoonful each hour until relieved. 

Chronic Meningitis, Cerebral: In all probability, this affection is the 
result of a poison in the system, known as syphilis, either acquired or 
hereditary, and a history of the constitutional affection should always be 
sought for. Even when it is not clearly found, if the inflammation can- 
not be traced possitively to another cause, the existence of syphilis is to 
be suspected and govern the treatment. Iodide of Potassium should be 
given. Take of the Saturate Solution of Iodide of Potassium one ounce, 
and give at first Ave drops, in. sweetened water flavored with Essence of 
Peppermint, three times a day. Increase the dose by one drop each day, 
until relief is obtained. Thirty or forty drops may be given at a dose, if 
relief is not sooner obtained. Give after meals. 

Quiet of mind and body is necessary. Nutritious food and warm 
©lathing should be provided, and a warm bath be given two or three times 
a week. If the patient is pale and weak, Iron and bitter tonics should be 
given. The Citrate of Iron and Quinine is an eligible form in two-grain 
doses; one dram of the drug dissolved in four ounces of syrup or water, is 
a convenient mixture. 

Dose : A teaspoonful, given before meals. 

Let us repeat. Iodide of Potassium appears to be the remedy for 
chronic meningitis not dependent upon tubercle or an injury. 

The writer is of the opinion that cauterization, blistering, etc, in this 
disease, are not, in the slightest degree, beneficial in arresting the disease, 
but add to the discomfort of the patient. They are not to be used, except 
in obstinate vomiting, when a fly blister should be applied to the nape of 
the neck. 

Treatment of 'Tuberclous Meningitis : This disease, depending upon 
the presence of tubercular deposit, offers very little encouragement for 



INFLAMMATION OF THE BRAIN. .1C7 

treatment, if the diagnosis is clear. "We are bound, however, to do what 
we can to give relief. The general principles of the treatment of acute 
and then of chronic meningitis obtain. Depletion should not be practiced. 
Cathartics should be limited to the relief of the constipation, which, as a 
rule, exists. For this purpose, Calomel, in one or two-grain doses to a 
child, and ten grains to an adult, followed, in six hours, by Castor Oil — 
a teaspoonful to a child ; a tablespoonful to an adult, if the bowels have 
not opened. In the main, measures to relieve pain and prolong life, are 
alone indicated. 

For the relief of pain, restlessness, etc., the use of Opium, Chloral and 
Bromide of Potassium, are indicated. The dose of Opium will vary from 
one-tenth of a grain to a child a year old, and a grain to an adult, 
repeated at intervals of two hours, until pain is relieved. Or Chloral 
Hydrate can be given in combination with Bromide of Potassium, as fol- 
lows: Take of Chloral Hydrate two scruples, Iodide of Potassium two 
scruples, Syrup of Tola and water each one ounce. Mix. 

Dose: Give a teaspoonful, three or four hours apart, to a child one 
year old. The dose for an adult would be twenty grains of each drug. 
To prolong life, stimulants, in doses of a teaspoonful of whisky or 
brandy, may be given to a child, and one or two tablespoon fuls to an 
adult, in addition to nourishing, easily-digested food — as milk and eggs, 
either alone or beaten together; cream, meat essences and extracts, and 
raw lean meat, minced fine. 

Preventive treatment is by far the most important and hopeful, 
especially for the consumptive predisposition, which is generally 
hereditary. If a baby, he (or she) should be brought up by a hearty wet 
nurse, and should not be weaned until he has cut all his teeth. Flannel 
should be worn next the skin, and the clothes should be warm. Over- 
exertion of mind and body should be avoided, but free exercise taken in 
the open air. The diet should be plain and nutritious. Milk should be 
freely taken. If the patient is reduced or decreasing in strength, Cod 
Liver Oil should be given. The Syrup of the Phosphates with Iron is, also, 
an appropriate remedy. Exposure to measles, and whooping cough, 
should be avoided, being especially liable to be followed by some form of 
tuberculous disease. 

H'JMCEPATHIC TREATMENT.— With regard to the treatment of this 
disease, we may begin by stating that medical aid should always be pro- 
cured, if within reach ; but when it is impossible or difficult to secure 
such assistance, the following remedies may be resorted to: 

Aconite is invariably required at the commencement of the attack, 
when the skin is hot and dry, and the pulse rapid, with the ordinary indi- 
cations of pure Inflammatory Fever, which is especially liable to be the 
case in young plethoric subjects. 

Dose: Dissolve six globules in three tablespoonfuls of water and give 
a teaspoonful of the solution every hour, until the pulse diminishes 
in force and frequency, and the skin becomes moist or covered with 
profuse perspiration ; after which, the intervals may be extended to 
two hours and the administration be proceeded with, if no other 
medicine appears to be indicated, until general and progressive im 
provement becomes apparent. But if any of the subjoined symp- 
toms remain or supervene, consider the following medicines, and 
select that which is indicated by the symptoms present. 



138 THE BRAIN AND NERVOUS SYSTEM. 

Belladonna seems to possess a certain specific influence over inflam* 
mation of the brain and its membranes, and is generally the remedy we 
should select, when the following, amongst other symptoms, present 
themselves: great heat of the head; redness and bloatedness of the face, 
with violent pulsations of the arteries of the neck; burying the head in the 
pillow, and increase of suffering from the slightest noise, with extreme 
sensibility to light; violent shooting and burning pains in the head; eyes 
red and sparkling, with protrusion or wild expression; contraction or dila- 
tion of the pupils ; violent and furious delirium; loss of conciousness ; some- 
times low muttering; convulsions; occasionally symptomatic hydropho- 
bia; vomiting ; involuntary evacuations of the faeces and urine. 

Dose: Of a solution of six globules to three tablespoonfuls of water, 
give a teaspoonful every two hours, until a change. But if distinct 
improvement supervene, (without intervening apparent aggravation.) 
the intervals should be extended to four hours, and, again, after two 
more doses — if the amelioration be regularly progressive — to eight 
hours; and so on, until permanent improvement or change. But, in 
very urgent cases, and when repeated doses of Belladonna have pro- 
duced inadequate results, consider the next medicine, and proceed 
accordingly. If in alternation with Zincum, a similar solution of 
each (separately) administered by teaspoonfuls, at intervals of half 
an hour (or even fifteen minutes,) in rotation, until the urgent symp- 
toms abate. 

Zincum may be had recourse to, after, or in alternation with Bella- 
donna, when that remedy effects only partial amendment. In those 
extreme cases, where symptoms of threatening paralysis of the brain are 
manifested by the following indications: Loss of consciousness; half- 
closed eyes; dilated, insensible pupils; icy coldness of the extremities, or 
of the entire surface of the body; blueness of the hands and feet; impeded 
respiration; small, weak, scarcely perceptible pulse; Zincum has been 
found effectual in averting a fatal issue. 

Do.se: If singly, dissolve six globules in three teaspoonfuls of water ; 
and give a teaspoonful of the solution, (or, otherwise, three globules 
dry on the tongue,) every hour, (or, in very urgent cases, even every 
quarter of an hour,) until the lividity and coldness, and the indica- 
tions of the pulse assume a more natural aspect — and then every 
three hours, until general improvement or change. If in alternation 
with Belladonna, as directed for that medicine. 

Bryonia. This remedy will frequently be found of great efficacy in 
children, when Aconite and Belladonna have produced but trivial improve- 
ment, and the symptoms manifested resemble those enumerated in the 
article on "water on the brain." 

Dose: Dissolve six globules in four teaspoonfuls of water, and give a 
teaspoonful of the solution every two hours, until amelioration or 
change; but if partial improvement only should become apparent, 
within two hours after the third close of Bryonia, pause two hours 
longer, and proceed with the next medicine. 

Helleborus-Niger is required after Bryonia, in cases exhibiting the 
characteristic features of water on the brain, when the last named medi- 
cine has been inadequate to overcome the disease. In such cases, and 
when partial improvement only has resulted from the previous adminis- 
tration of Bryonia, Helleborus should be given four hours after the third 
dose of the last named medicine. 

Dose: As directed for Bryonia. 



WATER ON THE BRAIN. 139 

Hyoscyamiis is appropriate when there is drowsiness, loss of con- 
sciousness; delirium about one's own affairs; inarticulate speech ; tongue 
coated white, with frothy mucus about the lips; dilation of the pupils; 
fixedness of vision ; skin dry and parched; redness of the face, and picking 
of the bed clothes with the fingers. 

Dose: Of a solution of six globules to two tablespoonfuls of water, 

give a teaspoonful every one to three hours, until amelioration or 

change. 

Opium. When there is lethargic sleep, with snoring respiration; half 

open eye*, and confusion or giddiness after waking; congestion of blood to 

the head; complete apathy and absence of complaint. 

Dose: Of a solution of six globules to two tablespoonfuls of water, 
give a teaspoonful (or otherwise three globules dry on the tongue,) 
every hour, until amelioration or change. 

Stramonium* When there is starting or jerking in the limbs; sleep 
almost natural, followed by absence of mind after waking, but sometimes 
attended with moaning and tossing about; vision fixed, and the patient 
frequently appears in a state of dread, and utters cries ; redness of the face ; 
feverish heat, with moisture of the skin. In many of the symptoms this 
remedy bears a close resemblance to Belladonna, with the exception of 
being indicated by signs of a more spasmodic character, and by less acute 
pain in the head. 

Dose : As directed for Hyoscyamus. 



HYDROCEPHALUS. 

DROPSY OF THE BRAIN. WATER ON THE BRAIN. 

In general, we understand by Hydrocephalus, every unhealthy accu- 
mulation of fluid in the cavity of the skull. It may be either acquired or 
exist from earliest life. 

Acquired Hydrocephalus is seldom an independent disease, but rather 
is generally symptomatic of some other constitutional disease. It becomes 
an important symptom when the disease sets in as a chief complication in 
meningitis; or when it develops itself so rapidly that it acts like apoplexy, 
and speedily terminates fatally, (then it would be called serous apoplexy.) 
It is very hard, indeed always uncertain, to diagnose this disease. It 
scarcely ever calls for a special treatment, and had better be treated with- 
out medicines, by means of care and diet. 

Congenital hydrocephalus (that which exists from earliest life,) com- 
mences before the child is born, but may increase after birth. 

The quantity of accumulated fluid may be very large, and hence the 
skull may acquire an extraordinary size. Its effects upon the child are 
sometimes imperceptible, but at other times very decided; the mental 
actions of the brain are mostly involved. It is only in very fully developed 
cases, that the motions of the muscles are interfered with, in which case a 
more or less complete paralysis sets in. The life of the patient is not 
absolutely threatened; it may be admitted that hydrocephalic children, 
who have got over the period of infancy, have pretty nearly escaped the 
most imminent danger of death, from this immediate cause. But they 
always remain weakly, irritable, and unusually disposed to frequent and 
malignant diseases. Hydrocephalus, or dropsy of the brain, is a curable 



. 140 THE BRAIN AND NERVOUS SYSTEM. 

disease, but such a cure is mostly spontaneous, taking place in proportion 
as the bodily development progresses, and if the body does not develop, 
the limbs remaining small, or paralyzed, the chances of cure are propor- 
tionately less. A cure may, indeed, be facilitated by artificial means, but 
not by medicines. A main point is to bring up such children with great 
care, to accustom them to light and nourishing food, and to active bodily 
exercise, and to excite their mental faculties until the body is well devel- 
oped. Such children should not be allowed to attend school until they are 
fourteen or fifteen years of age, and there need be no uneasiness about 
them falling behind their companions of the same age. If so held back 
they will, almost without exception, excel in study when permitted to 
apply themselves. 

H03KE0PATHIC TREATMENT.— Among medicines, if we do use them 
at all, there are none which offer more hope than Carbonate of Lime 
(CalcariaCarb.,) and Arsenicum , but they must be given in small and very 
rarely repeated doses. Do not bandage the head of infants tightly for this 
disease. A very moderate bandage, in very early life, will likely be beneficial, 
while the tight bandage will be likely to cause inflammation and death. 

ALLOPATHIC TREATMENT.— This disease unfortunately gives very 
little hope of benefit from treatment. Physicing, bleeding, blisters, and 
salivation are to be avoided. Gentle laxatives or injections should be 
depended on to keep the bowels open. Plain nourishing food and Cod Liver 
Oil or Cream should be given. A child can take a teaspoonful of Cod Liver 
Oil two or three times a day, while a tablespoonful is enough for an adult. 
The active remedies which appear the most useful are Iodide of Potassium 
and Iron. A convenient prescription for a child is : Take of Iodide of 
Potassium thirty-two grains, Phosphate of Iron sixteen grains. Dissolve 
each salt in a little water separately, then mix and add simple syrup suffi- 
cient to make a two ounce mixture. 

Dose: A teaspoon half full four times a day, to a child one year old. 

One drop each of the Vinegar of Squills and Tincture of Digitalis can 
be given to a child three or four times a day to keep the kidneys active. 

As a last resort, the physician would be barely justified in resorting to 
puncturing, to draw the water, and compressing the head by strapping. 

Preventive measures should be closely followed. The strength of the 
child having a tendency to hydrocephalus, should be increased as far as 
possible. Nourishing food with as much milk as can be digested, meats, 
and, if the child is reduced in strength, Cod Liver Oil should be given. 
Warm clothing, a daily bath, good sleep every night, in a well ventilated 
room, and exercise in the fresh air, are all helpful. Stimulants should be 
avoided. When the child has become of an age to commence its education 
(seven or eight years) only short and varied lessons should be given, 
and mental fatigue avoided. 

Congenital Hydrocephalus, or dropsy of the brain. — If the disease is 
congenital (from birth,) it may be questioned whether anything should be 
done to relieve the infant, except attending to its general health. There 
are medicines which, in many instances, diminish watery accumulations in 
internal cavities; the parents are very anxious for the recovery of the 
little one; some recoveries are reported. These facts, and the hopelessness 
of the disease, if left to nature alone, lead the physician to resort to medi- 
cinal treatment. 



LOCK-JAW. 141 

Medicines which act on the kidneys (diuretics) are generally supposed 
to be called for, and with reason. The best of these is Iodide of Potassium, 
as an efficient diuretic, and, possibly having a direct influence over the dis- 
ease. The dose for a child, six months or a year old, is one or two grains 
three to six hours apart, dissolved in half a teaspoonful of Syrup of Pep- 
permint, or sweetened water flavored with Essence of Peppermint. 

Pressure of the head by a closely fitting cap, or very narrow strips of 
adhesive plaster, (one-third of an inch wide) and applied evenly over the 
skull, from side to side, and then from back of the neck to the orbit, may 
be of great use. Care in the use of pressure should be exercised, not 
to produce compression of the brain. If pressure is tolerated, and health 
good, the prospect is better. Generally the fluid accumulates so the straps 
must be loosened in two or three days. This process should be managed by 
a physician 

Tapping is sometimes resorted to, and, also, sometimes after the re- 
moval of the fluid, a solution of Iodine, one-third of a grain, and Iodide of 
Potassium one grain, to an ounce of distilled water, is injected into the 
cavity of the arachnoid membrane. This requires a physician. 

I can see no indication for irritating applications. 

Attention to the general health is necessary. Constipation of the 
bowels should be relieved by an occasional purgative, as a half teaspoonf ul 
of Rochelte Salts; three to five grains of Calomel, or a teaspoonful of Castor 
Oil. (The disagreeable taste of Castor Oil is removed by mixing it with an 
equal quantity of pure Glycerine and flavoring with a couple of drops of 
Oil of Cinnamon or Wintergreen, The diet should be of the breast milk, 
with Cream or Cod Liver Oil, and raw meat minced fine. 

The treatment of acquired dropsy of the brain will be noticed in the 
diseases leading to this affection. Generally there is but little encourage- 
ment for treatment. Diuretics are called for. Iodide of Potassium and 
Acetate of Potash, are the best; the dose of the former is one or two grains, 
and the latter three to six grains, four to six times a day. 

Blistering should be produced behind the ears with the Blistering Col- 
lodion. Active congestion will call for cold to the head, cathartics and 
Bromide of Potassium in doses of five to ten grains, three or four hours 
apart, for a child a year old. Constipation should be relieved. 



TETANUS. 

TRISMUS. LOCK-JAW. 

A painful disease, the leading symptom of which is persistent spasm of 
the voluntary muscles. When the muscles of the lower jaw are aifected 
it is called trismus, or lock-jaw. 

The disorder is chiefly occasioned, either by exposure to cold or by 
some irritation of the nerves resulting from local injury, particularly of 
tendinous parts, (example in the hand or foot,) it is then called trumatic 
tetanus or trumatic trismus. The amputation of a limb, or the pulling on 
a nerve by some ligature used in tying some of the blood vessels, cut 
into either accidentally, or during some surgical operation When it 
takes place in consequence of such a cause, or from any other external 
injury, the symptoms generally set in about the eighth day, sometimes later, 



142 THE BRAIN AND NERVOUS SYSTEM. 

but when they follow exposure to cold, they usually set in much earlier. 
In some cases the attack comes on suddenly, and with extreme violence, 
but it more generally approaches gradually, a slight stiffness being first 
experienced in the back of the neck, with an uneasy sensation at the 
root of the tongue, and a difficulty in performing the act of swallowing, 
an oppressive tightness is complained of across the breast or in the chest, 
with a pain at the lower end of the breast bone, or in the pit of stomach, 
extending into the back, the breathing is hindered, the face pale, 
pulse small, bowels constipated and urine high-colored; a stiffness 
takes place in the lower jaw, which soon increases to such an 
extent, and presses the jaws so closely together that the smallest opening 
is unattainable, and now the patient has the lock-jaw. In some cases the 
spasmodic contractions proceed no further ; in others they return with 
great frequency and intense severity, and, also, extend to the arms, the 
abdominal muscles, the back and lower extremities, so as to bend the 
body forcibly backward (Opisthotonos), even to such a degree that the 
back of the head touches the heels, or forward (Emprosthotonos) until 
his nose touches his toes, or sideways (Pleurostiiotonos). Finally, the 
arms, lower extremities, head and trunk become rigidly extended, caused 
by an equal contraction of all the muscles. The tongue is, also, seized with 
spasm, and is, not un frequently, injured by the teeth becoming clenched 
together just as it is convulsively darted out. As the affection advances, 
the eyes become fixed and immovable, the whole countenance is fright- 
fully distorted and expressive of extreme anguish, the pulse irregular, 
the strength completely exhausted, and a termination is put to the suffer- 
ings, generally, about the fourth day, in acute cases, by one concentrated 
spasm. In some cases, the fatal termination is protracted considerably 
beyond the stated period. 

The spasmodic action does not continue unremittingly, the muscular 
contractions occasionally admitting of some abatement, but is generally 
renewed as soon as the patient makes an effort to speak, drink or move. 

Prognosis. — This disease is so intractable, that under any known 
treatment, the most stolid practitioner can but consider the attack as 
unfortunate in the extreme, and his prognosis must be unfavorable, 
although not always fatal. 

ALLOPATHIC TREATMENT.— "Lock-jaw" is so dangerous an affec- 
tion, that none would scarcely venture to assume the responsibility of the 
treatment, and, unless he be a physician, such a person would be fool- 
hardy. 

Most, if not all plans of treatment, prove unsuccessful in a large pro- 
portion of cases. The remedies, which appear to be most successful, are: 
Bromide of Potassium and Hydrate of Chloral. Forty grains of Bromide 
of Potassium, dissolved in water with syrup or sugar, should be given 
every two or three hours, or a dram (sixty grains) every three or four 
hours apart, during the day, until half an ounce (two hundred and forty 
grains) has been given; double this amount maybe necessary. At bed 
time, a full dose of Chloral Hydrate, forty grains, dissolved in water with 
syrup or sugar, should be given for the purpose of securing sleep. In the 
morning, thirty grains of Chloral may be given, if the temperature 



LOCK-JAW. 143 

Nitrite of Amyl has been used with success in a very limited num- 
ber of cases. It appears to control the spasms, and may be administered 
by inhalation, three to six drops on a handkerchief. A fullness of the 
head dictates the removal of the handkerchief. It should be repeated 
sufficiently often to relieve the spasms. I would recommend giving 
Chloral Hydrate at bed time, as directed above, even if the Nitrite is 
depended on. 

Calabar Bean. — Of late years this remedy has come largely into 
vogue in the treatment of tetanus. Out of fifty nine cases treated with 
this drug thirty-two recovered. Dr. Fraser recommends beginning with 
one-third of a grain of the extract by subcutaneous injection, and increase 
the dose continuously until the reflex excitability is sensibly diminished, 
then continue the injections at that dose. In milder cases, the medicine 
may be continued by the mouth in doses three times as large as the 
largest given by hypodermic injection. It is possible that if a good qual- 
ity of extract could be used every time, the result would be better. 

In all cases attention should be strictly paid to nourishing the patient 
and so support the powers of life. Four ounces (one-fourth of a pint) of 
good rich milk, with brandy, should be given every four hours, and a 
raw egg beaten with milk and brandy, four times in the twenty-four 
hours. 

In cases of trumatic tetanus (caused by injury), all remaining sources 
of irritation, such as fragments of bone, bullets, pieces of cloth, or any- 
thing else, should be removed. Oftentimes the surgeon is justified in 
amputating the injured part, as a means of cure of the lock-jaw. This 
procedure is the more hopeful, if the spasm is confined to the jaw. 

Tetanus of infants is best prevented by cleanliness, warmth, fresh air 
and dry apartments. On southern plantations, where the disease appears 
endemic, it is arrested by having the cabins whitewashed with lime, both 
inside and out ; raising the floors up from the ground, that air may cir- 
culate freely under them; removing all filth from and about the houses ; 
particular attention to cleanliness of the bedding and clothing of the 
mother and child, and preventing any matter from the navel coming and 
remaining in contact with the skin. A dressing of one part Turpentine 
and two parts Sweet Oil or Lard, is highly recommended. A warm bath 
should be given the child daily. 

After the disease has become developed, the foregoing hygenic meas- 
ures should be carried out rigidly. The medicinal agents, which, in my 
judgment, are preferable to all others, are the Bromide of Potassium and 
Hydrate of Chloral, given after the same manner as directed for adults. 
The dose for an infant would be three grains given every two or three 
hours, which may be increased to five, or even ten grains, if the spasms 
are not relieved. 

AVhen desirable to produce sleep, I would give two grains of Hydrate 
of Chloral with the Bromide of Potassium, every hour, until sleep takes 
place. After a couple of doses of the Hydrate of Chloral, if sleep has not 
taken place, the dose should be gradually increased until five or six grains 
are given, or until the desired effect is reached, namely, sleep. Eight 
scruples of the Bromide of Potassium, dissolved in two ounces of simple 
syrup, contains ten grains to a teaspoonf ul. Of this mixture, one-fourth 



144 THE BILAIN AND NERVOUS SYSTEM. 

of a teaspoonf ul will be a dose to begin with. Six scruples of Hydrate of 
Chloral, dissolved in two ounces of syrup, gives eight grains to the tea- 
spoonful, and one-fourth of a teaspoonf ul the dose to begin with. If the 
spasms are so severe that the child cannot swallow, I would not hesitate 
to give at once, by injection into the bowel, a teaspoonf ul of the Bromide 
of Potassium mixture and a half teaspoonf ul of Hydrate of Chloral mix- 
ture. The disease is very dangerous, too dangerous to be treated without 
a physician. 

A blister, the size of a dollar, over the navel, is said to be useful when 
the disease does not yield to remedies by the mouth. 

The spine may also be thoroughly rubbed with some stimulating appli- 
cations, as turpentine, or hartshorn liniment. 

Brandy should be given in doses of ten drops to half a teaspoonful, 
with milk or beef essence, at short intervals, to prevent the rapid exhaus- 
tion of the patient. 

HOMEOPATHIC TREATMENT.— Aconite is useful in lock-jaw, where 
there is frequent alternation of red and pale face, witli distorted eyes, 
thumb turned into the palm of the hand, and the hand clenched, pulse full 
and bounding. 

Arnica. — In cases arising from an injury, such as bruise or cut of the 
flesh, or the puncture of a needle, pin, hay-fork, or like sharp pointed instru- 
ment, it should be given internally, ten drops in a quarter glass of water, 
two teaspoonfuls every hour, or half hour, if the case is urgent, at the 
same time it should be applied externally to the wound ; take one part 
Tincture Arnica to five parts water, moisten a soft cloth, and keep it on the 
parts injured. 

Opium is a useful remedy in some of the severest forms of tetanus, 
as well as lock-jaw, either from an injury or cold. The muscles of the 
whole body tremble, there is foam at the mouth, and finally the whole 
body is bent backward, in the form of an arch, when Opium is useful. 

Niix-vomica, or Strychnia, — When there are extremely severe 
spasms, followed by a short period of relaxation, then another spasm at 
periods of three to six minutes. 

Belladonna.— -In attacks of trismus among children, when a jar of 
the bed will bring on a spasm. 



DELIRIUM TREMENS. 

This is a disease frequently occurring in persons who are in the habit 
of using intoxicating liquors, even when they do not drink enough, at any 
one time, to become intoxicated. It is a dangerous disease, which 
frequently destroys life, or causes a state of insanity. 

Symptoms: It usually commences with some degree of nausea, vom- 
ting, and loss of appetite, especially for breakfast, which is, sooner or 
later, followed by constant wakefulness, incessant talking, walking about 
restlessly, and, sometimes, raving from the first. There is a constant 
trembling and unsteadiness of the limbs; the hand is unsteady ; the tongue 
is tremulous when protruded; the walk is staggering, the skin is cold, and 
the pulse is weak and rapid. 

As the disease progresses the symptoms become worse ; the patient 
is not silent for a moment; he is constantly talking, scolding or laughing ; 



DELIRIUM TREMENS. 145 

changing from one thing to another, rapidly; arranging his clothes, room, 
bed, etc., with more or less agitation and mental suffering. He imagines 
the presence of things which he knows are mere illusions, or they may 
appear so real as, for a time, to make him actually believe that they truly 
exist; but, most generally, this deranged perception may be explained 
away, for the moment, by some kind friend. Among these imaginary 
objects, are: rats, mice, serpents, fiends, witches, guns, dragons, bugs, 
insects, etc., to free himself from which, he will have the most fearful 
struggles, with expressions of disgust, distress, and eveu fear and horror. 
It is impossible to name the various fancies which he creates ; at one time 
laughing, at another begging, with tears in his eyes, for life; then humbly 
asking pardon for some imaginary wrong. Again, pointing, with raving 
expressions, to the objects conjured up in his disordered mind; and, finally, 
raving almost like a maniac. 

His eyes are bloodshot and in constant motion, with a peculiar glare, 
glancing fearfully and suspiciously at every object around him ; the coun- 
tenance is usually pale, haggard and distressed, the tongue coated with a 
thick, yellowish mucus, the head hot, and the bowels costive, with occa- 
sionally nausea and vomiting. 

If the patient is not relieved, he becomes worn out, and is compelled 
to lie down from sheer weakness, and may die suddenly, in an apoplectic 
or epileptic fit, or, he may gradually sink, the surface becoming cold, with 
clammy sweats, low, muttering delirium stupor, picking at the bedclothes, 
twitching of the tendons, and death. Sometimes the first symptom is an 
epileptic fit, or apoplexy, on recovery from which, well marked delirium 
tremens occur. 

The development of the disease most frequently follows a sudden 
abstinence from the use of liquors, among those who have become addicted 
to their excessive use, by which means the brain becomes excessively 
weakened and impaired. 

It likewise frequently happens, while the person is in the full tide of 
his "spree," and also, occasionally, after a continued but moderate use of 
alcoholic drinks. It usually comes on, in from one to five days, after the 
discontinuance of the inordinate alcoholic excitement. 

In the treatment of a patient with delirium tremens, opposition and 
the use of force should be avoided as much as possible, because they give 
rise to irritation, and increase the difficulty. Gentle and persuasive 
measures are the best, with a degree of firmness ; and at no time must you 
yield to the fancies of the patient, but rather reason or laugh him out of 
them. This course will accomplish much more than an opposite one. 
Take of the SuIpJiate of Quinine eight grains, Sulphate of Morphia one 
grain, mix and divide into four powders; one of these powders should be 
given every hour, for two or three doses; afterward, lengthening the time, 
so that too much Morphine be not given. Give the patient, shortly after 
the first powder, a tablespoonful of good brandy, in water and sugar, as a 
reward for a promise from him that he will lie still and try to go to sleep; 
repeat, if need be, until he does sleep; then let him rest three hours; after 
he awnkes, give light food. 

ALLOPATHIC TREATMENT.— The success of treatment in this disease, 
attended with prostration, depends on nourishment,relieving the restlessness 
and inducing sleep. Milk, raw eggs, beef essence, or strong beef tea, should 

10 



146 THE BRAIN AND NERVOUS SYSTEM. 

be freely given. Both these ends are aided by the administration of Quin- 
ine, in two or three grain doses every three or four hours. The nervous- 
ness and restlessness, preceding the active delirium, is best relieved by the 
Bromide of Potassium, during the course of the disease; it is, also, equally 
useful to relieve the same symptom; but, to be effectual, it must be given 
in doses of forty to sixty grains, every four hours, dissolved in water or 
syrup- For the production of sleep, there is no remedy so uniformly suc- 
cessful as Hydrate of Chloral, given with the Bromide of Potassium, in 
doses of twenty to thirty grains. In old drunkards, it should be used with 
great caution. After a second dose of thirty grains of Chloral, if sleep is 
not induced, Morphine, in doses of one-third of a grain, may be given, and 
repeated, if necessary, in two or three hours. It is best given by hypoder- 
mic injection. However necessary sleep and quiet is, it is still more 
necessary to establish digestion, and support the powers of life, by suitable 
nutrition. In most cases, this, of itself, will quiet the delirium, induce 
sleep and carry the patient to recovery. 

Digitalis is found useful in this disease, in doses of a teaspoonful of 
the tincture, or a tablespoonful of the infusion, made to two drams of the 
leaves to a pint of hot water. After four hours, the dose may be repeated. 
Pouring cold water on the head, and the free use of hop tea, are frequently 
of advantage in quieting the delirium. 

The patient, should be treated kindly, and left in charge of an attend- 
ant in whom he has confidence. Visitors should be excluded from his 
room. 

Treatment of Alcoholism.— The chief point in the treatment of 
the mania for drink is to enforce at once total abstinence; this is more easy 
than to practice moderation 

The sleeplessness may be guarded against by forty to sixty grain doses 
of Bromide of Potassium at bed time. If necessary, with this can be com- 
bined fifteen to twenty grains of Hydrate of Chloral, or two teaspoonf uls 
to a tablespoonful of Tincture of Hyoscyamus, gradually diminishing the 
dose as the symptoms disappear. Tonics should also be given. Of these 
the Citrate of Iron and Quinine, in doses of five grains, dissolved in water 
or syrup, two drams and a half to eight ounces. 

Dose: A dessertspoonful three times a day. 

The Phosphate of Zinc, with extract of Nux Vomica in pill form, a 
quarter of a grain of the former, and a quarter to half of a grain of the 
latter, and one grain of Quinine, three or four times a day, will aid greatly 
in restoring the nervous system to a healthy state. The diet should be 
strong and nourishing, consisting largely of milk and eggs, beans, oatmeal, 
wheat and vegetables, with an absence of lean meat. This rule of diet 
should be observed after health is established. 

There is no more deplorable practice, both among physicians or in 
domestic practice, than the frequent giving or taking of alcoholic stimu- 
lants. It is not to be doubted that a habit of using liquors as a beverage 
not infrequently begins by "taking a little brandy and water occasionally," 
or " a glass or two of wine," for low spirits or a temporary indisposition. 
The practice is both harmful and useless. 

HOMEOPATHIC TREATMENT.— A rsenicum. Pale, yellow com- 
plexion; bloated face, and cold, blue skin; fainting fits, particularly during 
vomiting. The patient imagines that vermin are crawling about the bed, 



EPILEPSY. 147 

and ugly animals are staring him in the face. Great restlessness and fear 
of death. Extreme thirst; drinks little and often. 

Done: Six pills to a tablespoonful of water, one teaspoonful every 
thirty minutes. 

Belladonna. Persons of a full, plethoric habit of body. Flushed 
face and red eyes, with dilated pupils. Boisterous delirium, with desire to 
escape. lie tears the clothes, strikes, bites and shrieks, in his rage. Sud- 
den starting and jumping, while sleeping. 

Dose: As for Arsenicum. 

Camphor. Features distorted; eyes sunken; face, hands, and feet, 
icy cold. Confusion of ideas; maniacal delirium; convulsions, frothing at 
the mouth and insensibility. Retention of urine, with constant desire to 
pass water. 

Dose : A drop or two, on a little lump of sugar, every hour. 

Hyoscyamus. Twitching and jerking of the muscles, especially of 
those about the face and eyes. Furious delirium, with wild, staring look ; 
dilated pupils, and throbbing of the carotid arteries. Grasping at imagin- 
ary objects; muttering. 

Dose: As directed for Arsenicum. 

Nux Vomica. Trembling of the limbs, and spasmodic twitching of 
different parts of the body. Incapable of thinking correctly. Makes fre- 
quent mistakes in talking. Delirium, with frightful visions, and efforts to 
escape. Very irritable, and wants to be alone. Constipation with large 
and difficult stools. Apprehensive of death. 

Dose: Double that recommended for Arsenicum. 

The best remedies for the inclination to drink, and the evil effects of 
drunkenness, are Ars., Nux.-v., Sulph. 



EPILEPSY. 

MORBUS DIVIXAS, MORBUS IIERCULEUS. 

This is a disease marked by sudden and temporary seizures of un- 
consciousness, accompanied by convulsions, and is one of the most terrible 
diseases that afflict mankind. There are so many varieties of epilepsy 
that it is impossible to give a definition of the disease that will apply to 
them all. In most cases it is characterized by convulsions and loss of con- 
sciousness, occurring at longer, or shorter intervals, during which the 
patient is almost in good health. The absence of fever in epileptics serves 
to distinguish their affection from meningitis, and other inflammations 
accompanied by convulsions. The complete loss of conciousness, also, dis- 
tinguishes epilepsy from hysteria, as in most nervous diseases, a heredi- 
tary tendency is among the most frequent predisposing causes of epilepsy. 
Epilepsy often appears in the offspring of persons who have had various 
nervous complaints, such as epilepsy, insanity, paralysis, apoplexy, 
and hysteria. There is no doubt that women are much more frequently 
attacked with this disease than men. The most frequent periods at which 
epilepsy begins are: early infancy, and puberty, although no period of life 
is exempt from its first attacks. Various malformations of the body, and 
especially of the cranium, are certainly among the most frequent predis- 
posing causes. Weak constitutions are favorable to the production of 



148 THE BRAIN AND NERVOUS SYSTEM. 

epilepsy. Among other predisposing causes, are dentition, the first 
appearance, and the cessation of menstruation, onanism, and the abuse of 
alcoholic drinks. Almost all kinds of diseases may produce epilepsy, but 
among the principal we must place those affections in which the blood 
becomes altered, or diminished, and organic affection of the cerebro-spinal 
axis, and of certain other parts of the nerve centers. Another powerful 
cause is excessive loss of blood. Pregnancy, parturition (confinement), 
menstruation, frequently cause epilepsy. A tumor, or a nerve, or any 
cause of irritation on the trunk, or the terminal part of any sensitive 
nerve, and especially, in the skin, or mucous membrane very often pro- 
duces it. A wound, a burn, worms in the bowels, or elsewhere, stone in 
the bladder, or in other places, foreign matter in the ear, etc., are known 
to have caused epilepsy. It is quite certain that great mental excitement 
has originated it in many cases, but it seems probable that the disease was 
not introduced by those causes, but was only brought on by them to man- 
ifest itself. 

When a fit is about to take place, it is usually preceded by some sensa- 
tion, or some change in the mind of the patient. If a sensation precedes 
the fit, it comes most frequently from some part of the skin, and especially 
from that of the fingers and toes. This sensation is well known under the 
name of aura epileptica. There is as much variation in the variety, and 
intensity of the sensation, as in its point of starting. Most frequently the 
aura is a sensation of cold, or burning, or that kind of sensation produced 
by a draft of cold air on limited parts of the body. Sometimes the aura 
starts from the eye or the ear, and then a flash of light, or some other sen- 
sation comes from some part of the eye, or peculiar sounds are heard. The 
stomach and bowels are also often the starting point of the aura. Some 
epileptics become gay, others mournful when they are about to have a fit; 
in others, the attack is announced by some change in the digestive func- 
tion. A complete attack usually begins with an extreme paleness of the 
face, and at the same time, or nearly so, there are contractions of several 
muscles of the face, the eye, and the neck. Observers do not agree as 
regards the first manifestation of a fit, probably, because the seizure does 
not always begin with the same phenomena. Not only have we known 
the first symptom, not to be the same in different epileptics, but in the 
same one we have seen differences, in three different attacks. Many phy- 
sicians think the scream, the first symptom. It often is, but the pale- 
ness of the face usually precedes it. Some epileptics do not scream; as 
soon as these symptoms have appeared a rigid spasm takes place in the 
limbs, and the patient falls. Respiration is suspended, and the face 
becomes quite injected with black blood, and assumes a hideous aspect, 
both from the spasm of its muscles and its blackish or bluish hue. Some- 
times a momentary relaxation is then observed in the limbs, but all at 
once clonic (jerking), convulsions occur everywhere in the trunk, the 
limbs, the face, and often in the various internal organs, as the bladder, 
the bowels and the uterus. 

The mouth then ejects a frothy saliva, often reddened with blood 
from the bitten tongue. The respiratory muscles, after the first spasms 
which produce the scream, and suffocation, causing a gurgling or hissing 
sound, become relaxed, and then those employed in inspiration contract, 



EPILEPSY. 149 

and almost as soon as air has reached the lungs, the convulsions cease or 
notably diminish. Ordinarily the fit is over in a few minutes, but it is 
not unfrequently the case, that after a general relaxation, another seizure 
comes on, and sometimes many occur with very short intermissions. 
During the whole time the fit lasts, the patient is deprived of conscious- 
ness, and when he recovers he remembers nothing that has taken place 
in the meantime. In some cases, the seizure is followed by prolonged 
coma, (insensibility) ending sometimes in death. 

When a patient recovers from a fit, even if it has not been very se- 
vere, he usually feels fatigue and suffers from headache. Fortunately he 
soon falls asleep, and ordinarily is almost as well as usual, when he 
wakes up, except that the headache and fatigue still continue, though 
much diminished. When many fits have taken place, even at some- 
what long intervals, such as several weeks mental derangement often 
supervenes, and in this way epilepsy often leads to insanity. In some 
cases the fits recur at regular periods, in others they return with every 
return of the circumstances which seem to have caused the first, such as 
menstruation, pregnancy, the influence of certain seasons, etc. There is 
sometimes, although seldom, perfect regularity in the length of the inter- 
vals between the fits, and they come every day, every week, every month, 
etc., at irregular hours. Many patients have very different intervals 
between their successive fits. Some have many fits a day, others every 
six months or every year. The greater the number of fits, the less violent 
they generally are. In the complete fit of epilepsy, there are two distinct 
features. 1. The loss of consciousness. 2. The muscular convulsions. 
Each of these may exist alone. In the case of a seizure, consisting only 
in the loss of consciousness, without convulsions, we have the so-called 
epileptic vertigo, which is a form of epilepsy which frequently exists alone, 
and also co-exists often with the form of the disease in which the attack 
is complete. In this last case, the patient sometimes has a complete seiz- 
ure, sometimes only an attack of vertigo. Whether vertigo exist alone or 
co-exists with complete attacks, it is very dangerous, not for the life of 
the patient, but because fits of simple vertigo lead more frequently to insan- 
ity than complete fits of epilepsy. The cases of epileptiform convulsions, 
without loss of consciousness, are not so frequent as the cases of simple 
vertigo. They are particularly produced by injuries to the nerves or spinal 
cord. 

The first thing to be done for an epileptic fit, is to find out, if possible, 
the cause which produced the attack, and, if it still exists, try to get rid 
of it. Very often epilepsy depends on some external cause of irritation, 
which may easily be removed. It is of the greatest importance to discover 
if there is anywhere such an irritation, and as the patient may not be 
aware of its existence, it is necessary to look for it everywhere. This is a 
proper place to point out the fact, not generally known among the masses 
of the people, that onanism or self-abuse, among children and young people 
of both sexes, is one of the most prolific causes of this truly terrible disease, 
and if the patient can be induced by any means to breakaway from the 
practice in any reasonable time, the epilepsy is virtually cured. Parents 
should not rest easy under the impression that their children would not be 
guilty of such a thing, but know to a certainty that such is not the case. My 



150 THE BRAIN AND NERVOUS SYSTEM. 

young friend, troubled with epilepsy, you know whether this is one of your 
habits, contracted by the influence of companions in school or elsewhere, 
and if such is the case, you may rest assured, that if you continue in the 
habit, absolute and certain ruin of your body and mind are the inevitable 
consequences. Patients and their families should remember that the rules 
of hygiene must be followed much more closely by epileptics than by those 
afflicted by almost any other disease. 

ALLOPATHIC TREATMENT. The treatment of Epilepsy will have 
reference to the management of the paroxysms (fits,) and, also, to measures 
for effecting a cure, which are to be employed during the intervals between 
the fits. During the fit, the patient should be laid on a large bed, or even 
the floor, where the fresh air can freely circulate around him. No effort 
should be made to restrain the convulsive movements. The necktie and 
all tight clothing should be loosened. A cork, roll of linen, or piece of soft 
wool should be held between the teeth to prevent the patient biting the 
tongue. Cooling washes may be applied to the head. 

In those cases which have a brief warning of an approaching fit (which 
is called the aura epileptica) the paroxysm may be warded off by inhaling 
Nitrite of Amyl at the beginning of the warning. The patient should carry 
a small vial of Nitrate of Amyl and inhale from three to five drops upon a 
handkerchief, when this warning or aura is experienced. The handker- 
chief should be removed when fullness of the head is experienced. Also 
those cases characterized by frequent repetition of the fits the same remedy 
is very useful in stopping their recurrence. It is also recommended as a 
means of mitigating severe attacks, but in advanced stages of the parox- 
ysms, it should be used very cautiously. Of all the remedies which enjoy 
a reputation for preventing or mitigating a fit, this occupies the first rank. 

Among other remedies which are recommended for the purpose of 
preventing a fit, Chloric Ether, Hoffman's Anodyne and Fluid Extract of 
Valerian, are to be mentioned ; the dose of Ether is a teaspoonful. These 
same remedies are, also, used to prevent the frequent recurrence of parox- 
ysms before alluded to ; Tincture of Belladonna or Opium are said to be 
useful for this end, given in doses of from fifteen to thirty drops. The 
physician is often led to try the inhalation of Chloroform. But all these 
remedies are, in my opinion, inferior to Nitrite of Amyl. If other mea- 
sures fail, or are not at hand, compression of the carotid arteries may be 
tried, first upon one side of the neck, for ten or fifteen minutes, and then 
upon the other side. If the convulsions are very severe, both arteries may 
be compressed at once. The compression is produced by pressing the 
artery with the finger or thumb, firmly against the spinal column. 

The treatment of epilepsy, as far as a permanent cure is concerned, has 
not been very successful. Endeavor must be made to improve the patient's 
general health, and to this end all the vital functions must be carefully 
inquired into, with all the penetration of the most skillful physician. 
All advanced physicians are agreed that every thing which depresses the 
vital powers does harm. The habits of life must be regular and moderate; 
daily exercise, early hours, and plenty of sleep, quiet occupation; atten- 
tion must be given to regularity of the bowels, and urinary secretion; 
Mental excitement should be avoided, and if the patient is a child, be 



EPILEPSY. 151 

kept from school. The diet should be simple, but generous and nutritious, 
including animal food, milk and eggs. Frequent bathing, two or three 
times a week, should be practiced. 

The habits of life which are pernicious, and may stand in a causative 
relation to epilepsy, and are to be prohibited, are: over-tasking of mind or 
body, either undue exposure or sedentary habits, the free use of alcoholic 
liquors, or tobacco, and sexual excesses, or self-pollution. 

There is no better established fact in the healing art, than the benefit 
of the Bromides (usually the Bromide of Potassium) in the treatment of 
epilepsy. It is not to be understood that the remedy is infallible, but it is 
true that it has been in~re useful than all other remedies combined. It is 
well determined that Bromide of Potassium is most valuable in those 
cases of epilepsy which are characterized by violent and frequent convul- 
sions. It is also noticed, that the beneficial effect of the remedy is more 
marked in attacks occurring in the day time than those occurring at night. 
The nice discrimination, in the use of remedies in epilepsy, requires the 
skill of an accomplished physician. But, roughly, it may be said, that 
Bromide of Potassium should be given in all cases which have a con- 
gested, (flushed,) or full appearance of the face, rush of blood to the head, 
(or more accurately, to the brain, this is most accurately determined by 
the physician, by examination with the ophthalmoscope). The dose of 
Bromide of Potassium at the beginning, should be about fifteen or twenty 
grains, three times a day, increasing the dose by ten grains each week, 
until from forty to sixty grains are taken at a dose, three or four times a 
day. The medicine should be continued in these doses until the peculiar 
effects of the drug (called Bromism,) are produced, or the fits have ceased. 
Bromism is shown by mental weakness, heaviness of the intellect, failure 
of memory, partial loss of voice, drowsiness, depression of spirits, pallor, 
and an eruption of the skin, and sometimes by abscesses. The remedy, if 
it prevents the fits, should be continued for several weeks, or even months, 
at the dose which has proved effectual, and gradually decreasing the 
dose until twenty or thirty grains are reached three times a day. The 
drug should not be discontinued, until fifteen or eighteen months have 
passed without a paroxysm. It is better for the patient to take the bro- 
mides all his life, than to have fits. The addition of the Bromide of Iron 
from one-half a grain to a grain, to a dose of the bromides, will do much 
to prevent the impoverishment of the blood due to bromism. The follow- 
ing is a good formula: 

Take of Bromide of Potassium, six drams: Bromide of Ammonium, two 
drams: Bromide of Iron, six grains: water, six ounces. Mix and give a table- 
spoonful three times a day. 

It is a good rule, even after the case has been free from fits for fifteen 
or eighteen months, to give a dose of from two scruples (forty grains) to 
a dram (sixty grains) every night for a couple of years. 

Many of those cases of epilepsy which are not benefited by the bro- 
mides, are greatly benefited by Strychnine, especially in subjects which 
have the lighter seizures (petit mal) as well as the severe paroxysms 
(grand mal), and, also, in those cases having the attack at night, though 
in the latter cases, if severe, the bromide will be required, also. The dose 
of Strychnine is one-thirtieth of a grain. It had better be given in solu- 



152 THE BRAIN AND NERVOUS SYSTEM. 

tion, though it is disagreeable to take, on account of its bitterness. The fol- 
lowing is a suitable formula: Take of Strychnine one grain, dissolve in two 
ounces of Dilute Phosphoric Acid, and two ounces of water. The Strychnine 
dissolves slowly, and plenty of time should be given for solution to be 
effected before taking it. If the appetite is poor, thirty grains of Quinine 
should be added to this mixture. The dose is a teaspoonful three times a 
day. Should it be found impossible to take this mixture, the pills of 
Strychnine, of one-thirtieth of a grain each, may be given instead. I pre- 
fer the pills of Phosphorus, one-hundredth of a grain, with Strychnine, 
one-sixtieth of a grain. 

Dose: Two pills three times a day, for a grown person. The Phos- 
phorus is valuable in improving the nerve nutrition. 

The direct Galvanic (electric) current is, sometimes, of great service, 
and may be used in connection with either Strychnine or the Bromides, 
or both. It can only be of service in essential or idiopathic epilepsy (i. e., 
cases not dependent on structural changes, or other obvious cause). The 
current should include the whole brain, having the poles of the battery 
behind each ear; or on the forehead and nape of the neck; or one pole 
on the nape of the neck, and with the other follow the course of the 
sympathetic, and, also, the nerves along which the aura, or warning, is 
transmitted. Each method of application may be used for one-third of 
the time at each sitting. If beneficial, the use of the Galvanic current 
should be continued for several months or a year. 

In some cases, it is necessary to pass a seton quite deeply through 
the back of the neck, in addition to the internal remedies. This is par- 
ticularly serviceable in connection with the Bromide. Both it and the 
Bromide seem to relieve the so-called reflex irritation. Cases of epilepsy 
caused by injuries to the skull, which is not relieved by the Bromide 
of Potassium, may call for surgical operation. If the patient has had 
syphilis or has syphilitic parentage, the Iodide of Potassium should be 
given either alone or in conjunction with other treatment, until all 
syphilitic symptoms disappear, when, if the fits cease, the further treat- 
ment will be that appropriate to that diseased condition, syphilis. For 
this complaint, medical advice should be sought. 

Belladonna and Hyoscyamus, are recommended by high authority. 
They are applicable to these cases, in which Strychnine is most useful, 
viz.: in epilepsy occurring at night, in the lighter fits {petit mat), and in 
pale, delicate subjects, with cold hands and feet, a blue skin and feeble cir- 
culation. Belladonna, if used, should be given as follows; One fifth of a 
grain of the Solid Extract of Belladonna, or a hundred and twentieth 
(1-120) grain of Atrophine, its active principle, each night for a month, 
when the dose should be doubled for the second month, trippled for the 
third month, and so on until as large a dose as can be borne should be 
reached. Trouseau speaks very highly of this remedy, and recommends 
its continuance for from one to four years. Hyoscyamus may be used 
in the same way, beginning with one-half grain of the Solid Extract. 
These remedies can be had in pill ; for the first month, the dose is one 
pill; for the second, two pills; for the third, three pills, and so on, until 
the largest possible dose is reached. 

The existence of anaemia (impoverished condition of the blood) 



EPILEPSY. 153 

demands the use of tonics of Iron and Quinine. The Citrate of Iron and 
Quinine, two to five grains in syrup, before each meal. The Pyrophos- 
phate of Iron will be found useful in one or two-grain doses, instead of the 
Citrate of Iron and Quinine, if the appetite is not deficient. Cod Liver 
Oil is always useful in improving nutrition of the body. It should be 
given in doses of a teaspoonful, gradually increased to a tablespoonful. 

HOMOEOPATHIC TREATMENT.— Belladonna has, among its patho- 
gnetic symptoms, the whole series of the phenomena which characterize an 
epileptic fit. It is most useful where the disease has not continued long, 
and has the fits rather close together, and especially if an attack of vertigo 
is apt to supervene; rush of blood to the head, red and bloated face, renewal 
of the attacks by contact, distention of the eyes with dilation of the pupils, 
full, hard, and hurried pulse, sudden starting from sleep with a cry and 
fear, obstinate, malicious temper, desire to tear everything, to bite, spectra 
which cause anxiety, fear; deep sleep with smiles and distortion of the 
features. 

Dose: Six pills every morning and evening, for a week, then every 
morning, for two weeks; then every third morning, for six weeks; 
then every week, as long as its beneficial effects are apparent. Fre- 
quently a dose of Sulphur occasionally helps materially. 

Cuprum is one of the few remedies which we know positively has 
cured many cases. In cases where epilepsy is a primary or original dis- 
ease, and not merely a symptom of some other disease, Cuprum is one of 
the first remedies to be thought of and used. It may not be any the less 
suitable in complicated cases. In this latter class of cases, the accessory 
symptoms will be found the best guide in the selection of the remedy; 
probably, in cases where the disease breaks out in the night, this medicine 
will be found the most beneficial, the aura commencing in the extremities 
and moving upward, until the speech is gone. In the treatment of epi- 
lepsy, use the higher potencies in less frequently repeated doses. "We 
intend this last remark to apply to all the remedies in the Homoeopathic 
treatment. And we may further say, that a careful arrangement of the 
symptoms, and careful selection of the remedy, by the use of the Reper- 
tory, will be decidedly the most satisfactory mode of selecting the remedy. 

Dose : As for Bell. 

Plumbum is very nearly related to Copper. Plumbum is particularly 
adapted to epileptic attacks with a well defined aura, or to attacks where 
paralytic conditions are present ; entire or partial loss of consciousness 
remain for some time after the attack. Plumbum acts very slowly, but, on 
the other hand, its action lasts long; it is very penetrating, so it, for this, if 
no other reason, is suited to cases of long duration. 

Dose: A small powder, or eight pills, at times as directed for Bell. 

Coniutn, in epilepsy, arising from self-abuse. 

Opium, in epilepsy, arising from a fright, or where it supervenes 
during insanity. 

Hana Bufo is undoubtedly a capital agent in the treatment of 
epilepsy, especially if the patient is the victim of onanism, and will dis- 
continue the practice. 

Bromide of Potassium. — Three grain doses, three times dally, and 
gradually increased, until the dose is ten grains for an adult; dissolve in a 
little water. 



154 THE MUSCLES OF THE FACE, AND BONES OF THE VERTEBIiiE. 




mg. 1. 
A. The Occipito frontalis, a broad muscle extending 
over the head from the eyebrows to the lower back part of 
the head; by means of the frontal portion (B, B,) of which 
the eyebrows and skin over the root of the nose are raised 
and the skin of the forehead thrown into wrinkles. C. At- 
toleus Aurem — This muscle in man is rudimentary on ac- 
count of the ears being almost immovable ; but in some of 
the lower animals is quite large and* gives motion to the 
ears. D & E. Obicularis Palpebarum surrounds the eye 
and gives motion to the orbit and eyelids. F like C is a ru- 
dimentary muscle, Attraheus Aurem. H is the little fellow 
that helps show disdain by raising the corners of the nose. 
T. Obicularis Oris is the muscle surrounding the mouth. 
P. The Masseter muscle is one of the great powers of the 
lower jaw. U, V, W, X, Y, are muscles of the head and 
neck, and their action is in moving the head and jaws. 

Fig. 2. 
The spine is composed of thirty-three bones called ver- 
tebrre, and is divided into four sections, namely : 7 cervical, 
12 dorsal, 5 lumbar, 5 sacral and 4 coccygeal. These bones 
are united by strong ligaments and through a central open- 
ing in each bone passes the spinal cord. In Fig. 3 the two 
upper cervical vertebrae are shown enlarged, on the upper 
one of these two, the atlas, rests the skull at C, C; through 
an opening in which projects A — the odontoid (tooth-like) 
point of the lower of the two bones called the axis, from the 
fact that on it rotates thp head. In Fig. 4 the same bones 
are shown separated. 



THE BRAIN AND NERVOUS SYSTEM. 155 

ECLA3IPSIA. 

ECLAMPSIA. INFANTUM. FITS OF LITTLE CHILDREN. 

Eclampsia occurs most frequently at an age when epilepsy is least fre- 
quent; that is, during the first months of infancy, until the fourth year. 

Symptoms and Course of the Disease.— Eclampsia sets in without 
any premonitory symptoms, only when it is the first symptom of the 
beginning of some other acute disease. As an independent disease, it is 
almost always preceded by preliminary symptoms. These are: ill humor, 
a whining mood, obstinacy, indisposition to play, sudden starting when 
touched ever so lightly, without expecting it, sleeplessness or restless 
sleep, during which the lids are not entirely closed; a peculiar twist of the 
mouth, gritting the teeth, change of color from the least cause, crying out 
without any apparent cause, sudden relinquishing of the nipple, uneasy, 
unequal breathing, sometimes a peculiar livid color around the mouth and 
eyes, and pointed appearance of the nose and chin. After these premoni- 
tory symptoms have lasted for a longer or shorter time, the actual paroxysm 
breaks out with the same suddenness as an epileptic attack, only with this 
difference: the patient utters no cry. Otherwise the attack has all the 
characteristic features of an epileptic fit. At the beginning the convul- 
sions are for some time tonic, (stiff and still,) after which they become 
clonic, (jerking.) and in less frequent cases they affect only one side. The 
features become distorted, the eyes stare, generally squinting upwards, the 
body is tossed to and fro, but the extremities are not as still or rigid as 
they are during an epileptic fit. The breathing is hindered, the abdomen 
distended. The face is either blue-red and bloated, with considerable full- 
ness of the blood vessels, jr else it is pale and sunken, the bodily tempera- 
ture is rather decreased than raised. During the ueight of the convulsion 
the consciousness and sensibility are completely extinct. Usually the 
paroxysm ends with a deep, moaning inspiration, after having lasted a few 
minutes, or even a number of hours, and the patients sink into a deep 
sleep, from which they awake in apparent health. 

The paroxysm does not always have such a fearful degree of intensity. 
Eclampsia, as well as epilepsy, has a series of gradations, the attack being 
sometimes marked only by partial convulsions, movements of the muscles, 
a staring look, with some squinting and drawing up of the mouth. The 
consciousness remains either entirely undisturbed, or is only partially 
interfered with, sometimes the attack consists in a comatose soper, (death 
like sleep,) which lasts for hours, with the characteristic half closing of the 
eyelids, and a few convulsive twitchings, taking the place of the convul- 
sions, even the face may retain its natural expression and color. A single 
fit is scarcely ever the end of the trouble. In the first place, there generally 
remains a disposition to relapse, and, in the second place, several fits 
usually follow, one after the other, the intervals between the fits being of 
uncertain duration, and the intensity varying in degree, sometimes increas- 
ing, at others decreasing in violence. 

Eclampsia may terminate in recovery, partial recovery, or death. 
Recovery may take place after any fit, sometimes quite unexpectedly, so 
that a child may be playing about one morning, which the day before was 
the victim of terrible fits. In partial recovery, some of the symptoms 
either remain permanently, or disappear only gradually. In such cases it 
is a question whether such remaining symptoms are not the result of 



156, FITS OF LITTLE CHILDREN. 

disease of the brain, which may, also, have been the cause of the fits. 
Among such remaining symptoms, we mention paralysis of the eyes, less 
frequently the muscles of the back, idiocy, or only a certain degree of 
backwardness in the development of the mental faculties, and an unusual 
degree of nervous irritability. Death results, either during the attack, or 
else the death like sleep (coma,) terminates in death. 

The prognosis depends on many accessory circumstances, and is always 
doubtful. Age is an important consideration; the younger the child, the 
more likely they are to die, especially infants at the breast, but even they 
frequently recover, if the treatment is in careful hands. Where the disease 
is inherited, there is little probability of recovery. The more rapidly the 
fits follow each other, the more danger there is, especially if they contin- 
ually increase in violence. Convulsions, setting in at the commencement 
of some acute disease, are scarcely ever dangerous. If they set in during 
the course of the disease, they are more dangerous; they generally mean 
death. 



HOJKEOPATRIC TREATMENT.— Belladonna is. without doubt, the 
main remedy in eclampsia. It is particularly indicated in the case of 
robust, fleshy children, who show unmistakable signs of congestion of the 
brain, with very red face, the pupils expanded, the eyes stare, or constantly 
vibrate, the lower jaw firmly pressed against the upper, the head drawn 
backward, possibly the urine may be discharged involuntarily. 

Hyoscyamas acts very similarly to Bell. The sight of the eyes con- 
tracted, face dark red and bloated, the walls of the abdomen drawn firmly 
in, and the attack being caused by a fright, are indications for the use of 
Hyosc. ' 

Cuprum. See indications under Epilepsy. 

Ianatia. If the attack is sudden and violent, the fit being more free 
from jerking than common, if the spinal cord appears to be the seat of the 
disease, that is an additional indication for Ignatia. 

Chamomillais seldom useful for the fit, but may be needed to remove 
trouble with the bowels, before or between the fits. The child moans and 
worries, and wants to be carried. 

Cina, or Pantonine, if the attack arises from worms. (See worms.) 



CATALEPSY.— TRANCE. 

We mention this disease, only because you expect us to, and can only 
say that it is one in which the consciousness and the voluntary motion of 
the muscles is suspended ; though they retain the faculty of passive motion. 
There are very few well established cases on record. 

It is very generally conceded, among physicians, that no treatment 
yet known amounts to anything. It may be necessary, in order to main- 
tain life, to inject food into the rectum, or, by means of the stomach pump, 
into the stomach. 



THE BRAIN AND NERVOUS SYSTEM. 157 

HYSTERIA, OR HYSTERICS.* 

It is not only difficult, but almost impossible, to furnish a satisfactory 
and sufficiently comprehensive definition of hysterics. 

It is a nervous spasmodic affection common to females, but known by 
some other name, when it appears (as it rarely does) among males, usually 
as hypochondria. It attacks pregnant as well as non-pregnant females, and 
however alarming any single attack may appear, it is, in fact, seldom 
attended with any danger, unless it should pass into epilepsy. 

Symptoms: Usually the lady, from a calm or excited condition, but 
in which no symptoms of disease are shown, by an unwise word, and often 
from no apparent reason, commences crying and laughing at intervals, 
perhaps, also, venting reproaches; peal upon peal of immoderate crying and 
laughter, sobs, floods of tears, stolid silence, wringing of hands, tearing of 
hair, stiff (tonic) convulsions, clonic (jerking) spasms, and smiles, are all 
irregularly combined and followed by a profound calm of the constitution, 
and a feeling of complacency. During these symptoms the female, at the 
commencement, is attacked with a sense of tightness about the throat, 
with throbbing, or repeated attempts at swallowing. Sometimes a sensa- 
tion as if a ball passed upward to the throat and lodged there, is experi- 
enced, and which is called the "globus hystericus.'' She may roll about 
from side to side, or she may lie perfectly still and motionless. She fre- 
quently presses her hands to her breasts or carries them to her throat, as 
if to remove some pressure or obstruction, the face is, usually, pale, though 
not always, and is not distorted ; no froth issues from the mouth, nor are 
there convulsive motions of the lower jaw, but the large muscles of the 
back are violently contracted, so as in many instances to cause the body to 
describe an arch backward. The trunk of the body is twisted forward and 
backward, the limbs are variously agitated, and the fists are firmly closed. 
Sometimes there is obstinate constipation and retention of urine; gener- 
ally, however, the urine is pale and copious. 

The paroxysm continues for a longer or shorter time, the sobbing 
becomes more violent, or the patient screams and sheds tears, and thus the 
fit ends. Sometimes they will lie apparently insensible and immovable 
for a longer or shorter time. The attack is often preceded by dejection of 
spirits, anxiety, yawning, shedding of tears, difficult breathing, nausea, 
palpitation of the heart, numbness of the extremities, etc. 

It is not uncommon for ladies affected by this terribly annoying dis- 
ease, to complain of dreadful and excruciating pains in the hips, knees, 
spine, etc , with great tenderness to the touch, and which is owing to the 
severe muscular contraction caused by the spasms, rather than by any dis- 
ease of these parts. Sometimes a species of paralysis accompanies hyste- 
ria, and, occasionally, ladies will imagine many strange things, and even 
practice more or less deception, speaking in a whisper, pretending to vomit 
blood, meat, etc. 

In some women, and especially during pregnancy, with a very slight 
warning, they may be attacked with a severe fit of hysterical convulsions 

* I believe that the common opinion, that hysterics amounts to nothing, has done a vast amount 
of mischief in the world, aside from all the actual suffering it has caused. I wish to say, once for all, 
that hysteria is as much a disease, and as real in every sense as small-pox, hut a little more under the 
control of the will, if the disease has not already overpowered that, too, which it does in many case*. 




" Madam, you cannot have health without exercise in the pure air. 



(158) 



HYSTERICS. 1-39 

which may occur daily, every other day, or at longer intervals, and which, 
if not removed, will induce miscarriage, which usually occurs at the time 
of a fit. 

Causes. Hysteria is a disease that attacks only women, after Uie 
beginning of menstruation, and may be produced by various causes, as: 
want of sleep, excessive fatigue, disordered digestion, sudden mental 
shocks, as, joy, fear, grief, etc., excitement of the reproductive organs, 
onanism, excessive sexual intercourse, or, more frequently, abstemiousness 
among unmarried or widow ladies. Females of a nervous, irritable tem- 
perament, are most likely to be attacked. The paroxysms occur more fre- 
quently about the monthly period than at any other time. Excessive dis- 
charges, or debilitating diseases, frequently give rise to attacks of hysteria 
which occur during convalescence, and are renewed frequently, and from 
the slightest causes. 

Hysteria may be distinguished from epilepsy by observing that, in the 
former, there is no frothing at the mouth, no protrusion of the tongue, and 
after the paroxysm is over, the patient recovers her usual state, and does 
not fall into a sleep as in epilepsy. 

It may be distinguished from apoplexy by observing that in this the 
patient loses consciousness and voluntary motion first, and finally all 
motion ceases, and the breathing is stertorous. 

From puerperal convulsions, by observing that in these, the action of 
the muscles are violent and irregular, the head is strongly rotated to the 
right and left, and backward, with violent jerking convulsions of the mus- 
cles of the back, abdomen, and upper and lower extremities, spasmodic 
action of the muscles of the face is rapidly repeated, the lips and teeth are 
firmly closed, the breathing is loud and hissing, the tongue is very livid, 
protruded forward, and often bitten so that the blood and saliva is thrown 
to some distance through the compressed lips, the face becomes livid and 
the attack usually occurs in first labors, among females with short, thick 
necks. 

HOMEOPATHIC TREATMENT.— The medicines which offer the 
closest similarity to the symptoms of the fits, when they occur, and which 
are most successful in restoring the patient during the paroxysms, 
may, in many cases, be administered in repeated doses, for the pur- 
pose of overcoming, or, at all events, of moderating the predis- 
position. It should, also, be borne in mind, that if this condition 
be associated with other derangements, the treatment which is 
particularly appropriate for such derangements is also the best preventive 
and eradicative resource. There are, however, a few medicines which are 
especially and particularly applicable to the removal or modification of 
this constitutional tendency; these, however, we shall simply enumerate, 
with their chief and characteristic indications. 

Sejria is, in the great majority of cases, the medicine upon which 
the chief reliance can be placed, more particularly if the patient has been 
affected with green-sickness, whites, or with other chronic derangements, 
or diseases of the womb and its appendages ; or, again, when she is liable 
to be seized with sudden attacks of debility, approaching to general but 
temporary palsy, and attended with outbreak of profuse and often clammy 
perspiration. 



160 TIIE BRAIN AND NERVOUS SYSTEM. 

Dose: Four globules in a teaspoonful of water, every night at bed 
time, for ten days (unless change should sooner occur); then pause 
a fortnight, after which the course may, if necessary, be repeated as 
before, and so on, from time to time. 
Calcarea Carbonica, on the other hand, is more especially appro- 
priate for the treatment of persons of an attenuated, sickly-looking frame, 
and pale, wan, sunken countenance, with whom the general convulsion 
attending the attacks is very violent, and who are subject to fainting- 
fits, or to an habitually impaired and capricious appetite, the menstrual 
discharge occurring too frequently, and in excess. 
Dose: Four globules, as directed for Sepia. 

Natrum Muviaticum is to be preferred, also, in cases in which the 
countenance is sickly, pallid and sunken, but more particularly when 
there is an habitual dislike to society, and when constant gloom, sadness, 
or despondency is apt to affect the patient; whilst feeble powers of diges- 
tion, and prevailing chilliness, with occasional flushing of the face, and 
retarded menstrual discharge, further characterize the case. 
Dose: Four globules, as directed for Sepia. 

Veratrum is of much service in overcoming the constitutional ten- 
dency to hysterical attacks, as well as in modifying their immediate vio- 
lence, in cases in which they are attended witli clenching of the jaws, or 
general spasm, coldness of the extremities, and clammy sweat, especially 
on the face and forehead. 

Dose: Three globules, as directed for Sepia. 

Treatment of the Attack. Belladonna is appropriate when the 
paroxysms are characterized by, and commence with, a sensation of chok- 
ing, with spasmodic closing or obstruction in the throat, and every sensa- 
tion as if suffocation would ensue; the face being hot, bloated, and of a 
dark-red hue, and there being other indications of determination of blood 
to the head ; or, when, as the paroxysm proceeds, the eyes become prom- 
inent, wild, and staring, and the pupils much dilated; or, when, again, 
during the intervals between attacks, the patient habitually sleeps in a 
disturbed and restless manner, suddenly tossing in, or even starting from, 
sleep. 

Dose: When the sensations of an approaching attack are apparent, 
give two globules in a teaspoonful of water, repeating the dose after 
the lapse of a quarter of an hour, and again half an hour later, if 
the symptoms do not sooner subside ; or, again, after the subsidence 
of the attack, or during the momentary intervals of calmness, give 
similar doses from time to time. After the attack, the doses should 
be repeated every six hours, for twenty-four hours. 

Ignatia is of great value for the treatment of hysterical paroxysms 
affecting patients of a mild and very sensitive disposition, or those who 
are subject to extreme variations of spirits, and when the attacks are apt 
to be somewhat suddenly announced by convulsive laughter, provoked 
by some slight or imperceptible cause; the face, previously pale, becom- 
ing flushed, deep-red, or even livid, and the laughter terminating in 
screams ; or, more especially, when the attack is preceded by the sensation 
of a ball in the gullet, which gives rise to a feeling of suffocation, attended 
with spasmodic eructation ; further, when convulsive movements of the 
extremities, with clenching of the thumbs, occur during the paroxysm ; 
or when, again, there is alternation of flushing and pallor; or when the 



HYSTERICS. 161 

patient is affected with frequent fits of yawning, or with drawing of a 
deep breath upon recovery. 

Dose: Two globules, as directed for Belladonna. 

Pulsatilla is appropriate for the treatment of patients of mild and 
sensitive or exceedingly timid disposition, or of phlegmatic or lymphatic 
constitution, and when there is an habitual or very frequent derangement 
of menstruation, or. more particularly, with predominant derangement of 
the organs and functions of digestion at the period of the menstrual dis- 
charges, and when the attacks are characterized by tearfulness or fits of 
crying without any ostensible cause. 

Doss: In all respects as directed for Belladonna. 

Gclscminum should be given when the hysterical paroxysms assume 
the proportions of convulsions ; there are : excessive irritability of body 
and mind ; a semi-stupid condition, with languor and prostration; nerv- 
ous headache, commencing in the back of the neck, and thence spread- 
ing over the head; vertigo and dimness of vision; difficult menstru- 
ation . 

Dose: As directed for Belladonna. 

Stramonium may be named as especially appropriate when the 
attacks are characterized by the predominance of hiccough and are at- 
tended with convulsive movements of the arms, and with an expression 
of extreme exhaustion or of vacancy, and difficult articulation ; or some- 
times with violent raving, sudden desire to remove, as if from the reach of 
some fancied danger, and with alternations of crying, or even discordant 
attempts to sing, and violent convulsive laughter ; or when, again, the 
violence of the attack is liable to be re-induced or aggravated by the sight 
of shining or glistening objects. 

Dose: As directed for Belladonna. 

Xux Vomica is preferred when the patient is habitually of an 
irritable disposition, or of nervous or bilious temperament, and of costive 
habit — or generally, of a meagre frame and pointed features ; the attacks 
being preceded or accompanied with twitchings of the limbs or of partic- 
ular muscles, and when a vexation or disappointment has been the excit- 
ing cause of the attack. Also when stimulants of various kinds have been 
too freely employed from time to time. 

Dose : In every particular as for Belladonna. 

Veratrum is generally to be recommended when the attacks are 
characterized by clenching of the jaws, or general spasmodic affection of 
the entire frame, coldness of the extremities, and clammy perspiration, 
especially on the face and forehead, and when a considerable quantity of 
pale urine is generally voided before or after the attack. 

Dose: As directed for Belladonna. 

Conium should be administered when there is much vertigo, partic- 
ularly on lying down ; she cannot turn in bed, without exciting great 
dizziness. The breasts swell, and become painful and hard, as the men- 
strual period approaches, at which time the hysterical symptoms are 
usually developed. Choking sensation in throat, as though a ball were 
ascending from the stomach. 

Dose: In every particular as directed for Belladonna. 

Jfoschus. Violent, long-continued scolding, until she falls down in 
11 



162 THE BRAIN AND NERVOUS SYSTEM. 

an hysterical paroxysm . Great anguish ; she feels as if she must die, and 
insists that she will die. Feeling of constriction or tightness on the chest 
during the paroxysm. 

Dose: As directed for Belladonna. 

Caulophylum will prove of value in some cases, when the hysteria 
can be traced to disordered condition of the menstrual flow, or to some 
disease of the womb. 

Dose: As directed for Belladonna. 

HOME MEASURES. Above all things, it is necessary that any 
portion of the clothing which may fit tightly should be loosened as an 
attack ensues, or threatens to ensue ; all strings and fastenings should be 
undone. Whatever may tend to impede the circulation should be 
removed, and the patient should be stretched out in a recumbent position, 
(the floor being the safest and best place,) beyond the reach of any article 
which she might strike against in the convulsive movements. A free 
current of air should then be admitted, and the face of the patient should 
be sprinkled with cold water. Friction of the wrists, ankles, and palms 
of the hands, is often also of service. 

General Remarks. In order to overcome the constitutional ten- 
dency to hysteria, a long and judicious course of treatment is always 
required in inveterate cases. Persons who are subject to hysterical attacks 
should avoid tight lacing, or any articles of clothing which fit too closely 
and firmly round the body. Elastic jackets are much to be preferred to 
corsets. They should also take regular exercise in the open air, without 
fatiguing themselves, avoid all depressing and exciting emotions, live 
regularly, keep early hours, abstain from rich, seasoned, or stimulating 
food or drinks, and partake only of plain but nourishing food. To these 
regulations may be added such others as have been enumerated under the 
head of " Green-Sickness," "Suppressed Menstruation,'' "Excessive Men- 
struation," "Difficult or Painful Menstruation,'' "Whites," and also the 
general rules prescribed in the article on " Eradicative Treatment." 

ALLOPATHIC TREATMENT. Hysteria. The name given to this dis- 
ease was because of a supposed connection between it and a diseased uterus 
(womb). In a certain proportion of cases there can be no doubt that this rela- 
tion exists. When the uterus is affected, with a decided alteration in shape, 
general treatment, while not without benefit, will quite frequently fail in 
removing the disease. If the patient is young and unmarried, without 
any irregularity in the catamenial flow, without pain in the back, or with- 
out pains or undue frequency in micturition, such cause may be excluded, 
and the patient placed at once on general treatment alone. If the patient 
is married, but barren, there is a probable causative relation between the 
womb and the hysteria, or, in any case, if there is marked irregularity of 
thecatamenia (monthly sickness.) backache, and frequent passage of urine, 
in only small quantities, there is doubtless a displacement of the uterus, 
which should be restored to its proper position and maintained in a state 
of rest. The services of a competent physician will be required for this 
purpose. 

Regarding general treatment, one of the principal objects is to invig- 
orate the body by good nutritious food, exercise in the open air just short 



HYSTERICS. 163 

of weariness, and regular habits regarding sleep. The mind should be 
strengthened by healthful occupation. Everything which excites the 
feelings, emotions, passions, or imagination, should be avoided. 

The patient should be urged to arouse the will against giving way to 
the paroxysms. The discreditable opinion commonly held of the disease 
may be urged as a motive for the patient to resist, to use the power of her 
own will, in warding off the affection. This part of treatment is moral 
and its success rests on the tact of the attendant, but requires discretion 
and delicacy. Many times is the physician's patience sorely tried by 
patients prolonging the malady by their own desire to excite sympathy. 

If the patient is in reduced health, the Elixir of Quinine, Iron and 
Strychnine, in doses of a teaspoonful before each meal, will prove benefi- 
cial. Or the Elixir of Bark, Iron and Strychnine, may be given in the 
same doses, or doses of a dessertspoonful (two teaspoonfuls). 

If the patient is young, and in vigorous health, the Bromide of Potas- 
sium, in doses of twenty or thirty grains, three or four times a day, will 
often prove most beneficial, by allaying all forms of nervous excitement. 
Mono-Bromated Camphor is, also, beneficial, under the same conditions. 
It is best given in pills. The dose is four to ten grains, three or four hours 
apart. 

The distressing symptoms in hysteria demand attention and relief. In 
a hysterical convulsion, if it were not that the patient may inflict injury 
upon herself, as they would soon end of themselves, it would be well, gen- 
erally, to make no attempt to interfere, but let the paroxysm exhaust 
itself. Care should, however, be used to prevent the patient injuring her- 
self. Pouring cold water upon the head, from a littleheigb, will, generally, 
bring the "hysterical fit" to an end. The insensibility (coma) of hysteria 
will generally yield to the same means. 

Some of the remedies which many times have a favorable effect upon 
the hysterical condition, are : Assafcetida and Valerian Mixture or milk of 
Assafcetida, (two drams of Assafcetida, dissolved in a pint of water,) may 
be given in doses of one or two tablespoonfuls, just before an expected 
attack. It may be repeated two or three times in the twenty-four hours. 
The Assafoetida may be given in pill. 

Valerian, in fluid extract, dose, a teaspoonful; tincture , dose, two tea- 
spoonfuls; an infusion, (tea) made with a half ounce of the Valerian root 
to a pint of water. 

Dose: A wineglassful may be given to answer the same purpose as 
Assafcetida. 

The headache of hysteria is best relieved by Hyosoyamus and Camphor 
or the Bromides. The Tincture of Hyoscyamus and Spirits of Camphor 
may be given in doses of a teaspoonful. A pill containing a grain of the 
Extract of Valerian, a grain of Camphor, and half a grain of Extract of 
Hyoscyamus, may be given in doses of one or two pills, thrpe hours apart 
The Bromides may be given according to the directions in a previous para- 
graph. 

In the absence of other means, the free use of hop tea will afford a 
good degree of tranquility to the nervousness of the patient. 



164 THE BRAIN AND NERVOUS SYSTEM. 

CHOREA. 

ST. VITUS' DANCE. EPILEPSIA SALTATORIA. 

Chorea is a disease of the later years of childhood. It is seldom seen 
before the sixth year of age, and only occasionally after the fifteenth. 

Causes: Onanism, worms, fright, anger, second period of dentition, 
(teething,) and a continued effort to imitate some one afflicted with the 
disease. 

Symptoms: At first the patients show a certain uneasiness in their 
movements, and an unusual hurriedness, low spirits, ill temper. (The last 
two symptoms are often made much worse by the unkind rebukes the child 
receives, for what appears like hurried carelessness in handling things.) 

Gradually, or, in some cases, very soon, the involuntary movements 
begin, either confined to single parts, or affecting the whole muscular 
system ; the upper extremities are usually more affected than the lower 
ones. The face shows every possible contortion; even the eye balls are 
rolled about in every direction; the arms and hands are, at times, flexed, 
(drawn up,) at others extended. The grip is no longer firm; the patients 
cannot eat alone, or if they do, have to bring their food to the mouth by a 
very circuitous route ; the walk becomes unsteady, because the legs can no 
longer be put down with sufficient steadiness, and even the ability to keep 
them stiff enough to support the body firmly, is wanting. A striking 
feature of the disease is, that the more the patient tries to keep the part 
still, the more violent the involuntary motions become. It is peculiar to 
this disease, that even those excessive muscular movements do not fatigue 
the patient. 

After a gradual increase of the symptoms, the disease reachesits height, 
where it remains stationary for a time, lasting a few weeks, or even several 
mouths, and sometimes terminating in recovery, either quite suddenly, or 
only gradually. The cases where the convulsive movements become 
habitual, are very rare. Death is a very rare termination of the disease. 
So that the prognosis is favorable. 

ALLOPATHIC TREATMENT. Chorea-St. Vitus' or St. Gay's Dance. 
This disease occurs, in a large proportion of cases, in persons whose vital 
forces are, more or less, reduced, and in a state of anaemia (impoverished 
blood). The diet should be plain, and unirritating, but nourishing. Fresh 
air, and out of door exercise, are to be insisted on. In proportion to the 
weakness, and anremia, tonic treatment should be resorted to. Iron should 
be given, to restore the blood to its healthy state. I would use the Pyro- 
phosphate of Iron, in doses of a grain, three times a day. Take a dram of 
Pyrophosphate of Iron, dissolve in four ounces of simple Syrup, and give a 
teaspoon half full to a young child, and a teaspoonful to a nearly grown 
child, three times a day. 

Sweet cream, or Cod Liver Oil, will be useful in restoring health and 
strength ; of course, they are not to be given if the patient is full blooded, 
or over fat; but this is not likely. 

The bowels should be kept regular, and a daily bath should be given. 
Tf agreeable to the patient, and the reaction is good, a cool bath is prefera- 
ble, but if not, the bath should be warm. 

In some cases, the involuntary movements are so violent, that the 
patient should remain in bed. 



CHOREA. 165 

The two remedies which certainly exert a curative influence over the 
disease, are Arsenic and Strychnine. 

Arsenic is of undoubted value. It is conveniently given in the form 
of Fowler's Solution, in doses of five drops, three times a day, after eating. 
It can be given in water, or added to each dose of the Syrup of Iron, 
recommended above. It should be continued until swelling of the eyelids 
is produced. 

In obstinate cases, of general or local Chorea, this remedy has been 
found exceedingly useful, administered by hypodermic injection, in doses 
gradually increased to fourteen drops, diluted by an equal quantity of 
water. This treatment should be given and managed by a physician. 

The chief reliance of many physicians is upon Strychnine, but the 
most effectual manner of administering is such that it is unsuited to 
domestic practice. If the case is obstinate, and a physician cannot be 
obtained, I would recommend the following: Take one grain of Sulphate 
of Strychnine, water four ounces; after solution is effected, give a tea- 
spoonful three times a day, to a child ten years old. After a few days, it 
may be given four times a day. If rigidity of muscles is produced, the 
dose should then be diminished. 

In those severe cases in which the excessive choried movements pre- 
vent the proper amount of sleep, moderate doses of Hydrate of Chloral 
should be given to secure rest. Take of Hydrate of Chloral and Bromide of 
Potassium each two drams, simple syrup two ounces. Mix. 

Dose: A dessertspoonful once or twice a day, to procure rest. 

HOMEOPATHIC TREATMENT In view of the well recognized fact, 

that most cases of chorea get well themselves, although slowly, we would 
recommend the very limited use of medicine. 

The Homoeopathic remedies we will only mention the names of; they 
can be compared by the use of the Repertory : Cuprum, Stramonium, 
Belladonna, Hyoscyamus, 1 gnatia, Zineum, Cina, Gelseminum. If caused 
by onanism, Phosplwrie Acid. 



THE BRAIN AS SEEN FROM ABOVE. 

This cut shows the brain— cerebrum— as seen from above, a is at the 
front or forehead— called anterior portion, and b is at the back— posterior 
portion. 

The left half, c, is covered by the dura mater (the thin outermost mem- 
brane of the brain) through which may be seen the convolutions and undu- 
lations of the brain. 

The small round bodies upon the surface of the dura mater are called 
gland ula pacchioni, and are not present in infancy, but usually are after the 
seventh year, after which time they increase in number and size. 

d. On the right side the dura mater has been removed and shows the 
cerebrum stripped, e. The falx cerebri, so called from its sickle-like form, 
is an extension of the dura mater down between the two lobes of the brain 
to separate them. It contains the large blood reservoir that is laid open at/- 



166 



BRAIN. 



On the right side, the dura mater being removed on the front half of the 
side lettered (/, may be seen the eery thin membrane or middle coat of the 
covering of the brain called arachnoid membrane; through it can be seen 
the pia mater or inner membrane covering the brain with its blood-vessels ; 
at h the pia mater is cut through to show plainly how it with its blood-ves- 
sels 1 sink into the fissures— gyri — of the cerebrum ; on the back posterior 
part of the right side, all three of the covering membranes have been re- 
moved to expose the cerebrum ', or brain proper. 




In these various membranes, their extensions and blood-vessels, are 
located some of the very painful and sometimes dangerous inflammatory dis- 
eases of the brain. 

A rupture of one very small blood-vessel is quite enough to cause blood 
to flow into the space around it, and give rise to a stroke of apoplexy. 

The brain-coverings are also the seat of a variety of consumption often 
developed in our school-rooms, and called Tubercular Meningitis 



PART THUIfcJD. 
.+. ~. 

DISEASES OF THE HEAD. 

CHAPTER VII 



THE BRAIN AND NERVES. 



HEADACHE. 



Headache is one of the most common symptoms of many forms of 
disease. Hence we might name a great many forms of headache arising 
from a variety of causes, without, however, helping the treatment in the 
least by so doing. 

The headache will disappear as soon as the affection upon which it 
depends is cured. It is not always easy to find out the causes of headache 
— it is sometimes very violent, when the general disease seems very slight 
and on that account, to be more or less an independent condition 
of distress— but all attempts to point out remedies here, for all such cases, 
would be more than our space will allow. If the headache is simply an 
accompaniment of some other complaint, we must refer the reader to that 
complaint, and the Repertory, for treatment, and here only devote our 
attention to some particular forms of headache, which appear to be almost 
disconnected with other affections. 

1. Hemicrania or Megrim.— A headache which usually affects one 
side of the head, and occurs paroxysmally at more or less regular inter- 
vals. This headache is a pure neuralgia, and while it does sometimes 
occur in company with other diseases, it occurs more frequently without 
such associations. 

The Causes: Where it occurs as a complication of other diseases, it 
may depend upon liver-complaint, derangement of the stomach or heart, 
but more frequently upon an unhealthy condition of the sexual organs. 
As an independent disease, it is only met with in the constitution and 
temperament which we term " nervous." Hence, it is more frequent 
among females, and occasionally among children. 

The Symptoms : In general, the symptoms of this form of headache 
are very constant and uniform, varying only in less important points. In 
most cases, without any precursory symptoms, much less frequently after 

167 



168 HEADACHE. 

a previous feeling of fatigue, the patient awakes in the morning with a 
violent and constantly increasing headache. The pain is throbbing or 
tearing, or burning, or simply an ache, and is generally confined to a 
sharply circumscribed locality on one side of the head, usually the left. 
External pressure affords relief. Every mental and physical effort is pain- 
ful, while mental pleasure and attractive occupation afford some relief. 
As the pain increases, the eyes become sensitive to the light, and there is a 
copious flow of tears. When the pain is at its hight, the patient vomits 
a watery phlegm, after having experienced nausea for some time previous. 
After the vomiting the patients feel better, and want to sleep, and after a 
sound sleep they generally wake quite well, only a little weary. Such 
paroxysms sometimes recur again in a few days, sometimes not till 
months have elapsed ; in the case of females, they are apt to come on 
about the monthly period. The general condition of the system is not 
always affected by the attacks; in the intervals between the attacks the 
patients may have the appearance of enjoying good health . Very rarely 
the pain lasts beyond twelve hours; if it lasts longer, it may continue 
thirty six hours. (See treatment at the end of this article). 

Neuralgic Headache. What this form of headache has in common 
with megrim is, that it likewise occurs periodically, most commonly 
affecting only one side of the head, and likewise tending in some cases to 
excite vomiting. But unlike megrim, this headache never ends with one 
paroxysm alone, but after the headache has once begun, the paroxysm 
generally returns at the same hour for several days in succession, some- 
times with as much regularity as intermittent fever. 

The remaining varieties of headache — Catarrhal, Congestive, Gastric, 
Rheumatic, Sick and Nervous— will be kept in mind in the treatment of 
this subject, without further reference here to each of their peculiarities, 
and patients will find the treatment very satisfactory. 

ALLOPATHIC TREATMENT. Recurring headache is one of the most 
difficult troubles to treat successfully, as far as permanent cure is con- 
cerned, yet many cases are much benefited by treatment. Hereditary 
predisposition, which is found in many cases, is beyond the reach of art, 
as far as removal is concerned, but their operation may be greatly less- 
ened by prudence and proper treatment. 

The disease, when not a symptom of the numerous affections which 
it accompanies, as active congestion of the brain, inflammation of the 
membranes of the brain, inflammation of the brain, the essential fevers, 
etc., is, especially, neuralgic, and similar measures are called for in its 
treatment. When the pain is located in the face, or forehead, in the 
scalp, or back of the head and neck, and twp or three tender points are 
found by pressing on the skin with the finger, the disease is a neuralgia 
of those parts, and should be treated as directed in the article on neu- 
ralgia. 

The treatment will embrace measures to be employed at the time of 
the attack, when immediate relief is urgently demanded and during the 
intervals, when the design will be to guard against a recurrence of the 
attacks, and moderate their severity. If the patient is a hearty, robust 
person, with an abundance of blood, and the headache dependent upon 
fullness of blood, and such symptoms of congestion occur, as a flushed 



DISEASES OF THE HEAD. 169 

face, throbbing of the head and ears, the congestion should be relieved. 
Probably a saline purgative, as a tablespoonful of Epsom Salts (Sulphate 
of Magnesia,) in water slightly acidulated with lemon juice, or in coffee, 
will prove effective against both the congestion and the headache. Such 
means as the application of cold to the head, by means of cold, wet 
cloths, or pounded ice in a sack or bladder, and hot foot-baths of simple 
warm water, or with the addition of mustard or red pepper, may be 
employed. In such persons the diet should be somewhat reduced, more 
exercise taken, and if constipation exists, it should be overcome by a daily 
dose of a teaspoon ful of Epsom or Rochelle Salts. 

Many cases occur where congestion is not so violent, following some 
error of diet, in which mild purgatives are useful ; two or three Compound 
Cathartic Pills, U. S. P., or the Improved Cathartic Pills, will answer a 
good purpose, though many others may be given. The salines act more 
quickly. 

If patients are not unpleasantly affected by Opium, an attack may 
frequently be warded off, shortened or lessened, by a full dose of Opium 
in some of its forms, as, one grain of powdered Opium, or one-sixth to 
one-third of a grain of Sulphate or Acetate Morphine, or a grain of Codia. 

Carbonate of Ammonia, in doses of from five to ten grains, is some- 
times successful in affording relief ; also the Muriate of Ammonia (Sal. 
Ammoniac,) in doses of ten grains. 

The congestive form of sick headache is generally dispelled by one or 
more full doses, twenty to forty grains, of the Bromide of Potassium. The 
variety in which it acts, almost as a specific, is characterized by a Hushed 
face, throbbing temples and intolerance to light. Ergot is also a valuable 
remedy in this variety of headache, and should be given in doses of a 
dram (teaspoonful) of the Fluid Extract. Some physicians extend its use 
to all forms of headache. 

The opposite form of sick-headache, manifested by paleness of the 
face, dizziness, and ringing of the ears, is quite certainly relieved by Bel- 
ladonna. The distress may be increased at first, but great relief follows 
afterward. The following is a useful formula : 

Take of Atr opium (the active principle of Belladonna) one-fourth of a 
grain; Chinoidine, twenty grains. Mix and make into twenty pills. Take 
one pill two or three times a day. Five grains of Extract of Belladonna 
may be used instead of the Atropium. Relief is often obtained in this 
form of headache by the use of Elixir of Guaraua, in doses of a table- 
spoonful frequently repeated— from thirty minutes to an hour apart. 

If the face is pale and bloodless during the headache, three to six 
drops of Nitrite of Amyl inhaled from a handkerchief, will give relief. 

Some cases of nervous headache are quickly relieved by a teaspoon 
half full of Hoffman's Anodyne (Compound Spirits of Ether.) 

I have found cases in which the following relieved the pain with 
greater certainty than anything else used in their treatment: Take of 
t hloral Hydrate eight scruples; Bromide of Potassium one dram ; Simple 
Hyrup two ounces. Mix. 

Dose : A dessertspoonful, and repeat in two or three hours, if the pain 
is not relieved. 

The physician often finds it necessary to let the patient inhale a little 



170 HEADACHE. 

Chloroform. Evaporating lotions (washes,) as Alcohol, Spirits, Cologne, 
Vinegar, or Ether, often afford relief. Sometimes a towel, or other large 
cloth, wrung out of hot water and applied to the head, gives greater relief 
than cold applications. Strong coffee or tea may give great relief in some 
cases, though their constant use is often a cause of aggravating the malady. 

During the interval between the paroxysms, attention should be 
given to the general health, and to correct, as far as possible, any disorder 
which may be discovered. Indigestion and constipation are to be guarded 
against. The laws of health should be closely observed. Everything 
which is noticed to excite or increase the severity of the attacks, must be 
avoided. Sleep should be sufficiently long, and to this end the patient 
should habitually retire early. If the appetite is poor, and the patient 
weak and pale, or if he feels weary upon rising in the morning, he should 
have an Iron tonic, and plain but nourishing food. The Pyrophosphate 
of Iron one dram, dissolved in four ounces of water, or syrup, can be 
given in doses of a teaspoonful after each meal. Or the Citrate of Iron 
and Quinine can be given in the same way. 

In addition to Iron, I would recommend the pills of one-tenth grain 
of Phosphide of Zinc, and one-fourth grain of Extract of Nux-vomica, 
known as Hammonds' formula, of which one or two pills may be given 
three times a day; or the pills of Phosphorus, one-fiftieth of a grain, and 
Extract of Nux-vomica one-fourth of a grain, may be given in the same 
manner. 

Arsenic has been found useful, given between the attacks, and should 
be tried if the other means, after a faithful trial, do not benefit. It can 
be given in the form of Fowler's Solution, in doses of five drops in water, 
after eating. If swelling or watering of the eyes occurs, its use should be 
suspended until this symptom disappears, and then resumed again. 

Small doses of Quinine, two or three grains three times a day, may 
prove effective in guarding against a recurrence of the attack. It can be 
taken in powder or pill. 

Stimulants of all kinds are generally harmful, including beer and 
wine, and can be generally given up with advantage. Excesses of all 
kinds should be avoided. 

HOMCEOPATHIC TREATMENT. Arsenicum for intense frontal head- 
ache with vertigo, tearing in the head, with vomiting, when raising the 
head. Headache after meals, relieved by applying cold water, or by 
walking in the fresh air; sensation in the brain as if torn to pieces, with 
unquenchable thirst; all periodic headaches ; sometimes, when the head- 
ache is intense, a dose or two of Ars. gives as much ease as a dose of Opi- 
um ever does. 

Belladonna for headache from the heat of the nun. Nervous headache 
frequently on one side of the head, especially the right side, coming on 
from four P. M., to eight A. m., aggravated by the heat of the bed, and by 
lying down; better when sitting up, feeling in the brain like the swash- 
ing of water; cold sensation in the brain, in the middle of the forehead; 
pressive frontal headache, so severe when walking that the eyes are some- 
times drawn shut, frequently obliged to stand still, when walking, from 
the violence of the pain in the forehead; at every step it seems as if the 
brain rose and fell in the forehead, relieved by strong pressure on the 



DISEASES OF THE HEAD. 171 

forehead; violent throbbing in the brain, from behind forward, and 
towards both sides; finally, painful shootings, stabbing as if with a knife 
from temple to temple; boring, tearing, cutting, shooting pains in vari- 
ous parts of the head, worse on the right side and in the forehead, less in 
the back of the head ; headache is accompanied by dizziness, stupefaction, 
red and bloated face, red eyes; excessive sensitiveness to noise, light 
shock, jar, or slight contact ; ill humor ; pains come on suddenly, last indefi- 
nitely, but cease suddenly; headache from catching cold in the head, as 
from having the hair cut. 

Dose : Of a solution of eight pills in four tablespoonfuls of water, give 
a teaspoonful every fifteen minutes to two hours, according as the 
severity of the case demands. 

Nux-vomica. Congestive headache, and headache from derangement 
of the stomach (gastric), with nausea and vomiting, worse by coughing 
and stooping; pain as from a nail driven into the brain, or stitching pain 
with nausea and sour vomiting, stitches and pressure in one side of the 
head, worse in the morning, driving the patient out of his senses; exces- 
sive sensitiveness of the brain to motion and walking ; heaviness of the 
head, especially when moving the eyes or thinking ; with sensation as if 
the skull would split; whizzing in the head, with vertigo, or with shocks 
when walking; headache every morning on waking, after eating, and in 
the fresh air, when stooping or during motion, even when merely moving 
the eyes; the pains come again after drinking coffee ; aversion to coffee, 
pale, worn-out look ; constipation, with tendency of blood to the head, 
irritable, vehement disposition, or lively, sanguine tempers; persons who 
lead a sedentary life, or who drink. 

Dose : As for Belladonna. 

Calcarea Curb, for icy coldness in and on the head, also one-sided 
headache, with pale, puffed face, with empty belchings (eructations) and 
nausea, vertigo ; worse from mental exertion, stooping, or walking in the 
open air; better by closing the eyes or lying down; headache begins in 
the back part and spreads to the top of the head, so severe one thinks 
their head will burst and they will go crazy ; throbbing headache in the 
middle of the brain, every morning, lasts all day; headache from over- 
lifting ; menstrual headache ; worse going up stairs, talking, or walking, 
or riding in the hot sun, or from taking cold ; better from tight bandag- 
ing, vomiting of mucus and bile, and pressure with cold hands, or some- 
thing cold. 

Dose : As for Belladonna. 

Ignatia is especially appropriate for one-sided headaches proceeding 
from irritation of the spinal nerves, or may be required in cases where 
Pulsatilla appeared to be indicated, but failed to relieve. It is, also, an 
excellent remedy, and should be preferably selected in cases in which the 
pain is confined to a small space, and causes a sensation as if a nail were 
being driven from within outward ; also, when the pain is of a pressive 
aching, or of a shooting description proceeding from within outward and 
chiefly confined to the forehead and root of the nose; and when there are 
nausea and dimness of sight, and sensibility of the eyes to light; paleness 
of the face(Nux is red), and temporary alleviation from change of posi- 
tion ; aggravation from noise, strong odors, and drinking coffee. Ignatia 
is especially applicable to nervous females of a mild and sensitive dispo- 



172 HEADACHE. 

sition, or to those in whom the attacks are prone to be excited by depress- 
ing emotions, or return at the menstrual period. 

J>ose : As for Belladonna. 

Sepia is one of the most valuable remedies in the treatment of severe 
and inveterate sick headache or megrim. It is more particularly required 
in periodical headache, aggravated by mental emotions, in nervous 
females; the pain is either of a lancinating description, or it is a pressive 
aching, shooting, or a tearing, piercing or jerking pain, and affects the 
whole of the head, or it is only seated under the eye, or occupies one half 
of the head or forehead ; in the latter case, the pain is experienced chiefly 
in the morning, and is frequently attended with extreme sensibility of 
the eyes to the light. Sepia is, also, very efficacious in cases of obstinate 
megrim, with violent, piercing, or rending pain, intermingled with lan- 
cinations so excruciating that the patient is afraid to move, and can obtain 
only a very little relief by keeping perfectly still with the eyes closed; at 
other times, the pain is s'o severe as to cause the patient to scream out, and 
is accompanied with heat in the head, or faintness and giddiness, fol- 
lowed by nausea and vomiting. The source of the nervous headaches 
which call for the employment of Sepia, is to be found in derangement of 
the digestive organs, or in some derangement of the womb, in the case of 
females. The headache is, consequently, a secondary, and not a primary 
affection . We, accordingly, find that it is of the greatest efficacy in cases 
attended with green sickness, or with whites, in the intervals between 
periods, when a sensation of heat and fullness in the lower part of the 
belly, and, also, a peculiar offensive-smelling sweat, particularly in the 
armpits, and on the feet, prevail ; lastly, pale, dirty, or yellowish com- 
plexion, with a number of yellowish brown spots across the nose, a little 
resembling a saddle; shrunken features, or a countenance expressive of 
suffering ; spare habit of body ; constipation . 

Dose : As for Belladonna. 

Sanguinaria. This is one of the choice remedies for the sick head- 
ache to which Americans are subject; the attacks occur . paroxysmally ; 
the pains begin in the morning, increase during the day, and last till eve- 
ning ; the head seems to feel as if it would burst, or as if the eyes would 
be pressed out, or the pains are digging, attended with sudden, piercing, 
throbbing lancinations through the whole brain, involving the forehead 
and top of the head more particularly, and being most severe on the right 
side, followed by chills, nausea, and vomiting of food and bile, forcing the 
patient to lie down and preserve the most perfect quiet, as every motion 
aggravates the suffering, which is only relieved by sleep ; the head is 
congested, and the veins on the forehead are distended like whip cords. 

Dose : As for Belladonna. 

Pulsatilla is a remedy of great value in the treatment of megrim, 
characterized by rending or shooting pains, with heaviness of the head, 
giddiness, dimness of the sight, sensibility to light, or buzzing or singing 
in the ears, and earache; nausea, paleness of the face, lowness of spirits, 
headache with pain in the back of the neck; aggravation of the head- 
ache, with chilliness towards evening, during repose, or particularly 
when sitting; amelioration in the open air; disposition mild; tempera- 
ment phlegmatic. In females with retarded periodical returns. 

Dose : As for Belladonna. 



DISEASES OF THE HEAD. 173 

Bryonia for rheumatic headache, or headache with aching, piercing, 
or digging, tearing pain at a small fixed spot, or piercing, aching pain in 
the forehead, daily, after a meal, or coming on in the morning, disappear- 
ing in the afternoon and returning again in the evening with great vio- 
lence, when it is attended with a sensation as it' the head were pressed 
together, particularly at the temple; burning, tearing pains over the entire 
head, or shootings in one side of the head. The pains are increased by 
motion, and are attended with ill humor and disposition to chilliness or 
shivering; they are, sometimes, relieved or terminated by a fit of vom- 
iting. 

Dose : As for Belladonna. 

Sulphur is indicated in chronic headache, following the suppression 
or driving in of some eruption or disease of the skin ; headaches occurring 
every day or every eight days, worse in the morning, or during the night, 
and attended with heaviness of the head, aching, or pressive pains in the 
forehead above the eyes, causing the patient to knit the brows or keep the 
eyes closed, or over the entire head ; incapability of mental exertion from 
the pains in the head ; pains as if the head would split, or rending, shoot- 
ing, dragging, jerking pains on one side of the head; aggravation of the 
headache from meditation, the open air, or movement; extreme tender- 
ness of the scalp, cannot bear to touch or comb the hair; falling off of the 
hair. 

If none of these remedies appear to be appropriate, study, with the aid 
of the Repertory, the following additional remedies: China, Veratrum, 
Gelseminum, Colocyntfi, Cimicifnga. In general cases, headaches which do 
not simply occur as the result of casual or accidental derangements involv- 
ing irregularities of digestion, the diet should be plain, but (in the absence 
of fever) nutritious, and the meals should be regular. Regularity of the 
general habits, and early resting and rising, with exercise in the open air 
(short of fatigue), are valuable aids in promoting and assisting a perma- 
nent cure. Everything which is known to provoke or aggravate an attack 
should be carefully avoided. Nineteen out of twenty cases can be cured, 
if this treatment is perseveringly adhered to. 

HOME REMEDIES.— Soda one-fourth teaspoonful, pulverized charcoal 
one-fourth teaspoonful, paregoric ten drops. Mix, to be taken as one dose, 
and repeated in one-half hour, if need be. This is splendid for sick head* 
ache, and should be given as soon as the indistinctness of vision comes on. 

Blood Root, or Sanguinaria (Red Percoon), which is so common in om 
country, is a most sovereign remedy for American sick headaches. 

Constant headaches may, frequently, be cured by snuffing certain arti- 
cles, such as Camphor, the juice of Blood Beets, or Ground Ivy, or freshly- 
grated Horse Radish Roots. 

A towel or night cap, wrung out of cold water and applied to the head, 
on retiring at night, is good for a headache which returns every morning. 

Applications of water, sometimes hot, at other times cold, will give 
relief in many cases. 

NEURALGIA. 

NERVE-PAIN, PACE-ACHE, FACE-AGUE, AND NEURALGIA IN GENERAL. 

Symptoms.— Neuralgia is one of the most painful diseases, or rather 
symptoms of disease, to which the human family is subject. It commonly 



174 NEURALGIA. 

occurs in the nerves of the face, although it is met with in different parts 
of the head, in the breast, side, hip-joints, and other parts of the body and 
limbs. Its attacks are usually sudden, and the paroxysm of pain varies 
in its duration. 

The pain is agonizing, lancinating, and shooting along the nerves 
like a shock of electricity, frequent feeling as if red-hot wires were thrust 
into the parts, and after the pain passes away, a numbness remains for 
some time. 

Sometimes, instead of attacking suddenly, it commences with a slight 
heat or sense of itching or numbness, which augments in severity more or 
less rapidly. The pain occurs, from time to time, at longer or shorter 
intervals, and is often produced by the most trifling causes, as a draught 
of air, a slight jar or noise, or even talking. 

The prognosis is favorable, as far as life is concerned, but the fearful, 
and frequently returning pain exhausts the body and wears on the mind 
to such an extent, that the patient is often driven to insanity, melancholy 
apoplexy, and even suicide. 

Causes. — Exposure to miasmatic influences, injuries to the nerves by 
accident, heat or cold, derangements of the digestion, the growing of the 
bone through which the nerve passes, so as to close the very small open- 
ing through it; tumors growing in such a position as to make pressure on 
the nerve, and other causes, which are to this day not well understood by 
physicians. 

Neuralgia may be distinguished from rheumatism by the intensity of 
the pain, its short continuance and rapid return, and its liability to return 
on the slightest touch; in acute rheumatism there is fever, redness, heat 
in the affected part, and some swelling, all of which are absent in neural- 
gia; in chronic rheumatism the pain is continuous, less severe and often 
worse at night. From toothache, by the short continuance of the parox- 
ysms, the rapidity with which it comes and goes, and the frequent con- 
vulsive twitchings of neuralgia. 

ALLOPATHIC TREATMENT.— The treatment of neuralgia has refer- 
ence, in the first place, to the removal of the cause, or morbid condition, 
upon which the neuralgia is ascertained to depend. These may be mala- 
ria (or miasmatic poisoning), poisoning by lead, an impoverished condi- 
tion of the blood (ansemia), syphilis, pressure by morbid growths upon a 
nerve, etc. In all these instances, while it is common to consider the 
neuralgia a disease, it is, really, but a symptom, and the cause behind is 
the disease. A rheumatic or gouty condition of the system frequently 
contributes to the production of the neuralgia, and treatment appropriate 
to these conditions is called for, if they exist. 

We nearly always find the health poor ; the bowels should be kept reg- 
ular by means of laxatives, but physicing should be avoided. Aloes and 
Pepsin answer very well. Take of Aloes eight grains, Pepsin thirty-two 
grains, Syrup of Gum Arabic a sufficient quantity. Make a mass and divide 
into sixteen pills. 

Dose : One or two pills each day at dinner. 

A generous, nourishing diet should be given with plenty of milk and 
cream, raw eggs beaten with sugar and water, or milk and animal food, 
twice a day. Cod Liver Oil will be found beneficial in building up the 



DISEASES OF THE HEAD. 175 

health. The clothing should be warm, and flannel worn next to the 
skin. Often, in intercostal neuralgia (in the nerves between the ribs), a 
chamois skin shirt will be exceedingly useful, and chamois skin drawers 
will be equally useful in sciatica (neuralgia of the great nerve of the 
thigh.) 

Iron is the great restorer of the health in these cases, by enriching 
the blood. The Citrate of Iron and Quinine, dissolved in Orange Flower 
Water, or syrup, can be given in five grain doses three or four times a 
day, or the Tincture of the Chloride of Iron can be given in thirty-drop 
doses, largely diluted in sweetened water, after each meal. Other prepa- 
rations of Iron may be given with equally good results. When the bene- 
fit expected does not follow the use of iron, it should be given with Man- 
ganese. An eligible formula is : Take of Sulphate of Quinine, Dried Sul- 
phate of Iron, Dried Sulphate of Manganese, each, thirty grains. Mix, and 
let them be made into thirty pills. 

Dose : One or two pills, to be taken three times a day. 

When the neuralgia is periodical, i. e., the pain recurs at regular inter- 
vals, quinine is a sovereign remedy, but its success is often remarkable 
when given in cases which are not periodical. It should be given in large 
doses— fifteen to thirty grains a day— for a week or more. This remedy 
is elevated to the first rank as an internal remedy for neuralgia. Arse- 
nous Acid (Arsenic) will rank next in value to Quinine, and will be ordered 
by the physician in cases in which Quinine is not tolerated, though it will 
not be likely to succeed, if Quinine has failed. Fowler's Solution is the 
most convenient form, and should be given in doses of five drops in water 
after each meal. But if the hygienic and tonic plan of treatment fails, a 
physician had better be consulted before resorting any farther to internal 
remedies. In rebellious cases, the other remedies usually given are Strych- 
nine, the preparations of Zinc, Carbonate of Iron in large doses, Phos- 
phorus, Oil of Turpentine and Iodide of Potassium. The latter is indica- 
ted when the neuralgia depends upon a rheumatic condition, and, also, 
with Mercury, when the neuralgia depends upon syphilis. 

The relief of pain occupies a large place in the treatment. During the 
severe paroxysm, large doses of Opium are generally required. Morphine 
in doses of one-fourth to one-half a grain can be given every hour, until 
relief is obtained, then stop giving it. The most effective method of giving 
Opium is by injection beneath the skin (hypodermic), over the seat 
of pain, at the hands of a physician. The relief given is complete, and 
cures are effected in numerous instances, especially, in sciatica. This ele- 
ment in the treatment should be guarded most carefully to avoid the mor- 
phia habit. If the pain is not severe, relief may be had from Belladonna, 
Hyoscyamus, Conium, Stramonium or Aconite, etc. Probably as good an 
internal anodyne as any, is Brown-Sequard's Neuralgia Pills, in which 
several of the pain-relieving substances are combined ; the dose is one pill, 
from two to four hours apart. When the patient cannot take a pill, a 
watery solution may be made, or a pill may be crushed and taken as a pow- 
der In the absence of these pills, the Tincture of Belladonna may be given 
in doses of ten to twenty drops; or the Tincture of Hyoscyamus. in doses 
of a teaspoon ful to a tablespoonful, at the same intervals. The object to 
attain is relief from pain. 



17G NEURALGIA. 

Much relief may be obtained by local applications. The best of these 
are liniments of Aconite, Chloroform, or Opium. A piece of flannel 
should be saturated with the liniment, laid on the painful part and cov- 
ered with oiled silk. A good liniment, applied in this way, is this : Take 
of Tincture of Aconite and Chloroform, each half an ounce, Soap Liniment 
one ounce. Mix. 

Of the forms of counter-irritation resorted to in neuralgia, the one 
most generally useful is the "flying blister.'' Small fly plasters, about half 
an inch in diameter, are placed over the painful points, for two hours. 
The blistered points are to be dressed with simple ointment or tallow and 
allowed to heal as soon as possible. The blisters are to be repeated in a 
few days, if the neuralgia continues. Mustard plasters and dry cupping 
can also be resorted to. Severer counter-irritation will be resorted to by 
the physician in obstinate cases. 

In essential neuralgia, i. e., not dependent on an ascertained cause, 
there is no more useful agent than electricity in procuring relief from 
pain, and sometimes a cure results. Neuralgia of the face, neck and 
shoulder, and of the hip and thigh (sciatica,) are the forms of neuralgia, 
most likely to be benefited by electricity. The positive pole of the gal- 
vanic battery should be placed at the point of emergence of the affected 
nerve, and the negative over the principal divisions of the expansion. 
From five to ten minutes should be occupied at each sitting. In old cases 
of a sciatica, a needle, isolated nearly to its point, should be passed down 
into the flesh, near the nerve, and attached to the positive pole, while the 
negative sponge, electrode, is passed over the course of the nerve. Gal- 
vanism frequently gives the best results in neuralgia of the uterus and 
ovaries. 

A permanent cure will generally depend upon a correct appreciation 
and management of the (diseased) constitutional condition upon which 
the neuralgia is dependent, or with which it is associated, with hygienic 
and tonic measures to strengthen the tone of the system and general 
health. These were alluded to in the beginning of our description of the 
treatment of this malady. 

HOMOEOPATHIC TREATMENT. Belladonna is indicated by darting 
pains in the cheek-bones, nose, jaws, or in the bones adjoining the ears; 
or cutting and tensive pains, with stiffness at the nape of the neck, and 
clenching of the jaws, twitching of the eyelid, or violent, shooting, tear- 
ing, and dragging pains in the ball of the eye; jerking pains in the facial 
muscles and mouth ; heat and redness of the face. The pain is, generally, 
preceded by itching and creeping in the affected side of the face, and at 
times becomes so severe as to be almost insupportable. The paroxysms 
are prone to be excited by rubbing the usual seat of the sufferings. 

Dose: Three globules in a teaspoonful of water, or dry on the tongue, 
repeated at intervals of four hours, for the first two days (should the 
pains continue, or recur without change of character during this 
period,) and, subsequently, at intervals of twelve hours, for two 
days (if yet required); after which (if necessary and still indicated) 
the course may be repeated as before, and so on, until decided and 
permanent amelioration or change. 
Platina is appropriate when the subjoined symptoms are predomi- 
nant. Feeling of coldness and torpor in the affected side of the face, with 



DISEASES OF THE HEAD. 177 

severe spasmodic pain; or tensive pressure in the bones adjoining the 
ears, with a sensation of creeping or crawling, and aggravation or renewal 
of the sufferings in the evening, and when in a state of rest; flow of tears ; 
redness of the face, etc. 

Dose: Three globules, as directed for Belladonna. 

Gelseminum should be given when the pain comes on in distinct 
paroxysms, and is very severe, accompanied with twitching and drawing 
in the muscles around the part affected ; the parts in and around the orbit 
of the eye are most commonly affected. 

Dose : Three globules, as directed for Belladonna. 

Colocynth. Violent rending and darting pains, which chiefly occupy 
the left side of the face, are aggravated by the slightest touch, and 
extend to all parts of the head, temples, nose, ears, teeth, etc.; mitigated 
by perfect rest, and by external warmth. 

Dose: Three globules, as directed for Belladonna. 

Arsenicum should be given when there is a tendency to periodicity 
in the attacks or paroxysms, and the pains partake more especially of a 
burning, pricking, and rending character, and are experienced chiefly 
around the eye, and occasionally in the temples ; the sufferings being 
occasionally of so severe a description as almost to drive the patient dis- 
tracted ; great anguish ; excessive prostration, with desire for the recum- 
bent posture ; sensation of coldness in the affected parts ; exacerbation 
during repose, from fatigue, in the evening, when in bed, or after a meal; 
temporary amelioration from external heat. 

Dose: Three globules, as directed for Belladonna. 

China should be selected when, as in the instance of the foregoing 
remedy, there is a tendency to periodicity in the attacks, and when the 
pains are excessive, attended with extreme sensibility of the skin, and 
consequent aggravation from the slightest touch; the pains are located 
below the eye and in the cheek; great prostration after the paroxysms. 

Dose : Three globules, as directed for Belladonna. 

Veratrum is more especially indicated by insupportable pains, which 
almost drive the patient to distraction ; excessive weakness, even to faint- 
ing; general chilliness; exacerbation of suffering on getting warm in bed, 
or towards morning; temporary relief on moving about. 

Dose : Three globules, as directed for Belladonna. 

Spigclia is frequently a useful palliative remedy in all cases when 
the pain is excessive ; but it is more especially required when the pains 
are cf a jerking, tearing character, exacerbated by the slightest touch, or 
by movement of the affected parts, or when they appear to shoot from the 
center of the brain to the sides of the head, or to the ears; flow of water 
from the eyes and nose; further, when the pains partake of a burning and 
pressive aching character, and have their seat in the zygomatic process; 
glossy tumefaction of the affected side of the face; excessive agitation and 
anguish ; rheumatic pains elsewhere. 

Dose : Three globules, as directed for Belladonna. 

Mezereum is more especially indicated for burning, pressive pains, 
coming very suddenly, and which leave the parts numb, attended with 
chilliness and shuddering; they are worse from eating warm food, or from 
entering a warm room; there is frequently redness and burning of the 

12 



178 NEURALGIA. 

throat, and a stiff feeling of the jaws. It is, especially, suitable after the 
abuse of Mercury, or in syphilitic persons. 

Dose: Three globules, as directed for Belladonna. 

Iris Versicolor is adapted to such cases as are associated withsfcA- 
headache, where there is a good deal of vomiting of a sweetish mucus, and 
sometimes of bile. 

Dose : Three globules, as directed for Belladonna. 

Nux-vomica should be administered when the pain is mostly below 
the eye, and the eye is inflamed and watery ; profuse watery discharge from 
the nostrils ; the affected side feels numb. The patient is morose, irritable, 
belches a great deal, and is constipated. It is, especially, suitable after 
abuse of coffee, liquors or drugs. 

Dose : Three globules, as directed for Belladonna. 

Rhus Tox. will be found useful for drawing, burning, tearing pains 
in the face, and a feeling as though the teeth were too long; very great 
restlessness, and tossing about; particularly adapted, if brought on by 
getting wet, or after wet weather. 

Dose : Three globules, as directed for Belladonna. 

Bryonia may be administered, particularly in cases of rheumatic 
face-ache, when the pains are of an aching, pulling, or tearing description, 
exacerbated by movement; irritability of temper, and general tendency to 
rheumatic attacks. 

Dose : Three globules, as directed for Belladonna. 

Hepar Sulphuris is also of much service against face-ache, resulting 
from excessive mercurial treatment, and is more particularly indicated 
when the pains are so much aggravated by the pressure of the teeth or by 
eating, that the patient is afraid to allow the crowns of the teeth to meet; 
pains of a drawing or jerking character, often aggravated by entering a 
warm room, or by the warmth of the bed at night; also when there is great 
sensibility of the cheek and base of the temple, with extension of the pains 
into the ears, and up the side of the face. 

Dose : Three globules, as directed for Belladonna. 

Sulphur is frequently a medicine of considerable value, whether for 
the treatment of the immediate acute symptoms, or for the after-treatment, 
in cases in which abuse of mercury has developed a predisposition to face- 
ache. This remedy is especially indicated by throbbing, drawing and jerk- 
ing, or burning, aching pains in the bones of the face, and in the jaws, and 
all the teeth, whether sound or decayed ; or when the pains involve the 
whole face, and even head, and are accompanied with determination of the 
blood to the head, redness and swelling of the cheeks and nose, with suf- 
fused redness and inflamed appearance of the eyes; or when there are also 
aching, weary sensations in the limbs, or in the small of the back, or catch- 
ing, stitching, darting painsin theears; general chilliness and susceptibility 
to the least current of air, with sleeplessness during the whole or greater 
part of the night, and drowsiness towards morning or in the day; cold 
water or cold applications, and mastication, greatly aggravate or provoke 
a return of the pains, which are also renewed or aggravated, generally 
towards evening, at night, or by currents of air. 

Dose: If against the immediate acute symptoms, three globules, as 
directed for Belladonna. If for after treatment, four globules in a 
teaspoonful of water, the first thing in the morning, (fasting,) for ten 



THE EYE.— PLATE li. 



Fig. 1 




Fig. 2. 




DISEASES OF THE EVE. 



179 



days, (or until the earlier development of change,) then pause ten 
days, after which the course may be repeated, as before, if any ten- 
dency to a return of the attack should yet be perceptible, or dreaded. 

Phosphorus is indicated by tearing pains, which occur more especi- 
ally about the left side of the face, and which are further characterized by 
determination of blood to the head, and by a sensation of tightness in the 
skin of the face, by aggravation upon the slightest touch or movement of 
the parts, or by pains extending deep into the ear, and to the root of the 
nose, and often attended with a confused, shell-like roar in the ears. 

Dose: Three globules, as directed for Belladonna. 

Pulsatilla, on the other hand, is to be preferred when the pains are 
usually aggravated towards evening, and at night, or in the morning, when 
seated, and when they are somewhat moderated in the open air; or further, 
when there is general chilliness with depression of spirits ; or, again, when 
the patient is of phlegmatic temperament. 

Dose : Three globules, as directed for Belladonna. 




THE EYE.— PLATE 1. 

The eye, while being the great medium for the study of nearly every- 
thing else, is in itself a study that will excite the wonder of every one who 
has a taste for the mysteries of nature's workshop. 

In the beautiful illustration on the opposite page, we see in Fig. 1, the 
facial surface of eyelids of left eye, with the blood-vessels and nerves, which 
ramify every part in the most wonderfully confused exactness. 

Fig. 2 is a vertical section of the Orbit and Globe of the eye y through its 
centre from before backwards, a. The frontal bone. b. The upper jaw. 
c. Fat. (1. Frontal muscle same as seen at c. in Fig. 1. m. The optic 
nerve, n. The conjunctiva which covers the front of the ball and inside of 
the eyelids, the reflection of which is shown at o. r. The eornea. t. The 
front, u. The rear cornea on which every object presented to the vision is 
photographed for our examination, x. The crystaline lens. z. Corpus vi- 
trum, a collection of liquid contained in a capsule, to the lining of which the 
optic nerve is distributed, so, like hearing, we must have water to help us 
to see ; both sound and light are carried in water. 



CHAPTER VIII. 



DISEASES OF THE EYE. 



OPHTHALMIA.— INFLAMMATION OF THE EYES, 
ACUTE AND CHRONIC. 

Ophthalmia is a term applied to inflammation of the eyes, whether of 
the acute or chronic form. All parts of the eye are subject to inflamma- 
tion, more especially its outer covering (conjunctiva) and the inner sur- 
face of the lids. At this place catarrhal ophthalmia, purulent ophthal- 
mia, and inflammation of the iris will be considered. 

CATARRHAL OPHTHALMIA. 

Symptoms. The conjunctiva, or white of the eye, becomes swelled, 
and of a scarlet color, being more or less covered with blood vessels, pre- 
senting the appearance of what is usually termed bloodshot, with this there 
is a sensation of heat, smarting, and pain, as if particles of sand were in 
the eye, and which pain is aggravated by rubbing the eye. There is 
much pain and uneasiness on exposing the eye to the light, and sometimes 
.even on the least motion of the eyeball, so that the patient usually keeps 
the lids closed. A copious flow of hot or excoriating tears is also present. 
When the disease is very violent, or, in irritable habits, febrile symptoms 
are manifested. 

Causes. Catarrhal ophthalmia may be produced by exposure to cold, 
sudden changes of temperature, blows and other injuries to the eyeball, 
irritating vapors, foreign particles in the eye, improper exposure of the 
.eye to strong light, overtasking the eyes by reading or writing late at 
.night, intemperance, and other causes similar to those producing inflam- 
imation of other mucous surfaces. This disease may be distinguished from 
/rheumatic ophthalmia, by the presence of headache, the greater intoler- 
ance of light, and the severe, throbbing pain common to the latter, besides 

180 



INFLAMMATION OF THE EYES. 181 

in catarrhal ophthalmia the blood vessels are apparently tortuous and of a 
scarlet red color, and in the rheumatic form, they are straight, hair-like 
radiated, and of a pink or violet hue; in rheumatic ophthalmia the sensa- 
tion of roughness or foreign bodies in the eye is never present. There is 
seldom any danger to be apprehended in catarrhal ophthalmia, when 
properly treated. 

PURULENT OPHTHALMIA. 

Symptoms. Usually a great itching is felt in the eye, or a sensation, 
as if a particle of dust were between the lids and the eyeball, and this usu- 
ally happens at night; this is succeeded by a sticking together of the lids, 
generally in the morning, owing to a secretion of mucus. The lids are 
somewhat stiff, there is great and uniform redness of the eye, but without 
pain, tension, or intolerance of light, and a watery fluid is discharged. The 
disease soon extends to the globe of the eye, with high, vascular action and 
bright redness, great tumefaction of the membrane, and increased dis- 
charge. The conjunctiva suddenly swells, and becomes considerably 
elevated around the cornea. The cornea, appearing, as it were, at the 
bottom of a pit. This swelling is called chemosis, and is often so great as 
to overlap and nearly cover the cornea. The eyelids swell, and are almost 
immovable. The discharge is profuse and of a yellow color, and may con- 
tinue for ten or fifteen days without much change. Finally, the chemosis 
begins to shrink, the discharge diminishes and becomes thin and gleety, 
and the parts, which were the first attacked, are the last in which the dis- 
ease disappears. The inflammatory symptoms vary from a mild character 
to one of great violence, being accompanied with sharp, lancinating pain 
situated deep in the eye-ball, and which is usually worse at night. Some- 
times a deep-seated, throbbing pain in the eye comes on in paroxysms, or 
it may be violent and continuous, without any mitigation until the cornea- 
bursts. The disease may terminate in bursting of the cornea, abscess of 
cornea, ulceration of the cornea, opacity of the cornea, thickening or granu- 
lation of the lids. 

Purulent ophthalmia may be discriminated from catarrhal by the che- 
mosis, the bright red membrane, and the profuse purulent discharge. The' 
right eye more frequently suffers, and more severely than the left, though 
the discharge may attack either or both. 

Causes: The disease is propagated by contagion. It frequently occurs 
epidemically, and seems to depend upon some peculiar condition of the 
atmosphere And, under some circumstances, there is no doubt but it may 
be produced by exposure, injuries and other circumstances, that will occa- 
sion the catarrhal form. 

INFLAMMATION OF THE IRIS. 

Inflammation of the Iris, or Iritis, may be accompanied with rheuma- 
tism; sometimes with gout, and not unfrequently witli syphilis; hence the 
names, rheumatic iritis, syphilitic iritis, etc., have been applied to these 
various forms. The disease is, however, in all instances, only a modifica- 
tion of one, and of the affection. 

Symptoms. Uneasy sensations are experienced in the neighborhood 
of the eye, with pains about the forehead, brow, and orbit, extending to 
the side of the head. There is, also, a redness of the sclerotica or white o« 



182 DISEASES OF THE EYE. 

the eye, with intolerance of light, and watery discharge, as these symptoms 
increase in severity. The iris, or that part of the eye which surrounds the 
pupil, and which we judge of the color of the eye— whether blue, black, etc., 
—becomes involved. Its color undergoes a change; first in the lesser 
circle, which becomes of a darker hue, and afterwards in the greater, 
which becomes greenish, if it were originally blue or greyish ; and reddish, 
if it were brown or black. The pupil is contracted, its opening being 
deprived of the bright, black color it naturally possesses, and the motions 
of the iris are impeded. Headache and feverish disturbance of the system 
are generally present. After a violent attack, with great diminution of 
sight, the symptoms subside, the eye recovers, and sight is restored. The 
iris is found to be connected to the capsule by adhesions of white color. 
The inflammation returns again, and again new adhesions take place ; the 
pupil becomes more and more contracted, and finally vision is lost. Occa- 
sionally the first attack may be so violent as to occasion loss of sight. 

Causes: It may be produced by cold, and frequently attended w r ith 
rheumatism, syphilis, etc. Some rheumatic persons have one attack, or 
more, every year, in which the sight becomes gradually destroyed. 

ALLOPATHIC TREATMENT.— Simple Ophthalmia (Inflammation of 
the Conjunctiva). In a person who is robust, over-stimulated, or over-fed, 
a brisk cathartic of a tablespoonf ul of Epsom or Rochelle Salts, or a Sied- 
litz Powder, should be given, and repeated in four hours, if a free cathar- 
sis has not taken place. Such a patient should, also, have a low diet. 

A weakly patient, or one with impoverished blood, or one that habitu- 
ally feels tired and sleepy on rising in the morning, after a full night's 
sleep, should have hearty, blood-making, but plain, nutritious food; also, 
tonics of Bark and Iron. One or two tablespoonf uls of the Infusion (tea) 
of Cinchonia Bark (one ounce of Bark to a pint of water) may be given in 
doses of one or two tablespoonf uls, before eating Tincture Muriate of 
Iron may be given in doses of from ten to twenty drops, well diluted in 
sweetened water, after meals. The mouth should be rinsed with water, 
after taking the Iron. The Citrate of Iron and Quinine, in from two to 
five-grain doses, will fulfill all the indications. 

Rest, and temporary protection from light, will be required. 

Frequent application of water, either cold or warm, guided by the feel- 
ings of the patient, should be made. Quite warm applications are gener- 
ally preferred,and are more useful. 

One of the best stimulating washes is a solution of six grains of Alum 
or one grain of White Vitriol (Sulphate of Zinc,) and two to four grains of 
the Sulphate of Morphine, in two ounces of warm water. A few drops 
may be dropped in the eye, two to four times a day, with a quill or camel's 
hair brush. 

After using these stimulating applications for a ?few days, their use 
should be suspended for a day or two, and observe the result; for it does 
happen, sometimes, that the irritability of the congestion is kept up by 
their prolonged use. 

The extreme pain should be relieved, if necessary, by an occasional 
dose of Opium and Hyoscyamus. For an adult, a quarter of a grain of 
Morphine, or twenty drops of Laudanum, with one or two teaspoonfuls of 
Tincture of Hyoscyamus, are suitable doses. The Morphia, or Opium, may 



INFLAMMATION OF THE IRIS. 183 

be given, with one grain of solid extract of Hyoscyamus, in pill. For a 
child, Paregoric (Camphorated Tincture of Opium) and Tincture of Hyos- 
cyamus, should be used in equal quantities. 

Dose: From fifteen drops to a teaspoonful, according to age. 

When the ophthalmia continues, and becomes catarrhal (mucus form- 
ing), the treatment above recommended for simple application will be 
appropriate. The tonics recommended will, generally, be more urgently 
needed. 

Frequent bathing of the eyes, with warm water, will be useful. The 
edges of the lids should be smeared with Brown Citrine Ointment, or, in 
its absence, with Castor Oil, or some simple ointment. 

The stimulating wash, which is followed most rapidly by benefit, is 
Nitrate of Silver— its use requires the direction of a physician. 

Two or three drops of a solution of Sulphate of Atropine (two grains 
to the ounce of water) should be dropped in the eye two or three times a 
day ; or a solution of half a dram of Extract of Belladonna to the ounce of 
water. 

Purulent Ophthalmia usually occurs in persons feeble in general health, 
and where such is the case, tonics and nourishment are urgently called for. 
Citrate of Iron and Quinine should be given in doses of from two to five 
grains, dissolved in water or syrup, three times a day; or the following: 
Take of Citrate of Iron and Strychnine a dram and a half, Quinine half a 
dram, Citric Acid a dram, Simple Syrup four ounces. Mix. 

Dose: A teaspoonful, three times a day. 

Or the bitter infusions and Tincture of Iron, as recommended in sim- 
ple ophthalmia, may be given instead. The diet should be of nutritious, 
blood-making varieties, but plain. Fresh meat, milk, and eggs, may be 
allowed. 

A furred tongue and constipation will call for one or two Compound 
Cathartic Pills, once or twice a day, until the bowels move. Should the 
patient be robust and hearty, the tonic treatment should not be pursued, 
but an active cathartic should be given. Four Compound Cathartic Pills 
maybe given; or, doubtless, a full dose (one or two tablespoonfuls) of 
Salts will answer the purpose. In such cases, also, the diet should be 
reduced. 

Pure air is a necessity, and the patient must not be confined in bed, if 
it can be avoided. 

The greatest care should be exercised to avoid communicating the dis- 
ease to others. No other person should wipe on the towel or napkin used 
by the patient. If only one eye is affected, the well eye ought to be her- 
metically closed until all danger of contagion has passed. 

The great danger is, that the cornea may become ulcerated and slough, 
causing complete or partial blindness. 

I should strongly advise that no case should be treated without a phy- 
sician. 

The local treatment will consist of repeated cleansing of the eye by 
carefully injecting warm water with a syringe; a solution of Nitrate of 
Silver, three grains to the ounce of distilled water, should be dropped in 
the eye twice a day, or oftener; after a few days, a strong solution of Alum 
(ten grains to the ounce of water), should be substituted for the Nitrate of 
Silver, and vice versa. 



184 DISEASES OF THE EYE. 

During the course of this disease, a solution of Sulphate of Atropine 
(two grains to the ounce of distilled water), should be dropped in the eye 
two or three, or more times a day, according lo the urgency of the symp- 
toms. If the Atropine cannot be obtained, a solution of a half a dram of 
Extract of Belladonna, to the ounce of water, may be used instead. 

The pain may require relief by the administration of anodynes once a 
day, or oftener. Opium and Hyoscyamus, one grain each of the extract; or 
a quarter of a grain of Morphine, a grain of the Extract of Opium, or 
twenty or thirty drops of Laudanum, with two teaspoonfuls of Tincture of 
Hyoscyamus. 

Wet cups or blisters to the temple may be useful. 

Attendants often assisting the patient should immediately wash their 
hands to avoid carrying the disease to their own eyes. 

Granular Ophthalmia calls for the same general treatment as is recom- 
mended for the other forms of ophthalmia, and is appropriate under the 
same state of health. The form of iron I generally give is the Pyrophos- 
phate in solution with Icdide of Potassium, the latter having a favorable 
effect on the disease. Take of Iodide of Potassium Jive drams, Pyrophos- 
phate of Iron half a dram; dissolve each in two ounces of simple syrup with 
trituration in a mortar and mix. 

Dose : Give a teaspoonf ul after each meal. 

The bitter infusives recommended in simple ophthalmia may be given, 
if the appetite is poor. The diet should be good and abundance of exercise 
should be taken in the fresh air. 

The edges of the eyes should be anointed each night with Brown Citrine 
ointment. The nice local treatment demands a skilled physician; it con- 
sists principally in inverting the lid and applying the solid stick or crystal of 
Sulphate of Copper (blue stone) across the granulations. Before the lid is 
restored to its natural position, it should be bathed with a camel, hair 
brush, dipped in sweet oil. Another useful agent, applied in the same way 
is Nitrate of Silver; it should be fused with Nitrate of Potash, as the pure 
stick is too caustic. The lid should be washed with a camel, hair pencil 
clipped in water, after each application. Liquor Potasse, applied with a 
camel, hair pencil to the granulations is useful. These agents can be used 
in succession as the case continues. Once a day is frequent enough for 
their application. As a wash, a solution of Alum, three grains to the ounce 
of distilled (or rain) water is useful. If the edges of the lids are irritable 
or stick together at night, they should be anointed each night with Brown 
Citrine Ointment, Spermaceti Ointment, Castor Oil, or lard. 

Treatment of Chronic Ophthalmia.— The use of artificial light 
should be avoided, also ill-ventilated rooms and working upon small 
objects. If H is impossible to do this, care should be taken to obviate the 
ill effects. Great relief may be had by having a pale, blue chimney, or shade 
to the lamp or gas jet. Free exercise in the open air should be taken and 
plenty of regular sleep. The diet should be wholesome, consisting largely 
of fresh beef, mutton, or chicken, milk, and eggs. Some of the tonics 
recommended in other forms of ophthalmia will be useful, if the patient 
is in feeble health. The bowels should be kept regular." The eyes should 
be frequently bathed with warm water, and a solution of alum or sugar 
of lead three grains to the ounce of pure rain water, or a solution of Tan- 



INFLAMMATION OF THE IRIS. 185 

nin, ten grains to the ounce of water dropped in the eyes night and 
morning. It is sometimes well to bathe the closed lids after use of the 
eye water, with cold water. The edges of the lids should be anointed each 
night with Brown Citrine Ointment. 

Continual watering of the eyes in the wind should lead to the exam- 
ination of the lachrymal duct. In all tedious cases, which cannot be 
traced to a previous attack of catarrhal ophthalmia, or obstruction of the 
lachrymal duct, the edges of the lids should be examined to see whether 
an irregularly growing eyelash may not be the cause of the irritation. 

The irritability of the eyes of students is frequently relieved by bath- 
ing the eyes in very warm water, and the redness of the edges of the lids 
can be prevented by the use of Brown Citrine Ointment. 

The Opthalmia of Newly Born Children.— If the attack is a 
severe one, recovery.may depend on the health and vigor of the child. 
The health of the mother, and her ability to nurse the child properly, will 
govern, in a measure, the chances of the child's recovery with a useful 
eye. The child may need feeding, but ought not to be weaned, for almost 
as surely as the cornea becomes ulcerated, the eye will be lost, if the 
attempt is made to raise the child " by hand.'' The preventive treatment 
will consist chiefly in the avoidance of the causes which may originate the 
disease, which are, besides contact with the unhealthy discharges of the 
mother during birth, etc., rude washing with soap and cloths by the 
nurse, cold, exposure to strong light, and contagion. 

The eyes should be thoroughly and frequently cleansed with warm 
water. Probably this can be best done by a small glass syringe, introdu- 
cing itat the outer corner of the eye and gently injecting. No harshness 
should be used, but firmness, for the eye must be thoroughly cleansed. 
After each cleansing, which should be as often as every hour, a solution 
of Sulphate of Zinc one grain to the ounce of distilled water or pure rain 
water, should be dropped in the eye. In severer cases, (which should be 
in the hands of a skillful physician,) a stronger solution should be used. 
Sulphate of Zinc three or four grains, and Alum six or eight grains to the 
ounce of water. 

In cases which are not too severe to be treated without a physician, a 
solution of one grain of Sulphate of Zinc in from two to four ounces of 
water, will be perfectly effectual. A soft piece of muslin, wet with water, 
folded several times, should be laid over the eyes and tied loosely, but 
firmly enough to be kept in place. A skillful physician should have 
charge of the case, if possible. 

Scrofulous Ophthalmia is characterized by small serous vesicles 
which arise on the conjunctiva. It is especially liable to invade the 
cornea. The affection is especially liable to occur in feeble persons whose 
nutrition is not good. Good diet of a plain but nutritious kind is espe- 
cially called for. Fresh meats, cream, milk, and raw eggs are suitable. 
The Syrup of Iodide of Iron in doses of twenty drops after meals, seems 
especially serviceable; or the Tincture Muriate of Iron may be given in 
similar doses, well diluted, with sweetened water. If the appetite is poor, 
an infusion of Peruvian Bark, Gentian or Quassia, made by macei'atiny an 
ounce of Uw drug in a pint of hot water, may be given. 

Dose : Half a wineglass to a wine^rlassfuL 



186 DISEASES OF THE EYE. 

Or the bitter tonic and iron can be given together by using the Citrate 
of Iron and Quinine, in doses of two to five grains three times a day. 

A solution often grains of Tannin to an ounce of water, is a good ap- 
plication in this and all forms of conjunctivitis, or finely levigated Calomel 
may be dusted over the vesicles, by means of a camel, hair brush, once a 
day. The invasion of the cornea should be met with the solution of Sul- 
phate of Atrophine, four grains to the ounce of distilled water, dropped in 
the eye with a quill or clean camel's hair brush, two to six times a day, 
according to the intensity of the pain and inflammation. The edges of the 
lids should be kept annointed with Brown Citrine Ointment. 

If a skillful physician can beobtained, he ought to have charge of thecase. 
ALLOPATHIC TRE 1TMENT* In the treatment of Iritis, the first thing 
is to secure and maintain a full dilatation of the pupil, to prevent com- 
plete or partial obliteration of the pupils, by adhesion of the free edges of 
the iris, or by adhesion of the iris to the capsule of the crystalline lens, 
or possibly by adhesion of the muscular fibres of the iris. The required 
dilatation of the pupil is obtained by dropping into the eye, from two to 
four hours apart, a solution of two to four grains of Atropine in an ounce 
of distilled water. 

Pain should be relieved by Opium, in doses of one grain, or Morphine, 
in doses of one eighth grain, or Laudanum, in doses of twenty-five drops, 
repeated at such intervals as may be necessary to relieve the pain — two to 
six hours apart. 

If the strength of the patient is reduced, the Citrate of Iron and 
Quinine, in three grain doses, dissolved in Syrup of Orange, may be given 
three times a day. In case the patient is rheumatic, or the disease is obsti- 
nate, the Iodide of Potassium should be given in Peppermint Water and 
Syrup, in doses of five to ten grains after meals. 

Besides the above treatment in syphilitic iritis, Iodide of Potassium 
should be given in large doses. Mercury will also be required in this form 
of disease. 

Iritis should be treated by a physician. 

HOMOEOPATHIC TREATMENT. To save space and needless repeti- 
tion, we will here mention all the remedies needed in the treatment of this 
affection, viz: Acute, Chronic, Simple, Scrofulous, Purulent, Granular, 
etc., and that arising from external injuries. The remedy which will be 
best suited to the treatment of any particular case, can be readily selected 
by comparing the symptoms of the case with those mentioned under each 
remedy. Of course, you will not find all the symptoms that may arise in 
any case, under the proper remedy, but the leading symptoms for which 
that remedy can be fully recommended as curative, will be found, and, on 
account of the great difference in different cases, there will be more symp- 
toms mentioned than are likely to be found in any one case. 

Aconite, in inflammation of the eyes, where there is a pus-like dis- 
charge. The inflammation runs high ; dry hot skin, and full quick pulse; 
intense redness and swelling of the affected parts, attended with acute 
pain. Great intolerance to light. Fear, anxiety, and great restlessness ; 
flushed face and throbbing in the arteries of the neck. 

Dose: Six pills in three tablespoonfuls of water, of which give one 
teaspoonf ul every one to three or four hours, owing to the intensity 
of the symptoms, also as an external remedy. 



INFLAMMATION OF THE EYES. 187 

Belladonna in acute Ophthalmia, with very great intolerence to 
light or noise. Vivid redness of the sclerotica (white of the eye,) with 
the discharge of hot salt tears, or great dryness of the eyes, with sensation 
as if there was dust or sand in the eye. Sharp pains in the eyeballs, 
extending to the brain. Pains which appear suddenly, and disappear just 
as suddenly. Dimness of vision. Throbbing headache, increased by motion. 

Do.se: As for Aconite. 

Calcarea Carb., for scrofulous sore eyes, with inflammation, redness, 
and pus or pus-like secretion from the eyeballs, swelling and redness of 
the eyelids, which are aglutinated (stuck together). Stinging pains, worse 
at lamplight. Specks and ulcers on the eyeball, constant desire to keep 
the eyes in the darkness, swelling of the glands about the neck, and erup- 
tion on the hairy scalp, are additional symptoms calling for the use of Cal. 
Carb. Also chronic inflammation of the eyes. 

Dose: A powder of four pills every morning and evening. If the 
improvement is not satisfactory, give a single dose of Sulphur, and 
after three days, or in acute cases, sooner,return to Cal. Carb. 

Arsenicum, Inflammation of the lining membrane of the eyelids, 
and the outer covering of the eyeball, (conjunctiva) and even of the deeper 
coats of the eyeball, with dark redness and congestion of the blood vessels. 
Burning pains; the parts burn like fire. Inflammatory swelling of the 
lids. Specks or ulcers on the eye. Nightly aglutinations of the lids. 
Great anguish and restlessness. Intense thirst for small quantities of 
water very often. 

Dose: As directed for Aconite. 

Mercitrius. — For scrofulous ophthalmia. Violent inflammation and 
redness of the eyes. Cutting, burning pains, or pressure in the eyes, as 
if from sand. Excessive sensitiveness of the eyes to the glare of fire, or 
the light. Little blisters and pimples on the eyeball. Little boils or 
styes, scurfs around the eyes and on the margins of the lids. In inflam- 
mation of the iris (colored parts of the eye), this medicine is of great ser- 
vice. It should never be given in large doses. 

Do.se : As for Calcarea. 

Pulsatilla. — Aching, or burning and smarting irritation in the eyes, 
as if from copious secretion of mucus. Disordered stomach, foul tongue, 
with chilliness towards evening, followed by feverish heat. Piercing, 
shooting, pricking pains in the eyes with bright redness and flow of tears 
— especially on looking at the light or going into the open air ; or, on the 
other hand, excessive dryness of the eyelids, especially in the evening; 
sensitiveness, with disposition to weep. 

Dose : As for Aconite. 

Arnica is a very superior remedy when the inflammation is the 
result of an external injury. Use it simultaneously with its external use. 
(See external applications.) 

Dose: Internal, four pills every two to six hours. Application (exter- 
nal) five drops to two tablespoonfuls of water. Apply four times, 
daily. 

H03IE REMEDIES. — Alum curd, made by stirring or rubbing a lump 
of Alum in the white of an egg, is frequently applied in domestic prac- 
tice, and with benefit. 

Some simple ointment, or oil, applied to the edges of the lids, will 
add to the comfort, particularly at night. 



188 DISEASES OP THE EYE. 

SHOUT-SIGHT, NEAR-SIGHTEDNESS. 

Pulsatilla and Sulphur according to indications, may be men- 
tioned as of the chief importance in the treatment of short-sightedness, 
when this affection remains as an after effect of acute inflammation of the 
eyes. 

Dose: Of either medicine, as selected, give three globules in a tea- 
spoonful of water, morning and evening, for a week (or until the 
earlier development of improvement or change), then pause four 
days, after which the course may, if necessary, be repeated as before, 
and so on from time to time, until amelioration or change. 

Acidum Phosphoricum is to be preferred in cases in which short- 
sightedness occurs as the consequence of a severe attack of typhus, or has 
been occasioned by debilitating loss of blood or other animal fluids. 
Dose: Three globules, as directed for Pulsatilla and Sulphur, 
Carbo veg., Acidum nit., or Sulphur, will be appropriate for the 
treatment of short-sightedness, when this condition can be traced to exces- 
sive use of Mercury. 

Dose: Of Carbo veg. or Acidum nit. give three globules in a teaspoon - 
ful of water, every morning, — or, of Sulphur, six globules in a table- 
spoonful of water, every morning, the first thing (fasting), for ten 
days (or until the earlier development of new symptoms, improve- 
ment, or change); then pause a week, after which the course may, 
if necessary, be repeated as before, and so on, from time to time, 
until manifest amelioration or change. 



BLINDNESS. 

In common use, this name implies persons who are totally blind, or 
persons who possess some powers of vision, but not enough to enable 
them to distinguish the forms of objects. The causes of blindness are 
both ante-natal (before birth), and post-natal (after birth). 

It is contended by some, and likely with truth, that influences acting 
on the mother's mind(psycologically)may induce blindness in her offspring 
—as when the mother has received a powerful nervous impression from 
witnessing some horrible spectacle, or an extremely disgusting case of 
sore eyes, or malformation of the eyes. Many cases have been adduced 
which establish this as a truth in some cases, but not by any means with 
enough to establish the theory as a rule or law of psychological effect. The 
ante-natal causes which are now acknowledged to produce blindness, are 
the intermarriage of near relations, especially first cousins; scrofula and 
syphilis. In intermarriage, deafness follows more frequently than blind- 
ness ; in very many, indeed, in almost all of those cases where near rela- 
tives have married, the offspring shows a marked tendency to deficiency 
of the nerves of special sense; but in most cases, ante-natal, as well as 
post-natal, blindness is caused by imperfection or disease of the optical 
apparatus, which is accessory to the nerves of special sense, or, in other 
words, the defect generally exists in some part of the globe of the eye. 
Hereditary blindness is not frequent. Of seven hundred blind persons in 
the institutions of Philadelphia, whose parentage is known, only twelve 
had either parent blind. In Paris, of several hundred children born there, 
of whom one or both parents were blind, not one was blind at birth. 



BLINDNESS. 189 

After birth, the principal causes of blindness are: 1. Special diseases 
cf the eye, such as purulent ophthalmia, inflammation of the cornea and of 
the iris, cataract, or opacity of the crystalline lens, and amaurosis, or paral- 
ysis of the optic nerve. 2. General diseases, wtose sequelae attack differ- 
ent parts of the eye, as small-pox, scarlet fever, measles, typhus fever, and 
other inflammatory fevers, and scrofula. 3. Injuries frcm blows or wounds, 
and from malpractice ; the latter being the most fruitful of all causes. 
Hence, we say, in any disease of the eye, avoid all ignorant persons and 
experiments of every kind and nature, and employ only the highly skilled; 
if you cannot do that, better let nature alone, using only water to allay the 
inflammation. 

HOMCEOPATHIC TREATMENT.— For blindness caused by paralysis of 
the nerve of vision, from overtaxing the eyes, there is nothing that will 
excel the skilled and intelligent use of electricity. We are very far 
from meaning by skilled, those ignorant criminals, who go about the coun- 
try with their machines shocking every one they can persuade to take hold 
of the electrodes. 

Atropine, an alkaloid of Belladonna, is a prime remedy where blind- 
ness is the result of paralysis; it should be used in small doses, not fre- 
quently repeated. 

Aconitum is the medicine of chief importance in cases of this kind, 
w r hen characterized by a general fullness of the vessels, or by a full, hard 
pulse, and should be given, first, against the congestion, which is iden tided 
by the development of this symptom, as affecting the vessels of the head. 
It is the more appropriate when this symptom occurs associated with 
derangement of the stomach, and the congestion of the vessels of the head 
is recognized as of sympathetic origin. 

Dose: Three pills, in a teaspoonful of water, repeated at intervals of 
twelve hours, until general improvement or change. 

Causticum for sudden and frequent loss of sight, as from a pellicle 
drawn over the eyes, or as if looking through a mist. 

Dose: Three pills, as directed for Aconitum. 

Gelseminnm is indicated by sudden and total blindness, with giddft* 
ness; the eyes look heavy and dim. 

Dose: Six pills, as directed for Aconitum. 

Mercurius will prove of service when there are momentary parox- 
ysms of blindness, the eyes being very sensitive to light or the glare of a fire. 

Dose: Three pills, as directed for Aconitum. 

Cicuta Virosa should be given when there is frequent vanishing of 
sight, as if from absence of mind, with great giddiness, particularly when 
walking; when reading, the letters appear to move to and fro irregularly. 

Dose: Three pills, as directed for Aconitum. 

Phosphorus is most valuable when the obscuration of vision occurs 
at twilight, or at night; objects appear as if seen through a thick gray vail; 
blackness, or black points, or sparks before the eyes. 

Dose: Three pills, as directed for Aconitum. 

Pulsatilla should be selected in cases where there is a sensation, as 
if the dimness of sight could be removed by wiping the eyes; great 
dread of light; frequent and copious lachrymation ; the pupils are con- 
tracted. 

Dose: Six pills, as directed for Aconitum. 



190 DISEASES OF THE EYE. 

WEEPING-EYE.— FISTULA LACHBYMALIS- 
WATERY EYE. 

These names are applied to an ulcerated opening in the little sac, or 
bag, which is situated In the inner corner or angle of the eye, and which 
is technically named the lachrymal sac. Its office is to receive the tears 
and mucus of the eye, in order that they may be transmitted from thence 
to the nose. In the early stages, the affection consists of a thickened con- 
dition of the lining membrane of the sac, and the adjacent lachrymal 
parts, the result of inflammatory action, and, in consequence of which, 
the tears and mucus are obstructed in their passage to the nose, and hence 
escape by passing down over the cheek, giving rise to an habitually weep- 
ing eye, and an adhesion of the lids after sleeping. Children of a scrofu- 
lous habit, and adults who have suffered from rickets, or from swelling of 
the glands about the neck, groin, or other parts, in youth, and who are, 
more or less, troubled with derangement of digestion, are the most fre- 
quent subjects of the disease. When the disease is not checked, or in con- 
sequence of frequent returns of acute inflammation, sloughing ensues, the 
contents of the tumor escape through the break thus made in the skin. 
When the complaint has reached this stage, it presents a much more 
unsightly appearance, and if neglected or mismanaged, as it so frequently 
is by means of severe and irritating remedies, extensive inflammation 
and excoriation, are produced in all the surrounding parts ; in some rare 
cases a diseased state of the bones of the nose accompanies or precedes this 
malady. See treatment of Chronic Ophthalmia. 

HOMCEOPATHIC TREATMENT. In recent cases the cure is easily and 
speedily accomplished by homoeopathic treatment, without the aid of the 
painful, irritating, and disfiguring local means resorted to in some cases. 
In those of long standing, or of complicated character, occurring in scro- 
fulous, cancerous, or otherwise debilitated constitutions, the successful 
issue is necessarily of more difficult and tedious attainment. 

Aconitum is to be selected in all recent cases, but particularly when 
the inflammation and pain are considerable, when this remedy is of much 
efficacy. 

Dose: Of a solution of six globules to two tablespoon fuls of water 
give a teaspoonful every two hours, until the pain and redness are 
removed or diminished, or until other symptoms occur to indicate 
other treatment. 

Pulsatilla is more especially appropriate for the treatment of per- 
sons of phlegmatic temperament and of mild disposition, and when the 
symptoms have a tendency to become aggravated in the evening or at 
night. In such cases Pulsatilla should be administered twelve hours after 
the last dose of Aconitum. 

Dose: Three globules in a teaspoonful of water, night and morning. 

Nux-vomica is more especially appropriate for the treatment of per- 
sons of sanguine or bilious temperament and of irascible disposition, the 
symptoms, generally speaking, tending to become exacerbated in the 
morning. 

Dose: Three globules, as directed for Pulsatilla. 

Graphites, Calcarea c, Silicea, or Sulphur, are frequently 
required to complete the cure, or to overcome the tendency to recurrence 



Fig. 1. The an- 
terior (front) and 
internal muscles of 
the right eye. 

Fig. 2. The upper 
surface of the orbi- 
tal eye cavity, (the 
bony structures be- 
ing removed) with 
muscles and nerves. 

The means by 
which the eye is 
adapted to carefully 
view objects at dif- 
ferent distances are 
very hard to ex- 
plain ; but it can be 
understood that in 
the defect known as 
short or near-sigh t- 



THE EYE.— PLATE II. 
Fig. 1. 




edncss, the image, 
instead of falling 
direct and perfect 
on the retina, is 
formed by the con- 
vergence of the rays 
of light, before the 
retina is reached ; 
and can easily, and 
should be by means 
of glasses, adapted to 
that particular case 
by an expert oculist. 
The far - sighted 
eye has the focus of 
the rays of light 
completed behind 
the retina, and can 
well be remedied by 
good glasses. 




BLOODSHOT EYE. 191 

of the disease, after previous treatment, according to the instructions 
above afforded. In the severer forms of the complaint occurring in per- 
sons of bad constitutions, with or without implication of the nasal bones, 
or in uncomplicated cases of long standing, occurring either in children, 
with or without glandular enlargements, or in adults, they are still more 
frequently needed. 

Dose : Of either as for Pulsatilla. 



BLOODSHOT EYE. 

This derangement may arise from a blow or fall, the act of retching, 
vomiting, or violent coughing, crying, etc. It presents a bright, scarlet 
appearance in most instances at the commencement, but usually assumes 
a livid hue at a subsequent period. The affection generally disappears of 
itself; but as it is occasionally liable to prove exceedingly obstinate, the 
subjoined method of treatment may be required, or such other manage- 
ment as may be more particularly enjoined in the article on u External 
Cnjuries," or also in that on "Inflammation of the Brain.'' 

ALLOPATHIC TREATMENT. The immediate application of cold is 
generally most serviceable. 

If the trouble is not rapidly removed its cure is hastened by hot appli- 
cations. 

In case the congestion is greatly prolonged it is to be treated the 
same as is directed for conjunctivitis or simple ophthalmia, page 182. 

HO MYOPATHIC TREATMENT. Arnica should be employed inter- 
mi lly and externally when this derangement has been caused by external, 
injury, such as a blow or fall, and does not disappear spontaneously, in 
which case this remedy will quickly promote absorption, and remove the 
unsightly appearance. 

Dose {Internal) : Three globules in a teaspoonful of water, repeated 
after twelve hours, and subsequently, if necessary, at intervals of 
twenty-four hours, until the discoloration is removed. 
Application {External) : To two tablespoonfuls of water, add six drops 
of the concentrated Tincture of Arnica, and bathe the eye or eyes 
freely with this lotion, three times a day, until the discoloration 
disappears— only, however, during the internal administration of 
the same medicine as above directed. 
Belladonna is preferably indicated when the bloodshot eye is asso- 
ciated with symptoms of fullness and throbbing of the vessels of the neck, 
flushing of the face, oppressive pain in the head and the like, even in 
cases in which the direct cause of these symptoms is distinguished in a 
blow, fall, or other external injury ; or again, in cases in which the blood- 
shot eye appears as a symptom of cerebral derangement, as evinced by 
the associated symptoms, conditions, and circumstances. 

Dose: Two globules in a teaspoonful of water, repeated at intervals 
of four hours, until manifest improvement occurs, or such change 
should ensue as to render other treatment necessary. 



CATARACT. 

By this name is understood a partial or general turning white (opac- 
ity) of the more vital parts of the eye. The formation of a cataract is 
generally slow, requiring weeks, months, or years for its complete devel- 



192 DISEASES OF THE EYE. 

opment. It may appear in one eye or both ; but when the former is the 
case, the other eye is generally affected, either sooner or later. In cata- 
ract all objects, especially those that are white, appear to be encompassed 
with a cloud or mist. 

This disease is beyond the means that can be used at home, and must 
be treated by a good physician, who makes this his business. In his 
hands a small operation on the eye will, usually, entirely remove the diffi- 
culty. 

CROSS-EYES.— STRABISMUS, NEARSIGHTED. 

This trouble is usually present from birth, (congenital.) and can then 
only be cured by a surgical operation, by which the small muscle which 
turns the eye towards the nose is entirely, or partially severed, when the 
eye will very soon, if not at once, return to its proper position. This 
operation need only require two or three minutes, and give but little pain, 
and is a great help to any one so afflicted. There- is another variety, 
which is the result of too constant and close application of the eyes, espe- 
cially by lamp light, as in children overtasked at school, sewing girls, etc. 
This can be cured by at once quitting the work that is the cause of the 
overstraining. As a rule, a little Bell, will help very materially in bet- 
tering this condition. 

Blindfolding the stronger eye— the one which is constantly used — for 
a long time will gradually strengthen the weaker eye by the use which the 
patient will be forced to make of it. In many cases, the axis of vision in both 
eyes will, by this means, become the same when the strabismus is spontane- 
ously cured. As a rule, if the patient can bring the eye which turns in (or 
out) to the front, or a direct line, an operation should not be resorted to 
until the means above recommended have been faithfully tried. 

Other cases are relieved by glasses which will make the focus of vision 
of both eyes the same. 

The operation for strabismus should only be practiced as a last resort. 



STYE. 

Symptoms.— This is a little hard tumor, appearing like a small, dark 
red boil, generally in the corner of the eyelid, attended with severe inflam- 
mation, and frequently causing fever; considerable pain and suffering. It 
suppurates slowly and imperfectly ; usually being from four to six clays, 
and has no tendency to burst spontaneously. Presents a small yellow, or 
greenish yellow speck, in or near the center; when ready to be opened, 
touch lightly with a needle, or other sharp point, and apply a little pres- 
sure. 

ALLOPATHIC TREATMENT.— Styes may, sometimes, be aborted by 
the continuous application of hot fomentations. A large flannel cloth, 
wrung out of hot water, may be applied over the eye, and replaced by 
another as soon as it cools. I have known this procedure to cure a begin- 
ning stye in a day. Sometimes extracting the eye-lash, situated upon the 
stye, will be followed by a cure. Carefully brushing the surface of the lid 
with Tincture of Iodine will, sometimes, prove curative. If pus is formed 
and is spontaneously evacuated, the stye should be opened carefully. 



THE EAR— PLATE I 



Fig. 1 



Fig. 2 




STYE. 193 

The general health of a person subject to styes will require attention. 
H0MCE0PATH1C TREATMENT.— Pulsatilla alone, will, in most 
cases, suffice to remove the stye, if given upon its earliest appearance. It 
is a sure cure. 

Dose: Give three globules in a tablespoonf ul of water, morning and 

evening, until the stye is removed, or such change takes place as to 

require other treatment. 

Hepar Sulphuris should be given when matter threatens to form, 

(indicated by increased swelling and heat, usually attended with throbbing) 

in order to expedite the ripening of the tumor. 

Dose: Two globules in a teaspoonful of water, repeated six times, at 

intervals of three hours. 
Staphysagria should be given two days after the last dose of any 
medicine previously administered, to complete the cure, particularly when 
the swelling degenerates into a hard white tumor. 

Dose: Three globules in a teaspoonful of water, night and morning, 
for a week, (or until the earlier manifestation of decided improve- 
ment or change); then pause four days, after which the course may, 
if necessary, be repeated as before, and so on, until the dispersion of 
the tumor, or the accidental occurrence of new symptoms. But if 
no effect be produced within four days after the second course, pro- 
ceed with the next medicine. 
SiUcea should be employed after the foregoing medicine in some 
cases, in which, after a second course, the treatment just recomended has 
failed to produce any effect whatever, a condition which sometimes pre- 
vails in bad constitutions. 

Dose : In every respect, as directed for Staphysagria. 
Arsenicum, Lycopodium, Sulphur and Aurum, may be required 
in addition to those above prescribed, in cases of stye, which occur as asso- 
ciated with marked scrofulous taint of constitution. Aurum, it may be 
here observed, is particularly indicated when there is obstinate obstruc- 
tion and formation of scabs in the nose, with redness, and swelling in the 
eyelids. 

Dote: Of Arsenicum, or Lycopodium, give three globules in a tea- 
spoonful of water, night and morning" or of Sulphur and Aurum, 
six globules in a tablespoonf ul of water, every morning, the first thing 
(fasting), for a week, (or until the earlier manifestation of new 
symptoms, or of general improvement or change,) then pause eight 
days, after which the course may, if necessary, be repeated as before, 
and so on, from time to time, until manifest improvement or change. 
Diet.— During the inflammatory stage the diet should be sparing, and 
the restrictions should be more or less rigid. 



THE EAR.— PLATE 1. 

Of all the many wonderful organs, composed of many parts, performing 
their varying functions in this most wonderful piece of mechanism we call 
our bodies, there are none more worthy of careful study than the ear. 
Sounds low and high, soft and harsh, from far and near, are collected, car- 
ried into the labyrinths of the ear, analyzed, located and recorded upon 
memory's tablets by its means. And how unconscious of effort on our part ! 
How amazingly ignorant are we of how this delicate work is done ! To say 

13 



194 THE EAR— PLATE I. 

that the ear is composed of bones held in water, surrounded by bone lined 
with a thin membrane, would surprise many ; yet it is the truth. The 
outer ear, called Pinna or Auricle— shown in Fig. 1 and 2 with the muscles 
of the left side— is only a means of assisting in the collection of sound, and 
possibly by means of nerve communication helping to locate the direction 
from which the sound comes. The eye only takes cognizance of things in 
the direct line of view; the ear stops not at any intervening substance or 
any number of curves. Fig. 3, a vertical section of the left temporal bone, 
just back of the joint of the lower jaw, shows the internal ear Tympanum 
d, Cochlea g, semi-circular canal ?,o, and enables the observer to see how very 
small and fragile these parts must be when compared to the bones of the 
skull. Fig. 4 shows the internal organs of hearing exposed conjointly with- 
out the bony structures. Did you ever realize its complexity V and inside 
of this are placed the bones of Fig. 5. The Ossicula or bones of the tym- 
panum are placed within a cavity in the inner ear called the tympanic 
cavity, just back of the tympanum, and these bones being supported in 
fluid, like water, are among the main means of communicating the sound to 
the auditory nerve. The same bones shown joined together in Fig. 5 appear 
separate in Figs. 6, 7 and 8, and are called respectively Incas, Malleus and 
Stapes. Fig. 9 represents the cavity of the tympanum as it appears in the 
left side, showing the ossicular or small bones as they appear in position, 
a, Inner wall of the tympanum ; 6, finestra rotunda ; d, caput mallei (head 
of the mallet) ; /, manubrim mallei ; h, corpus incudis ; Z, stapes (styrup) ; 
t, the eustachian tube, bony portion leading into the mouth near the fauces. 



DISEASES OF THE EAR. 195 

CH APTER IX 



DISEASES OF THE EAR. 



OTITIS IXTERXA.— INTERNAL INFLAMMATION 
OF THE EAR. EARACHE. 

Inflammation of the inner ear is chiefly recognized by the extraordi- 
nary pain (earache) it causes. The pain is chiefly a tearing, throbbing or 
burning pain, is very much increased by motion, likewise by chewing, loud 
uoite, contact of the outer parts. Inflammatory earache is one of the 
most distressing tortures that man can suffer. The excruciating character 
of this pain accounts for the cerebral irritation which is almost always 
present in this disease. The fever is very violent, and the pulse is hurried 
and small. The head glows, whereas the extremities are cold as ice; delir- 
ium and fainting fits set in, before the brain can be said to sympathize with 
the distress. The outer ear usually shows signs of inflammation; the 
passage into the ear is sometimes entirely closed, red and very sensitive, 
and the swelling spreads to the outer ear and the surrounding soft parts. 
Otitis is very apt to result in suppuration, and is still more inclined to 
spread to the brain. It is not certain whether the invasion of the brain 
takes place more easily when the inflammatory process has reached its 
night, or after the pus has begun to form. Suppuration supervenes but 
too frequently during the course of a chronic affection of the bones; hence 
suppuration of a bone near the ear, may involve the brain, and lead to a 
fatal termination, even after all danger consequent upon inflammation, 
seems to be entirely removed. Otitis may be complicated with a menin- 
gitis, which runs a very rapid course, and is one of the most dangerous 
diseases. Its treatment has already been indicated in a former chapter. 
Otitis may terminate, in favorable cases, in complete recovery; this result, 
however, is rare ; generally a disturbance of the functions of the ear remain 
behind, sometimes assuming the form of perfect deafness. If pus forms, 
it is fortunate if it is discharged externally, even if the tympanum (ear 
drum.) should be greatly injured, and chronic otorrhcea (discharge from the 
ear,) should be the result. 

The causes of otitis cannot be mentioned with positive certainty. A 
cold ; and suppressed or receding skin diseases, are among the prominent 
ones ; syphilis and scrofula are other causes. 

OTITIS EXTERNA. 

As we remarked above, an inflammation of the external meatus 
usually accompanies an inflammation of the internal ear, and, by its pres- 
ence, always reveals the existence of a higher grade of otitis interna. As 
an idiopathic affection, disposed, however, to extend to the inner parts of 
the ear, it is either an inflammation of the cellular tissue, in the external 
passage, spreading uniformly all around, very painful, but not very dan- 
gerous, and of short duration, or else it consists in suppuration of one or 
more glands of the outer passage. In such a case, a small abscess is seen 
on one or the other side, more or less deeply in the inner ear. In this 



196 DEAFNESS. 

form of the inflammation the pain is, likewise, comparatively very acute, 
but usually ceases all at once, when at its hight, by the bursting of the 
abscess. This inflammation very frequently accompanies, as a compli- 
cating disorder, an inflammation of the parotid gland, or of other adjoin- 
ing parts. Erysipelas, likewise, does not unfrequently attack the outer 
ear, and, if it begins at the ear itself, may lead to errors in diagnosis. 



OTORBHGEA. 

Discharge from the Ear. — As a consequence of otitis, but some- 
times from other causes, we frequently meet with a discharge from the 
ears, which is, at times, slimy, at others purulent or ichorous, at others, 
again, watery or bloody. The slimy discharge is of a catarrhal nature, 
makes its appearance in the cases of many children, whenever they are 
attacked with a severe cold, and has no special significance. As a gen- 
eral rule, it very soon yields to a few doses of Pulsatilla. The other forms 
of otorrhcea are symptomatic manifestations of otitis, and require the 
same treatment as that disease. Injections of lukewarm water have 
always a good effect, and should never be omitted. 



DEAFNESS. 

Hardness of hearing may depend upon a variety of causes, by the 
peculiar nature of which, its curability is determined. If it proceeds 
directly from the auditory nerve, and is the commencement of complete 
deafness, it is not likely that much can be done for it by internal treat- 
ment. If the deaf ness is caused by a stoppage of the meatus externus, 
various obstacles may prevent the free entrance of sound, the most com- 
mon obstacle is the accumulation of indurated cerumen (ear wax) in front 
of the tympanum. This is most effectually removed by continued injec- 
tions of lukewarm water, until the plug is loosened, after which it can be 
readily grasped with a pair of pincers and drawn out. If an unopened 
abscess is the cause, which is not often the case, its reabsorption is easily 
accomplished by frequently dropping lukewarm water into the ear, which 
has to be retained in it for some time. A polypus in the passage may, if 
possible, be twisted or cut off; where this is not possible, the polypus can 
gradually be caused to shrink, by touching it frequently with the half- 
diluted tincture of of Thuya. If the tympanum (drum of the ear) is 
injured, a cure is, of course, impossible; in such case, the patients hear 
often much better by inserting a loose plug of cotton in the ear. This 
custom is so common, with many people, that they are never seen with- 
out cotton in their ears. It is a bad habit, which favors, more than any 
other proceeding, the formation of little plugs of earwax ; for the nuclei 
of most plugs, which we have removed in large numbers, were found to 
consist of cotton fibres. Still more hurtful is the habit of introducing 
medicinal substances into the ear. We are acquainted with a lady who 
has been using Camphor in thi3 manner until her tympanum has become 
perforated in consequence. If little children are hard of hearing, we 
must ascertain, in every case, whether they have not inserted something 
like a bean, pea, millet seed, radish seed, or like articles into their ears. 



DISEASES OF THE EAR. 197 

ALLOPATHIC TREATMENT.— The external canal (meatus) of the ear 
sometimes becomes obstructed by the natural secretion of the canal, owing 
to some accidental cause. Sometimes foreign particles add to the accu- 
mulation. These are best removed by thorough syringing with an ear- 
syringe with a warm solution of Bicarbonate of Soda (baking). 

Before attempting to syringe the ear, the plug somtimes will require 
previous moistening with a few drops of glycerine. A preternatural dry- 
ness of the canal of the ear sometimes exists, which is easily relieved by 
a small quantity of glycerine carried into the canal, occasionally, by a 
camel's hair brush. 

It is not un frequently necessary for the surgeon to have to resort to 
the use of the ear scoop and forceps for the removal of these obstructions. 
If, after their removal, there is intense and painful sensibility to sounds, 
a pledget of cotton, moistened with glycerine, may be laid in the exter- 
nal ear, and retained in place with a bandage or handkerchief. 

Chronic eczema (salt rheum) of the ear, generally depends upon some 
vice of the system, which may be removed by the use of the following 
tonic, viz. : Takeof Citrate of Iron and Quinine a dram and a half; Fowler's 
Solution a dram and a half ; Simple Syrup four ounces. Mix. 

Dose: Give a teaspoon ful three times a day. 

The ear should be syringed out, twice a day, with a warm solution of 
Bicarbonate of (baking) Soda, and, after each cleansing, the following 
application made by carrying it within the canal of the ear with a cam- 
el's hair brush : Take of Tannin a dram ; of Oxide of Zinc two drams ; of 
Glycerine one ounce. Mix. Shake the vial, and apply with a camel's hair 
brush or feather. 

Inflammation of the external canal (external otitis) occurs most fre- 
quently in childhood, from exposure to cold, or other causes. The 
inflammation extends from the outer covering of the drum to the 
bony lining of the auditory canal. The danger, aside from the imme- 
diate pain, is, that the disease may lead to perforation of the drum, 
and the possibility of necrosis (death of bone and exfoliation). In 
a few cases, the inflammation has been conveyed through the 
bony wall to the membranes of the brain, causing death. As a 
means of relieving pain, the canal may be rilled with a solution 
of Morphine four grains, and Atropine two grains, in half an ounce 
of Glycerine, applying at the same time, over the ear, several 
thicknesses of flannel saturated with hot water. Laudanum may be 
used instead of Morphine, but it is not so effectual. If this does not pro- 
cure relief, the inflammation is deeply seated, and may eventuate in 
necrosis, if not relieved. Such cases should be in the hands of a surgeon. 
It is probable that the most, or only effectual treatment is, to cut down 
to the bone through the whole length of the auditory canal. Usually the 
inflammation subsides in two or three days, superseded by a more or less 
profuse discharge. This is called otorrhosa. Otorrhcea (discharge from 
the ear) is a symptom, or consequent of many affections of the ear ; but 
from whatever cause, it requires in itself about the same treatment— the 
frequent use of the syringe. Warm water should be used, and should, 
generally, be rendered slightly alkaline with a little soda. If the dis- 
charge does not soon disappear, astringent washes should be used. A 



1: :;8 INTERNAL OTITIS. 

drain of Tannin, in an ounce of Glycerine, will frequently prove effectual. 
The Tannin may be added in much larger quantity. It can be applied 
with a camel's hair brush, or a feather. 

A solution of Sulphate of Zinc, or Alum in water, may be used instead. 
After using one of these, time should be given for it to take effect, and 
then moisten the ear with a very little Glycerine. 

In all cases of discharge from the ear, not dependent on evident inflam- 
mation of the canal, or previous inflammation of the internal ear, examin- 
ation should be made for disease of the mastoid cells (in the eminence 
behind the ears called the mastoid process,) which may require incision, 
and, perhaps, trephining (boring into them). 

Internal Otitis. Inflammation of the middle and internal ear is very 
serious, the pain is deep-seated and intolerable, attended with throbbing, con- 
fusion of the head, and fever. The inflammation is probably advancing to 
suppuration, possible disease of the internal ear, and permanent deafness. 
The drum of the ear should be closely watched by frequent examination 
with the speculum, and as soon as matter has formed, shown by the 
altered color and form of the drum, the drum should be punctured by the 
surgeon, and the pus let out. 

In this way the patient is not only spared much pain, but more serious 
damage, from the drum breaking down beyond repair; and the chances are 
also better for recovery without disruption of the internal ear. The throat 
is almost always inflamed. This should be met by appropriate treatment. 
Mustard plaster to the neck, or rubbing the neck with turpentine or harts- 
horn liniment, or the constant application of flannels wrung out of hot 
water, and astringent gargles of Sulphate of Zinc, a scruple to a teacup of 
water, or the application of Tannin in Glycerine (one dram to the ounce) 
with a linen mop, or such other suitable treatment as a physician would 
direct. The Eustachian tube should be inflated. This can be done, if a 
physician is not in attendance, by closing the mouth and nose, and making 
forcible^expulsion of the breath simultaneous with the act of swallowing. 
External applications will be the saiiF as directed for external otitis. 

Otalgia (or Neuralgia of the ear) uncomplicated with inflammation, 
is, I believe, very rare. It may be connected with some irritation of the 
mouth, as a decayed molar (double) tooth, or it may be due to some irrita- 
tion of the stomach, or some other organ supplied by the pneumo-gastric 
nerve. In these cases the trouble is reflex and its treatment consists in the 
removal of the offending cause. If no such cause is discoverable, and espe- 
cially if the pain is intermittent or periodical, such general treatment 
should be resorted to as is recommended in the article on neuralgia. Some 
relief may be given by applying over the ear, warm poultices of hops or 
poppy heads, or by pouring into the ear a few drops of Laudanum, Tincture 
of Aconite, or Belladonna, or the three may be mixed and diluted with a 
little glycerine. The local means for the relief of pain directed for exter- 
nal otitis are effectual here. Not unfrequently is the administration of an 
anodyne necessary. 

So often is earache caused by inflammation and the production of pus 
or mucus, that I believe the drum ought always to be thoroughly examined 
with the ear speculum, and, if indications of either are present, the drum 
ought to be punctured by the surgeon, and relief will follow the escape of 
the pus or mucus. 



DISEASES OF THE EAR. 199 

Deafness. Some of the causes of deafness which may be removed by 
domestic hand, are the following: 

A dried accumulation of the natural secretions of the canal of the ear, 
(meatus) may prevent the vibrations of sound reaching the tympanum 
(drum). This obstruction may be rendered still more complete, by wool or 
cotton with which the person negligently stops his ears, neglecting to prac- 
tice prober cleanliness. This obstruction is easily discovered. Its removal 
is best effected by thorough washing with warm water, or a weak solution 
of Bicarbonate of (baking) Soda, with a hard rubber ear syringe. A com- 
mon four ounce, hard rubber syringe, may be used, taking the precau- 
tions to wind the nozzle with muslin, until it is too large to penetrate the 
canal, except just at the point. A tin cup, with one side flattened, should 
be held under the ear, to catch the outflow of water. The injections 
should be continued at one or repeated sittings, until the canal is clean, 
and the passage to the drum is unobstructed. When the accumulation is 
unusually hard, it may be softened by moistening with Glycerine or 
bland oil, as Almond or Olive Oil. 

A deficiency of secretion in the canal may be partly overcome by mois- 
tening it with Glycerine, or Sweet, or Almond Oil, until the natural secre- 
tion returns. This may be hastened by very warm water injections and 
the application of essential oils, as Turpentine. They may require dilut- 
ing with Glycerine, or Sweet Oil to prevent too much irritation. 

Thickening of Vie lining membrane of the meatus may cause deafness, 
the result of chronic inflammation. It may be overcome by applying a 
mixture of Tincture of Iodine with Glycerine and Tannin. 

Take of Tannin one dram, dissolve in half an ounce of Glycerine, then 
add half an ounce of Tincture of Iodine, apply twice a day with a cameVs hair 
brush, or a feather. 

Attention to the general health is required, by the use of tonics as 
recommended in Eczema of the ear. 

Other causes of deafness require the attention of experts. 

H03IGE0PATHIC TREATMENT. Inflammation of the Ears. 
Aconitum is required in commencing treatment when the affection is 
attended with considerable febrile disturbance, dry heat of the skin, with 
fullness and quickness of pulse. 

Dose: Of a solution of six globules to two tablespoonfuls of water, 
give a teaspoonful every two hours, until the indicative symptoms 
subside. 

Belladonna is indicated when there is determination of blood to the 
head, with redness of the face, by digging, boring, tearing or shooting 
pains extending to the throat; fever and extreme sensibility to the slight- 
est noise; when the pains are more severe internally ; also, when the brain 
partakes of the inflammation, and delirium is present. Also, in external 
inflammation of theears, when the inflammation runs high, and threatens 
to extend to the face and scalp. 

Dose: Six globules, as directed for Aconitum. 

Hepar suiphuris should be administered twelve hours after the 
last dose of Belladonna, if, after the second day from the commencement 



200 RHEUMATIC EARACHE. 

of treatment, the pain and inflammation be not completely reduced ; or, 
again, and more especially in cases in which suppuration and discharge 
have taken place. 

Dose : Three globules in a teaspoonf ul of water, repeated at intervals 
of twelve hours, until decided and permanent improvement or 
change. 

Sulphur. This medicine should be administered twelve hours after 
the last dose of Hepar sulphiiris, if the discharge of matter, in particular, 
should continue unarrested; or twelve hours after the fourth dose of 
Mercurius, if, in addition to the discharge of matter there should be hum- 
ming in the ears and pricking pains. 

Dose : Three globules as directed for Hepar sulpliuris. 

Mercurius should be selected when the following symptoms and 
conditions characterize the case : — Shooting or tensive pains in the ear, 
extending to the cheeks and teeth ; sensation of coldness in the ear ; 
increase of suffering in the warmth of the bed ; inflammation and indura- 
tion of the ear, with soreness of the orifice, and discharge ; swelling of 
the glands. Also, in external inflammation, particularly when the adja- 
cent glands are involved. 

Dose : Six globules, as directed for Aconitum. 

Pulsatilla is a most valuable remedy in this affection. It is partic- 
ularly indicated when the external ear is simultaneously much affected, 
apd appears inflamed and swollen; attended with heat, shooting and 
tensive excruciating pain internally ; moisture in the ear, or somewhat 
copious discharge. This medicine is particularly useful for females and 
individuals of chilly habit. Applicable, also, to most cases of external 
inflammation of the ears. 

Dose : Six globules, as directed for Aconitum. 

NERVOUS OR RHEUMATIC EARACHE. 

Pulsatilla is not unf requently indicated for the treatment of cases 
of nervous or rheumatic earache, which ensue, from time to time, as the 
consequence of antecedent inflammation; or more particularly, if there be 
a tendency to discharges from the ear, or if the ear be habitually moist. 
This is the best remedy for earache in most cases. 

Dose: Of a solution of six globules, to two tablespoonfuls of water, 
give a teaspoonful every half hour, (when the pain is very distress- 
ing,) or every three hours, (in less severe cases,) until a degree of 
improvement takes place ; after which the intervals should be gradu- 
ally extended to twelve hours, and the administration thus continued, 
until the cessation of the pain, or the occurrence of other symptoms, 
. requiring different treatment. 

Phytolacca should be administered when there is shooting pain in 
both ears, the right being worse, aggravated by swallowing ; feeling as if 
the ears were stopped up, with crackling sounds in them ; the sense of 
hearing seems dull, while it is really more acute. 

Dose : A solution of six globules, as directed for Aconitum. 
Nux-vomica is preferably indicated when the pains are of a tearing, 
shooting nature, extending to the forehead, temples, and bones of the face, 
worse towards morning; dryness of the ear, particularly when the affection 
occurs in persons of a lively, choleric disposition. 

Dose: Of a solution of six globules, to two tablespoonfuls of water, 
give a teaspoonful every hour } (when the pain is unbearably severe,) 



DISEASES OF THE EAR. 201 

or every three hours, (in less distressing cases.) until a degree of 
amelioration becomes apparent; after which the intervals should be 
gradually extended to twelve hours, and the administration thus 
continued until permanent and decided improvement or change. 

Dulcamara should be selected when the affection has arisen from a 
chill or wetting, and will, in many cases, prove sufficient for its removal: 
it is also indicated when the pains increase at night, and are attended with 
nausea. 

Dose: A solution of six globules, as directed for Nux-vomica. 

Mercurius should be employed when the pain is attended with a sen- 
sation of coldness in the ears, and is characterized by exacerbation in the 
warmth of the bed; or, again, when there are shooting or tensive pains in 
the internal ear, extending to the cheeks and teeth. 

Dose: A solution of six globules, as directed for Nux-vomica. 

Cha mom ilia should be administered when there are stabbing pains 
in the ear, as if knives were driven into the head; great sensitiveness of 
noise, and even of music; extreme sensitiveness, susceptibility, and irrita- 
bility. 

Dose: A solution of six globules, as directed for Nux-vomica. 

SanguinaiHa should be exhibited when there is burning of the ears, 
with bright redness of the cheeks, and headache accompanying the ear- 
ache; the neck feels stiff; painful sensitiveness to sudden sounds. 

Dose : A solution of six globules, as directed for Nux-vomica. 

Arnica is often of much service for the treatment of individuals of a 
nervous, excitable temperament, subject to attacks of earache, provoked 
by trivial causes, and is, moreover, characteristically indicated when there 
is an excessive sensibility to noise. 

Dose: A solution of six globules, as directed for Nux-vomica. 

China is frequently suitable after Arnica, in cases in which the last 
named medicine has been productive of partial relief only, and when, 
moreover, the pains are aggravated by lying on the ear, or by contact. 

Dose : A solution of six globules, as directed for Nux-vomica. 

Sulphur should be administered, if the excessive sensibility to noise 
should constitute a predominant indication; it is, especially, suitable to 
persons subject to catarrh, or tendency of the blood to the head. 

Dose : Three globules, in a teaspoonful of water, night and morning, 
until permanent improvement or change. 

HOME TREATMENT.— Patients who are subject to attacks of nervous 
or rheumatic earache, should be very careful and moderate in the indul- 
gence of their appetite; and the food should be simple but nourishing. 
Fermented and spirituous liquors, coffee and strong tea, etc., are capable 
of themselves of provoking an attack; and, inasmuch as a tendency to 
derangements of the digestive functions is very frequently to be distin- 
guished as characterizing the predisposition to earache, it is very essen- 
tial that those things should be avoided which are likely to engender irreg- 
ularities of digestion, however apparently trivial. Everything which is 
known to operate as an exciting cause, should, as much as possible, be 
avoided. Moist heat may relieve. 

Humming on Buzzing in the Ears.— Nux-vomica will be found of 
service in the treatment of recent cases of humming or buzzing in the ears, 
when this annoying affection is most predominant, or the symptoms are 
aggravated at night. 



202 DISCHARGE FROM THE EAR* 

Dose: Six globules, in a teaspoonful of water, morning and evening, 
for a week; then pause a week, resuming the administration after 
the lapse of that time, if yet required. 

Pulsatilla is to be preferred when the evening is more especially the 
period of exacerbation, and for persons of a mild character, particularly 
females. 

Dose: Six globules, as directed for Nux-vomica. 

Causticum.— Loud vibration of all sounds, and even of the patient's 
own voice. 

Dose : Six globules, as directed for Nux-wmica. 

Mercurius is more distinctly indicated when the attacks are attended 
with sweating. 

Dose : Six globules, as directed for Nux-vomica. 

Discharge from the IS, ab,.— Arsenicum should be given when the 
discharge is profuse, smells very badly, and makes the adjacent parts sore ; 
also when there is prostration and weakness. 

Dose: Give four globules, in a teaspoonful of water, night and morn- 
ing, for four days, (or until the earlier development of manifest im- 
provement or change,) then pause four days, after which the course 
may be repeated, as before, if necessary, and so on, until manifest 
improvement or change. 

Aurum will be found to be useful in chronic cases, particularly after 
the abuse of mercury, under old school treatment, where the discharge is 
fetid, and the bones of the ear are diseased. 

Dose: Four globules, as directed for Arsenicum. 

Calcaria Carb,, should be administered in chronic cases, when the 
discharge looks like matter, the glands of the neck are swollen, the abdo- 
men is large, and there are other evidences of a scrofulous constitution. 

Dose : Four globules, as directed for Arsenicum. 

Carbo Veg. is suitable after the suppression of itch, or itch-like erup- 
tions ; the discharge is offensive, the ear is inflamed, and sensitive to touch. 

Dose : Four globules, as directed for Arsenicum. 

Hepar Sulphuris may be administered when the discharge is very 
profuse and mild, particularly in scrofulous persons, or when it results 
from acute inflammation of the internal ear. 

Dose : Four globules, as directed for Arsenicum. 

Sulphur is indicated when the discharge consists of offensive matter, 
particularly if the left ear be affected ; eruptions behind the ears, which itch, 
and bleed after scratching. 

Dose : Four globules, as directed for Arsenicum, 

Mercurius is indicated, if the affection be of syphilitic origin ; the 
ears itch, the face is covered with little pimples which secrete pus. 

Dose: Four globules, as directed for Arsenicum. 

Pulsatilla will be found to be a very valuable remedy in the treat- 
ment of this troublesome affection. It is indicated when the discharge is 
the result of a cold, (catarrhal) or follows acute inflammation of the ear. 
The discharge is usually thick and yellow; the ear is red and swollen, and 
there are stitch-like pains in it. The left ear is commonly affected. 

Dose: Of a solution of six globules, in two tablespoonfuls of water, 
give every three hours, if required, a teaspoonful. 



THE EAR— PLATE II. 




y r 



THE EYE AND NOSE. 



£03 



CBOSS SECTION OF HEAD. 

Cross section of the Head in a horizontal direction, the eyes and nasal 
cavities being cut through as you look down upon the cut part. 

B. B. Arteries supplying the brain with blood. C. C. Commencement 
of the optic nerves. D. Where the inner threads of the optic nerves cross each 
other. It will be seen how the optic nerve of the right eye has its origin in 
the left side of the brain, and the left in the right side. E. E. The optic 
nerve in the cavity of the eye. F. F. Muscles of the eye-ball. G. The eye ball. 



a. Vitreous 
Crystaline lens, 
belli nd the pupil, 
its capsule is the 
ease called ca- 
liis i meaning a 
called from the 
colors ii 
dividuals 
circular 
tain thro 
c i r c u 1 a 
the inser 
pupil b; 



(glassy) body. b. 

lies immediately 

and either it or 

seat of the dis- 

taract. c. The 

rainbow) so- 

factof its various 

different in- 

it is a thin 

shaped cur- 

which is a 

aperture for 

the 

of 




which light is 
the eye. The 
ties near the 
cut are the 
nose extending 
opening to that 



admitted to 
two long cavi- 
centre of the 
passages of the 
from the front 
in the back of 



the mouth, and on the mucous membrane lining these cavities becoming in- 
flamed depend those terrible Nasal Catarrhs. 

THE E Alt.— PLATE II. 

Continuing the subject of the ear and a study of its parts from Plate II., we see in Fig. 
10 the long labyrinth of the left ear external surface. The sound enters the parts before 
us at a, called "finestra ovalis," and runs its course around and through these various 
curves. Fig. 11 shows the same parts as Fig 10, cut through the centre to show the inte- 
rior of the labyrinth. Fig. 12 illustrates the manner in which the acoustic nerve is dis- 
tributed to these same parts coming in one nerve, as shown enlarged above e and/; it is 
divided into hundreds of fine fibres, and distributed to every minute portion of the inner 
part of this bony labyrinth. Then in Fig. 13 appears the very fine linings of the laby- 
rinth. Fig. 14. The bony cochlea with one side removed to show the internal arrange- 
ment of the same ; these curves are curious, beinir two and one-half circles c, d, e t respec- 
tively. Fig. 15. The cochlea cut through from apex to base to show the bony structure of 
Vuz same. 



204 DISEASES OF THE NOSEc 

CHAPTER X. 



DISEASES OF THE NOSE. 



CORYZA, CATAMBH.—COLI) IN THE HEAD 

Catarrh of the nasal mucous membrane is one of the most common 
and most frequently occurring affections. 

A simple catarrh arises from a cold. Individuals who watch them- 
selves somewhat, know very well, that if they feel chilly from exposing 
themselves to a current of air, after being heated, they will have a catarrh 
within twelve hours. Severe attacks always commence with a febrile 
sensation, lassitude, dull headache, especially above the root of the nose. 
At first the nose is drier than usual, sensitive to cool air, the smell is 
sometimes remarkably affected; there is a tingling in the nose and a desire 
to sneeze. If a discharge takes place at the commencement, it is 
generally very tenacious, yellowish, or almost entirely watery. In most 
cases the adjoining parts are involved, especially the tonsils, which are 
slightly reddened, and where a stinging pain is experienced. The larynx 
is likewise affected, the speech being somewhat hoarse. A peculiar symp- 
tom is the remarkable frequency of the pulse, with which some persons 
become affected at the commencement of a catarrh, and the striking eleva- 
tion of the temperature. Among children, particularly, the constitutional 
symptoms are much more striking than among adults; whereas the 
latter continue in the enjoyment of a sound sleep, children, on the 
contrary, spend restless nights. Usually, after the lapse of twenty-four 
hours, a copious secretion of mucus takes place, after which the patient 
feels better, and the constitutional symptoms disappear. Within nine 
days at most, the patient is completely restored to health, unless a relapse 
should have taken place. This very common form of catarrh scarcely 
requires to be treated medicinally. Cases may, however, occur, where the 
secretion remains copious and watery for three or four days, the patient 
feeling very much indisposed and very anxious to be freed from his com- 
plaint. Moreover, in the course of the catarrh, relapses may take place, in 
consequence of which, the febrile exacerbations may increase to such an 
extent, that a catarrh, which was, at first, quite unimportant, becomes a 
real torture. 

Under favorable circumstances, especially if the patient exposes him- 
self to frequent relapses, or, is otherwise constitutionally predisposed to 
the complaint, the acute form passes into the chronic. Generally, the 
chronic form consists in a profuse secretion of mucus, without any other 
trouble. Frequently, however, the profuse mucus secretion is accompa- 
nied by swelling of the mucous membrane and impeded respiration. After 
a number of relapses, the swelling increases to such a degree, that breath- 
ing through the nose becomes impossible, which gives rise to a number 
of ailments ; the speech has a nasal twang, the throat hurts in consequence 
of the dryness induced by breathing exclusively with the mouth open, 
and slea^ is variously disturbed. These difficulties remain even after the 



COLD IN THE HEAD. 205 

mucus secretion has entirely ceased; in that case, they are even more 
unbearable than before. If there is a peculiar predisposition, such as 
scrofulous, the internal parts of the nose becomes inflamed, side by side, 
with the catarrhal irritation, and an ulcerative process sets in, which 
secretes a foul-smelling purulent matter, (ozrena). A bad smell from the 
nose may, however, take place, without any ulceration. The structural 
changes in the mucous membrane frequently gives rise to fungoid growths, 
polypus, etc. 

ALLOPATHIC TREATMENT.— Acute Coryza.— Many times a cold 
in the head may be promptly relieved by inhaling the vapor of Iodine 
every three or four minutes, for an hour or so. Each inhalation should 
occupy a minute. The Iodine may be vaporized by merely holding a 
bottle of the Tincture, or Compound Tincture, in the warm hands under 
the nose. Greater heat increases the strength of the vapor. Pure Bromine 
may be inhaled in the same way, with bt.nefit. Should a prolonged sitting 
of an hour at the inhalation of the Iodine vapor fail, I recommend inhaling 
into the nose the fumes of cigarettes made of white blotting paper, soaked 
in Fowler's Solution; and, in case a cure was not affected by a night's 
treatment with the opiate, etc, followed by a cathartic in the morning, I 
would give two drop-doses of Fowler's Solution, three times a day, for a 
few days. 

Hot baths (air, vapor, or water,) may often do good. Hot applications, 
as the use of very warm water, applied with a sponge, or nasal douche, are 
also useful. 

Protection of the body from wet or cold is necessary to prevent recur- 
rence of the attacks, which may result in chronic catarrh. 

Treatment of Chronic Catarrh.— This is both local and constitu- 
tional. The nose should be thoroughly cleansed by a warm nasal douche. 
This must be completely done, and to effect it, the douche must be contin- 
ued as long as any of the secretion appears in the water as it flows from 
the nose. In the absence of a regular nasal douche, an ordinary flexible 
syringe, made to act as a siphon, can be used. The tube should be wound 
with muslin until it closes the opening of the nostril. There is, sometimes, 
an advantage in adding a little Salt, Alum, Sulphate of Zinc, a half to a 
quarter teaspoonful of Permanganate of Potash, to the pint of water, 
(especially if the breath is bad). 

After a thorough cleansing, the frequent inhalation of Compound 
Tincture of Iodine, with Carbolic Acid, is beneficial. 

Take of the Compound Tincture of Iodine half an ounce, Carbolic Acid 
half a dram, and inhale from the bottle. 

The vapor is generated by the heat of the hand clasping the bottle. 
The same mixture, diluted with an equal part of Glycerine, maybe applied 
to the lining membrane of the nose, with a camel's hair brush, twice a day. 
It should, also, be well applied to the posterior nares, through the throat, 
by thrusting the brush well up behind the palate. Other substances, which 
are useful for inhalation, are Bromine, which may be vaporized from the 
bottle, by the heat of the hand, and Iodoform. The latter is vaporized by 
sprinkling a little of the powder on a saucer, and applying heat. The 
vapor is conducted to the nostril by a paper or pasteboard cone, prepared 
for the purpose. 



206 DISEASES OF THE NOSE. 

The following ointments, applied through the nostril, are useful: 

Take of Citrine Ointment two drams, Extract of Belladonna half a 
dram, Simple Ointment half an ounce. Mix. Apply with a camel's hair 
brush, twice a day. 

The ointment may need softening, by warming, before using it, or 

Take of Tanin one dram, dissolve in seven drams of Olycenne, and add a 
dram of the Fluid Extract of Belladonna. Apply to the nostril, two or 
three times a day, with a camel's hair brush. 

Supposing the catarrh to have been of very long standing, in addition 
to douches, vapors, and astringent applications, attention will need to be 
directed to constitutional treatment. Two remedies, which do especial 
good in cases of habitual discharge from the mucous membrane, are Iodide 
of Potassium, and Arsenious Acid, and if the patient is feeble, Iron should 
be given, also, as in the following formula: 

Take of Iodide of Potassium five drams, dissolve in two ounces of simple 
syrup, and mix with a solution of half a dram of Pyrophosphate of Iron, 
with two ounces of simple syrup ; then add two and a half drams of Fowler's 
Solution. 

Dose: A teaspoonful after eating. 

Other tonics may be needed to meet any existing state of the system, 
as if the patient should be feeble, the Citrate of Quinine and Iron, in two 
to five grain doses, three times a day, will be required to build up the 
appetite and strength. If this is given, the iron should be omitted from 
the former formula. Nourishing diet is always to be given. If the patient 
craves sour drinks, or digestion is poor, Muriatic Acid, in fifteen drop doses, 
before eating, will be useful. It should be largely diluted in sweetened 
water, and the mouth rinsed after taking. 

Not unfrequently a change of air to a locality which agrees best with 
the general health of the patient, is of the greatest advantage. 

This treatment is, also, adapted for the extreme cases of catarrh with 
ulceration and offensive discharges, called Ozaena. 

H03ICE0PATHIC TREATMENT.— Camphor (Concentrated Tincture). 
This medicine, if employed upon the earliest development of symptoms of 
cold in the head, will sometimes suffice to arrest the progress of the affec- 
tion at once. It is particularly indicated when the premonitory stage of 
the complaint is characterized by fits of shivering and headache. 

Dose : One drop of the concentrated tincture, on a small lump of sugar, 
three times, at intervals of ten minutes, then twice at intervals of 
an hour, and, lastly, twice at intervals of four hours. 

Aconitum may precede, or be given alternately, with either of the 
next two remedies, when, in consequence of the swollen and congested 
state of the lining membrane of the nostrils, a painful sensation of full- 
ness, heat, and smarting is experienced; and, also, when active fever 
symptoms supervene. 

Dose: Of a solution of six globules, to a teaspoonful of water, give 
every three hours, until the indicative symptoms subside. If in 
alternation with Nux-vomica, or with any other medicine, give six 
pills separately of each, so that four hours elapse between doses. 

Nuoc-vomica is, generally, preferable to all other remedies in the first 
stage, and, especially, when there is dry obstruction during the night only, 
with pressive heaviness in the forehead, and confusion in the head ; heat in 
the head and face, increasing towards evening. If these sensations occur 



COLD IN THE HEAD. 207 

in combination with other catarrhal symptoms, refer to the indications 
afforded for the exhibition of this remedy, under the heads of Horseness 
and Cough. This direction equally applies to the other medicines here 
quoted. 

Dose: Six pills every two to six hours. 

Mercurius is indicated by profuse discharge, producing excoriation, 
swelling or redness of the nose, pains in the head and face. This is a valu- 
able remedy in the generality of ordinary cases of cold in the head, partic- 
ularly when the complaint is epidemic. 

Dose: Two globules in a teaspoonful of water, night and morning, for 
four days, but, if within twelve hours after the second dose the 
symptoms continue to become aggravated, notwithstanding treat- 
ment, proceed with the next remedy; or, if the nasal discharge and 
watering of the eyes predominate, consider Euphrasia. 
Hepar-sulphuris is chiefly of service when only one nostril is 
affected, or, when there is headache, which is aggravated by the slightest 
movement; or, when the complaint is renewed on each exposure to cold 
air; further, inmost cases in which Mercurius, though apparently indi- 
cated, has produced little or no improvement, when it should be admin- 
istered six hours after the second dose of that medicine. 

Dose: Four pills in a teaspoonful of water, night, morning and noon. 
If, however, the headache continues unabated, within six hours after 
the second dose of Hepar, consider Belladonna. 
Euphrasia should be employed six hours after the second dose of 
Mercurius in preference to Hepar-s., when the discharge from the nose is 
excessive, and there is, at the same time, confusion of the head, with red- 
ness of the eyes and eyelids, and copious, acrid or scalding flow of tears. 
Dose : Three pills in a teaspoonful of water, every three hours, until 

improvement or change. 
Belladonna should be administered, if the headache continues una- 
bated, or when it becomes associated with a sensation of heat and fullness 
about the head and eyes. When the sense of smelling is variously affected, 
being at one time too acute, at another time too dull, there will be addi- 
tional reason for resorting to this remedy. 

Dose; Six pills in a tablespoonful of water, repeated at the expiration 
of four hours, and again after an interval of eight hours, if the indi- 
cative symptoms be still predominant. 
Natrum-m. is indicated by cold in the head, renewed by the slightest 
chill or exposure to a current of air; obstruction of the nose every second 

day. 

Dose: Four pills in a teaspoonful of water, night and morning, for a 

week. 
Kali-bichrom is indicated by swelling of the nose and nostrils, with 
copious watery secretion, and diminished sense of smell. 

Dose: Four pills in a teaspoonful of water, night and morning, until 

amelioration or change. 
Arsenicum is indicated by obstruction of the nose, with, at the same 
time, discharge of a thin, acrid, excoriating phlegm, and burning heat in 
the nostrils, etc. Suffering relieved by heat; pain in the back; feeling of 
general debility, or prostration of strength. 

Dose: Two pills in a teaspoonful of water, every three hours, until 
amelioration or change; but if only partial relief ensue within three 
hours after the fourth dose, pause three hours more, and proceed 
with next remedy. 

13 



208 DISEASES OF THE NOSE- 

Sepia, in chronic catarrh, with pressive pains in root of nose; sore 
feeling in nose on drawing the air through ; nose swollen and inflamed ; 
nostrils ulcerated; scurfy nostrils; discharge of yellow water from the 
nose, with cutting pains in the forehead; dryness of the nose and throat. 
This is an excellent remedy. 

Dose: As for Mercurius. 

Dulcamara should be given, if, after the previous administration of 
the two preceding remedies, fresh obstruction is provoked by the slightest 
exposure to air. 

Dose: Three pills in a teaspoonful of water, night and morning, until 
permanent amelioration or change. 

Pulsatilla is indicated when the nasal discharge is thick, fetid, 
greenish-yellow, or mixed with clots of blood ; loss of taste and smell, head- 
ache, sneezing, chill, especially towards evening; disposition to weep, low- 
ness of spirits, heaviness or confusion of the head in a warm room 

Dose: Three pills in a teaspoonful of water, night and morning, for 
four successive days. 

CJiamomilla should be selected when the affection has arisen from 
checked perspiration, and there is an acrid discharge from the nose, causing 
redness of the nostrils, and excoriation or soreness under the nose ; chapped 
lips; shivering with thirst. 

Dose: Of a solution of six pills to four tablespoonfuls of water, give 
a tablespoonful every three hours, until amelioration or change. 

Ammonium-carb. is often of service in cases of cold in the head, 
with copious discharge, particularly of an acrimonious, burning, watery 
fluid ; hoarseness, tickling, suffocating cough, with alternate heats and 
chills; or stuffed nose, especially at night; swelling and painful sensi- 
bility of the nostrils ; dryness of the nose. 

Dose: Three pills in a teaspoonful of water, every four hours, until 
amelioration or change. 

Difficulty in Breathing.— Ipecacuanha should usually be se- 
lected instead of Aconitum and the successive remedies, when the sudden 
suppression of cold in the head is followed by difficulty of breathing. 

Dose: Six pills in a teaspoonful of water, every three hours. If, how- 
ever, within two hours after the third dose, there be no decided 
relief, pause four hours longer, and proceed with the next medicine. 
Hryonia should be administered six hours after the third dose of 
Ipecacuanha, if the employment of the latter medicine has been followed 
by inadequate relief, and the difficulty of breathing still continues pain- 
fully predominant. 

Dose: Four pills as directed for Ipecacuanha. If, however, there be 
no positive relief within two hours after the second dose of Bryonia, 
pause four hours longer, and proceed with the next medicine. 

Suljyhur should be administered six hours after the second dose of 
Bryonia, in cases in which the second dose of the last named medicine 
has been productive of inadequate benefit. 

Dose: Four pills in a teaspoonful of water, morning and evening, for 
three days. 

CONSTITUTIONAL SUSCEPTIBILITY TO COLD IN THE HEAD. 

Calcarea is very generally of service in overcoming the extreme 
susceptibility to cold, which distinguishes some constitutions. This remedy 



COLD IN THE HEAD. 209 

is, especially indicated when the attacks of cold in the head of infants, at 
the period of teething, occur, accompanied by oppressive breathing. In 
general, also, Calcarea is of service when the attacks are liable to be pro- 
voked by every change of the weather. 

Dose: Four pills in a teaspoonful of water, at bed time, two days in 
succession. Repeat in one week. 

Silicea should be employed upon the subsidence of a repeated attack, 
in cases (as just stated) in which Calcarea has, apparently, failed to modify 
the predisposition. 

Dose: Four pills, as directed for Calcarea. 

Pulsatilla is generally of great service in the treatment of predispo- 
sition to cold, when the attacks are complicated with marked derange- 
ment of the digestive functions, especially for persons of a mild and 
sensitive disposition and lymphatic constitution. 

Dose: As for Calcarea. 

HOME REMEDIES.— In view of the obstinacy of chronic catarrh and 
of the bad consequence it may entail, among which loss of smell is one 
of the most important, it is certainly advisable to devise a course of treat- 
ment that shall prevent relapses. One of the most useful means to accom- 
plish this result, is a gradual hardening of the whole body by means of 
cold water. Cold water is altogether an important remedy in the treat- 
ment of catarrh. When drank at the outset of an acute attack, in con- 
siderable quantity, it very soon moderates the most disagreeable sensa- 
tions; and, in the chronic form, it renders good service when drawn up 
into the nose several times during the day. This last-mentioned use of 
water, likewise, acts as an excellent prophylactic. For catarrh, properly 
speaking, it is better to draw up tepid instead of cold water ; tepid water 
loosens the tough mucus better than cold. In the chronic form, likewise, 
cold water is often much less suitable than warm water, which feels much 
more pleasant. That it has a favorable effect upon existing ulcers, is evi- 
dent were it only by cleansing the suppurating surface and preventing 
the formation of crusts. It is well known, that copious draughts of some 
lukewarm beverage are likewise recommended for catarrh ; it is undeni- 
able that it has an excellent effect in catarrhal conditions of the respira- 
tory organs. This management, however, seems so annoying to many 
persons, that only a few are willing to take this trouble. Of much more 
importance is the use of water in the epidemic catarrh of the respiratory- 
organs ; we shall revert to its use when treating of this disease. An 
ordinary proceeding in domestic practice is to excite a profuse perspira- 
tion. It is undeniable, that this proceeding moderates the course of a 
catarrh, almost without an exception. Nevertheless, serious doubts may- 
be entertained against such a course. In the first place, sweat is sought 
to be excited by medicinal herbs. This conduct is decidedly reprehensi- 
ble, for the reason that the organism should never be drenched with 
medicinal decoctions without the most urgent necessity. And, in the 
second place, the skin is rendered more susceptible to cold, which is much 
worse than that the first cold should remain uncured. If the skin is to 
be excited to increased action, the best and least hurtful means to accom- 
plish this, is a moderate vapor-bath ; or, if we desire to excite perspiration 
in the bed, we may drink a glass of warm water with a little syrup. 
14 



210 DISEASES OF THE NOSE. 

Permanganate of Potash, dissolved in water (just enough to give 
a beautiful color), is an excellent remedy for the offensive odor from a bad 
catarrh. 

Polypi in the Nose. — If we except the cancerous growth, there are 
two distinct kinds of polypi. One is a simple fungoid growth of the nasal 
mucous membrane, and owes its origin to chronic catarrh ; the other is 
rather an idiopathic growth, with vessels and cellular tissue. These 
excrescences sometimes impede respiration to such an extent, that they 
have to be removed, either by an operation, or by medicinal treatment. 
That the latter is sometimes adequate to their removal, has been placed 
beyond all question by numerous successful results. In treating a nasal 
polypus, we use the following remedies : Calearea carbonica, in the higher 
attenuations, is recommended by many authorities, likewise for polypus 
excrescences of the Schneiderian membrane. We have never been able 
to obtain any good from its use in this disease. Against cancerous polypi, 
we frequently find useful: Kali-bichromicum, Phosphorus or Sulphur. 
The result of the treatment, however, in such cases, is much less favorable 
than that of mucus polypi. 



INFLAMMATION OF THE NOSE, NASITIS.} 

Inflammation of the Schneiderian membrane generally occurs urder 
the form of a more or less intense catarrh, of which it is very frequently a 
symptomatic manifestation. The ulcerative process, to which attention 
has been called when treating of catarrh, depends upon vhis inflamma- 
tion. The treatment is conducted with the same remedies that have 
already been indicated in the former chapter. 

There is another form of nasitis where single follicles are attacked, in 
consequence of which abscesses form. This disorder is very painful, and 
it is desirable that its course should be shortened as much as possible. 
The best remedy for this purpose is Mercurius; Hepar Sulphuris may, 
likewise, prove useful. In some cases, if the affection is just beginning, 
it may be well to commence the treatment with Belladonna. The appli, 
cation of a warm fluid does the same good here as in any other abscess. 

Inflammations of the nose, which constitute partial manifestations jf 
other constitutional affections, will be spoken of in connection with the 
latter, where the proper treatment will likewise be explained. 

A peculiar inflammation of the nasal mucous membrane, which bears 
the greatest resemblance to eczema of the external skin, and frequently 
spreads in the form of an eczematous process to the external nose and to 
the lips, results in a continual formation of crusts and runs a very slow 
course, requires for its cure Mercurius, Kali bicJiromicum, or in more 
chronic cases, Graphites. Inasmuch as the cure does not take place very 
rapidly, it is well not to change the remedy too soon, 



EPISTAXIS.— BLEEDING AT THE NOSE. 

Bleeding at the nose is one of the most frequent occurrences; no 
organ is as easily inclined to bleed as the nose, the cause of which has to 
be sought in the peculiarly delicate structure of its mucous membrane, in 
its great vascularity, and in the circumstance that the nose is remarkably 
exposed to external influences and injuries. 



BLEEDING AT THE NOSE. 211 

Bleeding at the nose generally sets in unexpectedly without any pre- 
cursory symptoms, which, when existing, consist of congestion about the 
head, such as headache, vertigo, buzzing in the ear, etc., or fever. Gen- 
erally, the bleeding takes place only from one nostril, and, as regards 
quantity, varies from a few drops, mixed with nasal mucus, to whole 
pounds. Sometimes it is a scarcely perceptible flow of blood, sometimes 
a mere dribbling of a few drops, and sometimes, but very seldom, the 
blood rushes out in torrents. According as the bleeding vessels are located, 
the blood is poured forth from the external nostrils, or else from the pos- 
terior nares into the pharynx. The latter result is apt to occur at night 
during sleep. On waking, the patient vomits up the blood, or, if it had 
run into the larynx, it is coughed up, leading both the physician and the 
patient to suppose that he had an attack of haemoptysis, so much the 
more when the co-existing symptoms render this supposition more or 
less founded in fact. 

The bleeding may continue from a few seconds to whole days. If the 
single turns follow each other in rapid succession, it may often seem as if 
the bleeding continued for days. 

The causes are various ; but if a good deal of blood is lost, it is always 
desirable to investigate them with accuracy. There is, undoubtedly, such 
a thing as a constitutional predisposition to nose-bleed, in consequence of 
which the vessels are abnormally inclined to fill up and burst. This pre- 
disposition may even be hereditary, although it does not show itself in 
the looks of the individual. Besides this, a marked flow of blood to the 
nose, or even to the whole head, is one of the most frequent causes ; like- 
wise, mechanical impressions, ulcers of the mucous membrane, and, 
finally, a peculiar composition of the blood, which favors the exudation of 
the blood, as in typhus, scurvy, etc. The frequent appearance of nose- 
bleed at a time when the barometer is very low, causes us to adopt the 
theory that the atmosphere exerts a peculiar pressure, resulting more par- 
ticularly in the production of congestions about the head. 

Although nose-bleed, as we stated above, is, generally speaking, an 
occurrence of trifling importance, yet, under certain circumstances, it 
acquires a peculiar significance. In the first place, the quantity of the 
blood that is lost by one or by a series of successive bleedings, may be so 
great that the most dangerous symptoms of anaemia (bloodlessness) may 
result from such a loss. In the next place, the hemorrhage is dangerous 
in such conditions as anaemia and typhus, which do not bear any loss of 
blood. It is, undoubtedly, wrong to view the nosebleed in such condi- 
tions, as a critical endeavor of the organism, although such a view seems 
justified by momentary amelioration of single symptoms, especially, the 
congestive head symptoms. Such an improvement is very soon followed 
by a so much more disagreeable aggravation. Nature thus points out the 
value we are to attach to artificial bleedings, and that they, at most, only 
palliate the distress at the expense of the general organism. In little 
children and old people, nose-bleed is always a dangerous occurrence. 

ALLOPATHIC TREATMENT. Hemorrhage from the Nose. The 
neck ties, collar or binding should be unloosened, and the neck left per- 
fectly free. The application of cold water to the nose or back of the neck 



212 DISEASES OF THE NOSE. 

may stop the flow. Strong solutions of Alum, Sulphate of Zinc (white 
vitriol,) or Tannin may be applied to the nostril by snuffing it from the 
hand, or inserting plugs in the nose, soaked with the solution. In 
urgent cases, if you have solution of the Persulphate of Iron, or the 
powder, it may be carried well up into the nostril with a swab, and may 
stop the flow by forming a clot. Powdered Alum with Tannin may be 
snuffed into the nostril dry. If a clot of blood is formed in the nose, it 
should be left undisturbed until it comes away of itself, for meddling 
with it may rekindle the bleeding. If these means fail, and a surgeon is 
not available, it may be necessary to plug the nostrils by domestic hands. 
To do this, a twine well waxed, is passed through a gum-elastic catheter, 
and both are then passed through the nose into the mouth. By means oi 
a hook, crotchet needle, or forceps, the twine is drawn forward and made 
fast to a piece of sponge or plug of cloth. By removing the catheter and 
drawing on the twine projecting from the nose, the plug is drawn firmly 
into the nares. It should not be removed for forty-eight hours. Should 
bleeding continue from the nose, the anterior nares may also be plugged. 
Gallic Acid, in doses of a scruple, with twenty drops of Aromatic Sul- 
phuric Acid in water, may be given internally every three or four hours. 
Tincture of Iron, in doses of thirty drops, well diluted, may be given at 
the same intervals, or Ergot, in doses of a teaspoon ful of the powder, or 
fluid extract. Turpentine in doses of ten to twenty drops in mucilage or 
syrup, from two to four hours apart. The bowels should be kept regular, 
with mild laxatives. The diet should be nourishing meat, potatoes, celery, 
and fruits. 

HOMCEOPATHIC TREATMENT. Aconitum is indicated by prolonged 
or violent bleeding at the nose, in plethoric subjects, with a considerable 
degree of fever, flushing of the face, pulsation of the arteries of the tem- 
ples and neck, or general fullness of the vessels of the head. 

Dose: Of a solution of four globules to two tablespoonfuls of water, 
give a teaspoonful every half hour, until amelioration or change. 

belladonna is frequently of the greatest service when there is bleed- 
ing from the nose at night, which awakens the patient from sleep, and 
sometimes returns in the morning; bleeding from the nose from being 
overheated. 

Dose: Four globules, as directed for Aconitum. 

Bryonia is preferably indicated by bleeding from the nose, chiefly in 
the morning, or at night during sleep, causing the patient to awake; or 
when it arises from suppressed menstruation, or from overheating during 
warm weather; obstinate or irritable disposition. 

Dose: Four globules, as directed for Aconitum. 

Mercurius is of great service against bleeding of the nose during 
sleep, or while coughing, with speedy coagulation, so that the blood hangs 
in clots at the nostrils ; or when the affection is preceded by a sensation 
of tightness round the head, as if it were bound. 

Dose: Four globules, as directed for Aconitum. 

Carbo-v. is of essential service against bleeding at the nose during 
the night, with ebullition of blood ; violent nasal hemorrhage in the 
morning while in bed, followed by pain in the chest; discharge of a few 
drops of blood from the nose every forenoon ; excessive bleeding from 



BLEEDING AT THE NOSE. 213 

the nose several times a day, particularly after stooping, or after every 
exertion, preceded and followed by great paleness of the face. 

Dose: Two globules in a teaspoon ful of water, morning and evening, 
for three days (or until the earlier development of improvement or 
change) ; then pause four days, after which the course may, if neces- 
sary, be repeated as before. 

Graphites may sometimes prove useful against bleeding of the nose 
towards night, with heat in the face, preceded by determination of blood 
to the head, in the after part of the day, particularly in females who have 
scanty menstruation. 

Dose: Two globules, as directed for Carbo-v. 

Pulsatilla is indicated by discharge of blood from the nose every 
afternoon, evening, or before midnight, especially in females with sup- 
pressed or scanty menstruation, or in those of a mild and placid disposi- 
tion. 

Dose: Four globules, as directed for Aconiturn. 

Hamamelis should be administered in cases in which the blood is 
dark colored and flows sluggishly but profusely. It is also useful if the 
nosebleed be complicated with bleeding of the lungs, or if resulting from 
suppressed menstrual flow. One of the best remedies. 

Dose: Four globules, as directed for Aconiturn, 

Veratrum Alb. will be found efficacious, when there is present, death- 
like paleness of the face, coldness of the surface of the body, and slow, 
intermitting pulse. 

Dose: Four globules, as directed for Aconiturn. 

Arnica, in addition to being the principal medicine in violent nasal 
hemorrhage from external injury, or from great physical exertion, is, 
moreover, an important remedy in all cases in which the hemorrhage is 
preceded by itching in the nose and forehead; and when the nose feels 
hot, and the blood discharged is red and liquid. 

Dose: Four globules, as directed for Aconiturn. 

Rhus, is appropriate for the treatment of bleeding of the nose, occa- 
sioned by physical exertion, such as lifting a heavy weight, or when 
blowing the nose, spitting, etc.; or for discharge of blood from the nose, 
which becomes aggravated or renewed on stooping, or during the night. 

Dose: Four globules, as directed for Aconiturn. 

China is generally to be selected when the loss of blood has been very 
considerable, and when the patient is much weakened before assistance is 
rendered. 

Dose-. Four globules, as directed for Aconiturn. 

Ferruni should be employed after the previous administration of 
China, in cases in which the last named medicine has been productive of 
partial amelioration only. Ferrum is, moreover, of much service in the 
treatment of bleeding of the nose occurring in debilitated subjects, with 
excessive paleness of the face. 

Dose: Two globules, as directed for Carbo-v. 

Sejna. Frequent attacks of hemorrhage from the nose, with pale or 
sallow complexion, especially in females with obstructed menstruation. 

Dose: Two globules, as directed for Carbo-v. 

Nux-v. is more particularly indicated by bleeding of the nose, espe- 
cially in the morning, from being overheated, or from the suppression of 



214 DISEASES OF THE NOSE. 

an accustomed discharge, such as that of piles ; also, after drinking wine, 
etc., or in habitual drunkards. 

Dose : Four globules as directed for Aconitum . 

Crocus is useful for discharge of dark-colored, thick, or viscous blood 
from the nose; the blood hangs in long black strings; particularly in 
females who menstruate too copiously, sometimes followed by fainting. 

Do.se; Four globules, as directed for Aconitum. 

Moschus is frequently serviceable when the bleeding of the nose 
occurs in nervous, hysterical females, or when the bleeding has continued 
to depletion, and there is spasmodic jerking of the muscles. 

Dose: Four globules, as directed for Aconitum. 

Silicea is an excellent remedy for the treatment of those obstinate 
and sometimes habitual discharges of blood from the nose, which occur 
in persons of a marked scrofulous habit of body. 

Dose. Two globules, as directed for Carbo-v. 

HOME REMEDIES. When the hemorrhage is of an active kind, the 
patient should be placed in the erect posture, and kept cool and quiet for 
some time afterwards. 

When there is reason to fear suffocation from the bleeding continuing 
inwardly, and getting into the throat, as is liable to happen in extremely 
debilitated subjects, in whom little or no reaction appears to follow the 
administration of the remedies, the anterior and posterior outlets from 
the nose may be plugged ; the latter by passing threads up the nostrils, 
and bringing them out at the mouth, then securing pieces of sponge, or 
smalls rolls of lint, to the ends ; after this the threads should be drawn 
back, and tied sufficiently tight so as to bring the plugs somewhat firmly 
against the orifices. 

Cold water, ice, snow, or cold or cooling articles applied to the head 
and neck are beneficial, when the bleeding is evidently caused by excessive 
flow of blood to the head. 

Diet and Kegimen. — In all cases in which bleeding of the nose 
occurs, otherwise than as the result of a mere casual accident, (and even 
then, until the discharge is thorougly subdued), the diet should be plain 
and unstimulating ; it should, nevertheless, be nourishing, for— although, 
in many cases, as this discharge occurs in the place of some other natural 
evacuation, the system is not so much exhausted thereby as might be 
anticipated — it may still be looked upon as an indication of some local or 
general debility. The state of the organs of digestion should, therefore, be 
subjected to close attention, that any irregularities may be obviated, and 
that proper nutrition may be promoted. Regular habits, early hours, 
avoidance of over-intense application, extremes of temperature, or of 
excesses of any kind, a fair proportion of exercise in the open air, in favor- 
able weather (but without enduring fatigue), and the like, are essential. 

In cases of very debilitating and long-continued discharges of blood 
from the nose, change of air and scene will often materially assist in the 
restoration of the patient. 



PART FOURTH, 

THE GATE. 

CHAPTER XI. 



DISEASES OF THE MOUTH AND THROAT. 



STOMATITIS.— INFLAMMATION OF THE 3IOUTH. 
CANKER OF THE MOUTH 

We comprehend under this name all the catarrhal affections of the 
mouth and fauces, from simple hyperemia to the formation of erosions, 
aphthae. 

Generally speaking, it is a mere symptom of some more general dis- 
ease. In a few cases it is an independent disease, with a tendency to run 
a chronic course, and torment the patient to such a degree, that it becomes 
necessary to proceed against it. In such cases, we find certain places of 
the mucous membrane, most frequently the arch of the palate and the 
under side of the tongue, covered with spots of various sizes, of a uniform 
bright, and very seldom of a dark, redness, causing a feeling of intense 
burning, impeding mastication, and frequently disappearing very suddenly 
in order to break out again in some other part, and running altogether a 
very obstinate course. 

A catarrhal affection of the mouth and fauces accompanies the most 
diversified diseases of the digestive apparatus, as well as of the organs 
adjoining the mouth, and acquires importance, not so much from its inher- 
ent dignity, as from the fact that by it, we determine the condition of other 
organs. The coating of the tongue, for instance, which depends upon the 
degree and form of stomatitis, is, undoubtedly, an important diagnostic 
sign. The main symptoms of catarrh of the mouth are painfulness, 
which is particularly prominent in the case of little children^ altered 
taste, secretion of a greater or less quantity of tenacious mucus, attended 
with diminished secretion of saliva, fetid smell from the mouth, some- 
times frontal headache. The chronic form of catarrhal stomatitis is, 
likewise, characterized by an unusual secretion of mucus, altered taste 
and bad smell from the mouth, which is even perceptible to the patient. 
Of more importance is the chronic form of catarrh of the fauces, which is 

215 



2i6 DISEASES OF THE MOUTH AND THROAT. 

a source of great annoyance. It is generally met with among singers, 
smokers, drinkers, and is. likewise, one of the remote consequences of 
syphilis. If the affection springs from the last mentioned cause, it fills 
the patients with great anxiety, because they are in constant dread of a 
syphilitic affection in the mouth. It is generally confined to the posterior 
wall of the pharynx ; the tonsils, however, are frequently involved in the 
morbid process. The affected part shows a somewhat deeper redness, is 
traversed with distinctly injected, varicose vessels, is more or less swollen, 
sometimes exhibiting granulations, and at times streaks of swelling, so 
that the mucous membrane seems divided in regular parallel puffy eleva- 
tions, between and on top of which streaks of a very tenacious, yellow 
mucus are seen. This secretion of tenacious mucus is the greatest torture 
to the patients, for the affection is not painful of itself, but only becomes 
so when, by the constant efforts made to hawk up the mucus, the mucous 
membrane of the fauces becomes irritated. This trouble is always very 
obstinate. 

By aphtha?, we understand a peculiar disorganization of the mucous 
lining of the mouth. Aphthae, generally, sets in with the symptoms of 
acute catarrh of the mouth, seldom without premonitory symptoms, hav- 
ing the appearance of small watery or whitish blisters on the lips, tongue 
or cheeks, surrounded by a narrow, red areola. They soon break, leaving 
small ulcerations of the skin, with a yellow or yellow-gray base, and a 
vividly red, sharply circumscribed border. With the outbreak of the blis- 
ters, the fever often disappears, and only continues, if the eruption, instead 
of breaking out all at once, makes its appearance in a successive series of 
crops. The single little ulcer usually heals very rapidly, and it is only 
under very unfavorable circumstances that more deeply-penetrating ulcer- 
ations and diphtheritic membranous formations take the place of the sim- 
ple aphthce. 

Stomatitis proper, that is, inflammation of the mucus lining of the 
mouth, commences with the symptoms of a violent, more or less exten- 
sive hyperemia, from which, however, it soon differs by the greater 
swelling of the more especially affected parts, particularly the gums. 
Every part of the mouth is very painful, not even the softest nourishment 
can be taken without intense pain; if infants are the victims of this disor- 
der, they refuse the breast very obstinately. In the further course of the 
disease, the gums look dark-red, with whitish streaks, but, at any rate, at 
the beginning, without any loss of substance. There is no increased secre- 
tion of mucus, but profuse ptyalism, with metallic taste, and disagreeable 
odor of the breath. Fever is always present, sometimes to a high degree, 
and attended with the most threatening cerebral symptoms. After a while 
the digestion becomes impaired, the deficient nutrition leads to a loss of 
strength, which is still increased, by the fact that the sleep is usually very 
much disturbed. In the higher grades of the inflammation, the salivary 
glands are always very much inflamed, swollen and painful. 

This disorder scarcely ever runs a rapid course; it lasts at least seven 
days, and may become very much protracted by secondary ulcerations and 
inflammation of the salivary glands. In this way the lives of little chil- 
dren may be placed in jeopardy, or by an extraordinary increase of the 
cerebral irritation and appearance of convulsions. 



CANKER OF THE MOUTII. 217 

The morbid processes of the mucous membrane of the mouth, which 
we have enumerated so far, occur much more frequently, and break out 
much more readily in the organisms of children, than in those of adults. 
Whether this is owing to the greater delicacy of the infantile mucous 
membrane, or to deficient nutrition, is not very clear. Most diseases of 
this class, among infants, at any rate, undeniably arise from the circum- 
stance that the mouth is not kept sufficiently clean; whereas, on the other 
hand, stomatitis often attacks children where the utmost cleanliness is 
observed. One great cause of the disease, is the pernicious habit of giving 
children the breast much too frequently; not only is the proper digestion 
interfered with by this pernicious habit, but the mouth cannot be kept clean 
when it is continually lined with milk. A mother cannot be too careful 
in this respect; a slight derangement in the functions of the mouth is 
sometimes sufficient to interfere with the assimilative process, and to 
bring on a condition of things that must inevitably lead to the deteriora- 
tion of the infantile organism. 

Treatment— We have placed these apparently different, and yet in 
many respects, homogeneous diseases together, because the remedies which 
they require are generally the same, and unnecessary repetitions are thus 
avoided. 

ALLOPATHIC TREATMENT.— The treatment of Stomatitis is 
not, as a rule, very complicated. In follicular sore mouth and the aphthous 
sore mouth of children (thrush) a mouth wash of two drams of Chlorate of 
Potash, half a dram of Carbolic Acid, to eiyhv ounces of zoater, is gener- 
ally efficacious. The Borax and Honey of domestic practice, or preferably 
Borax and Glycerine, (two drams to the ounce) applied with a camel's hair 
brush or pencil, is also generally effectual. Or a weak solution of Sulphate 
of Zinc ("White Vitriol) or Alum will generally effect a cure. 

In ulcerative sore mouth, (canker,) Chlorate of Potash is almost a spe- 
cific. It should be finely pulverized, and mixed with an equal part of 
pulverized sugar The powder should be sprinkled on the ulcerated surface. 
Alum makes a serviceable application, by touching each ulcer with the 
crystal. Other astringent applications are useful, as Sulphate of Zinc, 
(White Vitriol,) Sulphate of Copper, (Blue Vitriol.) Nitrate of Silver, 
(Lunar Caustic,) touching each ulcer with the dry salt, or Tannin sprinkled 
dry upon the surface of the ulcer. 

In infants there is probably no better treatment than the Chlorate of 
Potash. The powdered salt may, also, be given internally to children, in 
doses of five grains, in sugar and water. 

When these painful ulcers occur periodically, the ulcers may be touched 
with Muriatic Acid, applied by means of a pine stick. In case there is any 
derangement of the stomach in these latter cases, the internal use of the 
Dilute Muriatic, or Nitro-Muriatic Acid, in doses of fifteen drops for adults, 
well diluted in sweetened water, three times a day, is often extremely ben- 
eficial. 

The general health will need attention, poor digestion is assisted by 
Pepsin alone, or with Bismuth. The ordinary dose of each is five grains. 
Impoverished blood calls for bitter infusions of Peruvian Bark and Iron. 
The bitter infusions are made by macerating a dram of the crude drug in a 
pint of water— the dose a wineglassful. The Citrate of Iron and Quinine, 
in closes of two to five grains, generally, fills all the indications. 



218 DISEASES OF THE MOUTH AND THROAT. 

The Elixir of Bark and Iron, or the Compound Syrup of Hypophos- 
phites, with a fourtli part Dilute Phosphoric Acid, in doses of a teaspoon- 
f ul to an adult, three times a day, will be useful. The diet should be 
nourishing and digestible, as is recommended below. 

In nursing sore mouth, the above treatment is applicable, but the chief 
object is to support the system so that the waste will be supplied. The 
diet should consist of meat, eggs, milk, cream, oat meal, graham, etc. The 
Citrate of Iron and Quinine, and Syrup of the Hypophosphites, will be 
materially beneficial. 

HOMffiOFATHIC TREATMENT. Belladonna. We can safely say, 
that in all cases where the lining membrane of the mouth becomes red 
and inflamed, without the appearance of little blisters, or sores, Bell, is 
the best remedy. It acts most powerfully on the organism of children, 
while they are most liable to these inflammations. It is most appropriate 
in the commencement of the attack; the higher the constitutional symp- 
toms run, the more appropriate this remedy becomes. In chronic catarrh 
or inflammation of the mouth, it is of very little use. 

Dose: Six pills in three tablespoonfuls of water, of which solution, 
take a teaspoonful every one to four hours, as the case is more or less 
urgent. 

Mercurius is a specific in cases where there are little blisters or sores 
(aphthae,) as Bell, is where there are none. It is suited to every grade of 
the disorder, even to ulcerations of the mucous lining. 

Dose : As for Belladonna. 

Other remedies are Nux-v., Dulcamara and Nitric Acid. The latter, 
for that form of the disease which is the result of the use of Calomel, or 
Mercury, in too large doses. 

HOME REMEDIES. Precautions in diet, are particularly important 
in cases of children and infants. A frequent cleansing of the mouth, has 
a palliative and curative effect, not only in the case of children, but in 
that of adults. Warm water is the best means to cleanse the mouth. 
The use of fat food must be strictly forbidden ; after eating fat food, every 
symptom of the disease becomes aggravated. Cooling washes are usually 
to be recommended. Honey and Borax, a weak solution of Alum, or Sul- 
phate of Zinc used as a gargle or wash. 



ANGINA.— SORE THROAT.-APHTHOTJS SORE THROAT. 

By this name we understand an inflammatory affection of the poster- 
ior (back) parts of the mouth and pharynx. According as it consists only 
in a catarrhal irritation of the mucous lining, or in actual inflammation 
of the parts, it is divided into catarrhal and tonsillary angina, which are 
two distinct forms of the disease. 

Catarrhal Angina is synonymous with acute catarrh of the pharynx 
and the posterior buccal cavity. The disease usually arises as independent 
of other affections, less frequently in the course of other catarrhal pro- 
cesses. Its most common cause is a cold; it likewise breaks out as a 
symptom of scarletina, less frequently as a symptom of typhus, and some- 
times it seems to spread even epidemically. Many individuals have from 
their youth a peculiar disposition to catarrhal angina, without showing in 



SORE THKOAT. 219 

their external appearance any signs of a peculiar irritability or weakness; 
on the contrary, they are persons of healthy-looking and vigorous consti- 
tutions. 

Symptoms. These vary according as children or adults are affected. 
In either case the disease usually breaks out suddenly without any pre- 
monitory symptoms. The children were quite cheerful the moment 
previous, and are suddenly attacked with all the symptoms of a very vio- 
lent fever and marked cerebral congestion. The temperature of the skin 
is very high, the pulse disproportionately accelerated, that is, in compar- 
ison with the trifling importance of the pathological process; the children 
want to lie down, and they sink into a soporous condition from which 
they are frequently roused by sudden exclamations or anxious fancies, 
which sometimes continue even after the patients are wide awake, so that 
they seem really delirious. All these symptoms are worse towards even- 
ing and attain their climax about midnight, after which they decrease in 
intensity. The cerebral symptoms are so intense, and, by their form and 
violence, cause so much anxiety, that it would seem at first sight as 
though the little patients were attacked with inflammation of the brain ; 
there is but one certain diagnostic sign, which is the copious sweat, that 
is scarcely ever wanting in this disease, and which always breaks out, if 
the patients are covered ever so little, sometimes even if they are not cov- 
ered at all, and which is never wanting, if the patients are sleeping. The 
appearance of the tongue may be perfectly natural ; generally, however, 
it shows a thin, whitish coating at an early stage of the disease. The 
pupils are at times dilated, at times contracted. If the children are old 
enough to describe their morbid feeling, they complain much less fre- 
quently of pain in the throat than of pain in the pit of the stomach and 
in the ears. The pain in the latter may increase to a high degree of 
intensity, and may cause the patients to moan all the time. The appar- 
ently threatening intensity of these symptoms in the evening or at night 
bears no proportion to their striking decrease in the morning, when the 
children are seen playing about very cheerfully, only, perhaps, feeling a 
little more tired than usual. If left to itself, the disease does not termin- 
ate here, but soon after dinner a fever sets in, which, however, does not 
attain the same degree of intensity that the fever had at the first outbreak, 
and ceases on the third, sometimes not till the seventh day. The appetite 
is very bad, the bowels constipated, thirst moderate. There is very fre- 
quently a peculiar odor from the mouth, which is not so much a foul 
smell, as rather like that of Phosphorus; and is always more marked in 
the more violent cases, perhaps, because in such cases the stomach is gen- 
erally very seriously involved. 

Catarrhal Angina is undoubtedly one of the most common causes of 
the cerebral congestions with which children are so often attacked, and 
is but too seldom recognized as their exciting cause. The above-mentioned 
diagnostic sign has never left us in the lurch, and we deem it so much 
more important as it is difficult, especially in the case of little children, to 
undertake an inspection of the throat. In children of six or seven years, 
marked cerebral congestions do not usually accompany this form of angina, 
which runs the same course, in their case, as in the case of adults. 

Among older individuals, catarrhal angina generally sets in without 



220 DISEASES OF THE MOUTH AND THROAT. 

any decided fever symptoms; if they are present, they correspond to the 
febrile stage of every catarrhal fever; that is to say, they consist of alter- 
nate attacks of chills and heat, great lassitude, and rheumatic drawing 
and tearing in the extremities. At the same time they complain of disa- 
greeable dryness in the throat, and painful deglutition (swallowing), 
especially of the saliva, which is generally very tenacious, and secreted 
in small quantities. Drinking, or swallowing solid food, is generally 
much less painful. The fauces (back of the mouth), especially at the arch 
of the palate, appear uniformly red, less frequently dark than bright red, 
the uvula (palate) is involved in the attack, looks swollen and elongated, 
so that its tip touches the root of the tongue, by which many patients are 
obliged to swallow all the time, and even causes an inclination to vomit. 
The tonsils are, likewise, somewhat swollen. 

If the disease is neglected at this first stage, or if the patient takes, 
perhaps, a second cold, the difficulty of swallowing increases a good deal, 
even to such an extent that the liquid returns by the nose, and the 
attempt to swallow solids causes actual paroxysms of suffocation. In 
such higher grades of the disease, even adults are affected with a very 
foul breath, the fever assumes a more continuous type, and violent head- 
ache, nausea and vomiting, are seldom wanting. On inspecting the 
mouth, we find the whole of the back part of this organ dark red, some- 
times we notice a few superficial ulcers; the mucous lining is very much 
swollen, and the tongue thickly coated. In children, we have seldom an 
opportunity of watching these different degrees of the disease; on the 
contrary, they always feel sickest at the commencement of the attack. 
Amid a gradual decrease of all the symptoms, the patient generally recov- 
ers in seven to nine days, provided no untoward accident interferes with 
the cure. Only in the lighter forms of the disease recovery may take 
place in three, and even in two days. 

Catarrhal angina is a prevailing affection of young people; where 
there is a constitutional disposition to this disease, its attacks continue to 
a late age; decreasing, however, in intensity. Before the first year, it 
occurs less frequently; between the second and seventh, it is one of the 
most common diseases. Whereas, among young people, it is very com- 
monly an independent disease; among individuals between the ages of 
forty and fifty, on the contrary, it is, most generally, a mere symptom of 
some general disorder. 

The prognosis is always favorable, especially, if the catarrhal angina 
is the only morbid symptom. Some profess to have seen death result 
from the convulsions caused by the congestion of the brain ; in such cases, 
however, the cause of death has, most likely, been ascertained only super- 
ficially. 

ALLOPATHIC TREATMENT. Simple inflammation of the throat 
(angina) is most properly treated by a mild purgative. Gargles of a solu- 
tion of Chlorate or Nitrate of Potash (Saltpetre) may be used to relieve 
the dryness and irritation of the throat. A small quantity of Mucilage or 
Glycerine applied to the throat with a brush or mop will meet the same 
end. If the case should not end at once in recovery, Chlorate of Potash 
maybe given internally in doses of ten grains, three or four hours apart, and 
Quinine in doses of three grains thre^ times a day. Should restlessness be 



SOKE THROAT. 221 

great, an anodyne of Opium and Hyoscyamus will be needed. One grain 
of each may be given at bed time to an adult. 

Should there be much secretion from the throat, five drops of the 
Tincture of Belladonna should be given every hour, until a slight dryness 
of the throat is felt, and every three or four hours thereafter. If there is 
much fever, Aconite should be given as directed for Quinsy. It can be 
given with the Belladonna. . 

In sub-acute cases, the throat is frequently dry, and may be relieved by 
the frequent application of Glycerine, and by allowing lumps of sugar to 
dissolve in the mouth. If other measures are needed, they are the same 
as those just described for the acute form of the disease. 

For the chronic form of the disease, which is quite common among 
professional men and others who lead a sedantary life, the treatment is, I 
believe, mostly hygienic. More time should be spent in the open air. 
Indeed, it would be better if some calling " out of doors" could be followed 
until the throat wholly recovers. Then, such time should be spent out of 
doors, as will maintain the body at its greatest vigor. This and recreation 
for both body and mind are necessary, and treatment is useless without it. 
generally unnecessary with it. Regular sleep of eight hours every night 
is, also, an essential. Every working man (physical or mental) requires one 
day's rest in seven. The clergyman should rest every Monday, and all 
others on the Sabbath. The throat requires protection. For this there is 
norhing better than a full beard, which nature provides. Tonics may be 
necessary, if the body does not regain its vigor. The form of the tonics 
should be changed from time to time, and their use continued for a long 
time. 

Astringent applications are useful, especially, in the follicular variety. 

A gargle of Alum a dram to the pint of water, or Sulphate of Zinc a 
half a dram to the pint, or Tannin in Glycerine, a dram to the ounce, applied 
with a camel's hair brush or mop are useful. If the secretion is great, ten 
drops of the Tincture of Belladonna may be given two or three times a 
day. 

HOMEOPATHIC TREATMENT.— In its ordinary form, there is no 
better remedy for this affection than Belladonna. When given every two 
or three hours, it hushes, in twelve to twenty-four hours, the most violent 
pains in the throat, removes the febrile and congestive symptoms, and 
leaves mostly only a little lassitude and an impaired appetite. This effect 
of Belladonna is almost constant among children who are sometimes seen 
in the morning, after taking Belladonna, jumping about bright and 
cheerful, even if they seemed deathly sick the evening previous. 

Dose: Four pellets every two or three hours. 

Mcrcurins, when there is loss of strength, profuse sweats, bad breath, 
delirium, etc. 

Dose: Six pills, every two hours, in a little water. 

Aconite, if the fever is very high, with hot skin. 

Dose : As for Belladonna. 

QUINSY. 

Inflammation of the Tonsils, Ulcerated Sore Throat.— This 
affection is usually met with only to the age of forty or fifty years, very 
seldom at a later period ; most frequently between the years of seven and 



222 DISEASES OF THE MOUTH AND THROAT. 

fifteen. It is certain that persons who have to use their voice a good deal 
are more liable to an attack of angina, and are more generally affected 
with the chronic form. One attack of quinsy predisposes, in a striking 
manner, to relapses. Such diseases are more frequent in spring and fall, 
than in summer and winter; their frequent appearance in the toe 
locality, at certain periods, justifies the inference that this disorder is 
sometimes epidemic. Damp, gloomy, and badly ventilated dwellings, 
are, undoubtedly, very frequent causes of amygdalitis ; we attend families 
in whom the children are, very frequently, attacked with this disease, 
and where, in the absence of any other unfavorable circumstances, the 
frequency of these attacks can only be accounted for by the unwholesome- 
ness of their habitations. The peculiar relation of syphilis and Mercury 
to the tonsils, although, as yet, beyond the bounds of comprehension, is 
well known. In scarlatina, we meet with amygdalitis as a characteristic 
symptom of the disease; in less frequent cases, amygdalitis, likewise, 
accompanies other exanthema, least frequently measles. 

Symptoms: Acute amygdalitis (quinsy) generally commences, like 
all other acute affections, with a violent chill, which is speedily followed 
by an unusual rise of temperature, and increased frequency of the pulse, 
with violent headache, and sometimes violent symptoms of cerebral hype- 
remia; so that in the absence of local symptoms, which have not yet 
made their appearance, we are easily led, especially, in the case of 
children, to suspect the invasion of some acute disease. Generally, all the 
morbid symptoms, which occur in catarrhal angina, make their appear- 
ance in this disease, only they are more continuous, the fever, especially, 
is less remittent, on which account, acute tonsillitis is more readily than 
catarrhal angina confounded with some violent acute disease, such as men- 
ingitis, even in the case of adults. This is, particularly, owing to the fact that 
the local throat symptoms do not make their appearance at once, but not 
till the fever has lasted already a whole day ; in consequence of which, 
we neglect to examine the throat at the onset of the disease. The throat, 
generally, looks redder, more so on one side than on the other. The red- 
ness is very soon followed by a swelling of the tonsils; at first, only one 
tonsil being affected, the other tonsil remaining either unaffected or being 
attacked after the other. The more rapidly the inflammatory swelling 
increases in intensity, and the higher the grade to which the inflamma- 
tion is carried, the greater the danger of the inflammation terminating in 
suppuration. The swelling sometimes enlarges to such an enormous size, 
that it is no longer possible to see the back of the tonsils. As the local 
symptoms increase, the general condition of the patient becomes more and 
more unfavorable; the fever remains at its hight; swallowing is almost 
impossible, and yet there is a constant urging to swallow. Speech becomes 
guttural, sometimes quite impossible; the breathing is, more or less, 
impeded. During perfect rest, the pain is not so great, but is excited or 
aggravated by every motion. The lassitude is continually on the increase 
— partly owing to the violence of the fever, and partly to the deficient sup- 
ply of solid, and, more particularly, of liquid nourishment. The tongue 
is lined with a thick, tenacious phlegm, which is exceedingly trouble- 
some to the patient, and seems to cause the urging to swallow, which fre- 
quently results in an inclination to vomit. The bowels are constipated, 



QUINSY. 223 

the urinary secretions diminished, and urine is very thick. In this man- 
ner, the disease continues about nine days, and sometimes increased to 
such degree in intensity that the patient, the day previous to the opening 
of the abscess, seems to be like one near death. Very seldom the general 
condition improves during the formation of the pus. As soon as the 
abscess breaks, the threatening symptoms disappear almost immediately. 
That perfect recovery cannot take place at once, must be self evident to 
any one who considers how much strength the body has lost by sleepless- 
ness and deficient nourishment. 

Not in every case, and, as we shall show more particular when speak- 
ing of the treatment of this disease, is the course of tonsilitis as acute as 
we have described. From the most violent fever, with sopor and delir- 
ium, to a scarcely perceptible disturbance of the general health, all sorts 
of degrees of constitutional malaise can be noticed, even though the local 
affection should be the same. If the inflammation is dispersed, this result 
does not take place very rapidly; on the contrary, in such a case, the 
inflammation is very apt to pass into the chronic form, which is much 
more rarely met with when the inflammatory process terminates in sup- 
puration. But even if the inflammation is dispersed, a febrile condition 
of the system, lassitude and loss of appetite, continue for some days; 
whereas, the decrease in the inflammatory symptoms ought to lead one to 
infer that the general well-being was much improved. The prognosis is 
almost always favorable. Only in children the disorder may terminate 
fatally, either in consequence of brain difficulties, or by suffocation, or 
even, under certain unfavorable circumstances, by mortification of the 
parts. Among adults, this danger need not be apprehended. Anginas, 
initiating or accompanying exanthematic affections (scarlet fever, etc..) 
have to be viewed from a different standpoint to that of independent 
angina. 

The chronic form of amygdalitis arises, in most cases, out of the acute 
form, in consequence of the reabsorption of the inflammatory exudation 
only taking place partially, and the swelling of the tonsil remaining. It 
seems as though, independently of all constitutional predisposition, such 
remaining infiltrations superinduced a tendency to relapses. Every new 
attack increases the swelling, so that an hypertrophy may ensue, by 
which access to the pharynx may be almost entirely prevented. After 
an abscess, hypertrophies of any size occur much less frequently. With- 
out any previous acute attack, chronic amygdalitis may develop itself 
almost imperceptibly, in persons who have to exert their vocal organs a 
good deal, such as ministers, singers, actors; but acute cases, arising from 
such causes are not near as violent or important as cases arising from the 
previously mentioned causes. 

It is only exceptionally that the enlargement of the tonsils causes 
trouble to the patients. It is seldom that they experience any pain ; nor 
is the pain ever very acute, unless an acute attack has just taken place. 
The most common derangement is an altered tone of the voice, as in an 
acute attack, and a weakness of the vocal organs, in consequence of which 
the sufferer is easily attacked with hoarseness. In spite of the swelling, 
which is sometimes very large, the difficulty of swallowing is either tri- 
fling, or else there is no difficulty at all. Only in rare cases, the patients 



224 DISEASES OF THE MOUTH AND THROAT. 

complain of the swelling, as of a foreign body in the throat. It is a pecu- 
liar feature in such cases, that every cold brings on an acute attack of 
amygdalitis, which is generally, however, confined to some fever with 
pain in the throat, and some difficulty of swallowing, with moderate red- 
ness of the tonsils. By neglecting such attacks, they may recur so often, 
and in such rapid succession, that the patient's health may remain dis- 
turbed for weeks. 

The enlargement of the tonsils is always a very obstinate difficulty, 
which it is so much more troublesome to remove, as the patients who feel 
tolerable well otherwise, do not feel disposed to take medicine. In an 
advanced age the swelling generally disappears spontaneously. 

ALLOPATHIC TREATMENT.-Quinsy, (tonsilitis) is often relieved 
in robust persons promptly, especially if previous attacks have resulted in 
suppuration, by a brisk saline purge (Epsom Salts) given in doses of a table- 
spoonful and a half in water. Cold applications should be applied to the 
neck and lumps of ice taken into the mouth. As soon as the bowels have 
moved, a full dose of Quinine, ten or fifteen grains, and a third of a grain 
of Morphine, or its equivalent of Opium (a grain and a half,) or Laudanum, 
(forty drops) should be given. The attack is frequently cut short by this 
treatment. If the Opium cannot be well borne, Tincture of Aconite 
should be given in doses of a drop every hour until the fever is reduced, 
and then continued every two or three hours. 

In case the disease is not cut short, Belladonna or Stramonium (James- 
town weed) should be freely applied to the neck and covered with a warm 
poultice. Cooling or warm drinks may be given as is most grateful to the 
patient. 

Should the inflammation result in suppuration, as denoted by heavy 
throbbing pain, the abscess should be opened by a surgeon. 

Chronic enlargement of the tonsils generally comes on slowly in scrof- 
ulous children, weakly youths and young women. The enlargement is 
sometimes so great that the fauces (throat) seems filled up, so that res- 
piration (breathing,) speech and hearing are interfered with. In these 
cases the enlarged organ ought to be excised by a surgeon. As much time 
as possible should be spent in the open air. The habits should be regular, 
and the diet good. Frequent bathing should be practiced. Every morning 
the throat should be bathed freely with cold water. Tonics may be indi- 
cated by the general health, and will require changing from time to time. 
Iodine seems, especially, useful. 

The syrup of the Iodide of Iron may be given in doses of five to ten 
drops to a child, and twenty drops to an adult. Iodide of Potassium and 
Pyrophosphate of Iron, have a good effect. Ten grains of the former, and 
t wo grains of the latter, in syrup, is a dose for an adult. A suitable formula 
is the following: 

Take of Iodide of Potassium five drams, Pyrophosphate of Iron one 
dram, Simple Syrup four ounces, Essence of Peppermint half a dram. Mix. 
Take a teaspoonful in water after each meal. 

An additional tonic effect is sometimes obtained, by giving the Iodide 
of Potassium in Elixir of Bark and Pyrophosphate of Iron. Five drams 
of Iodide of Potassium may be dissolved in eight ounces of the Elixir, and 
from a teaspoonful to a dessertspoonful, taken three times a day. 



QUINSY. 225 

This treatment will need to be continued for a long time, to be of much 
benefit. 

Irritating the neck over the enlargement, with Tincture of Iodine, 
applied daily, or every other day, may aid in reducing the enlargement. 
The Compound Ointment of Iodine is often preferred to the Tincture, and 
it is doubtless best, when its use must be long continued. The best result 
from Iodine is obtained by injecting the tincture into the substance of the 
enlargement. 

HOMEOPATHIC TREATMENT.— Belladonna should be given as 
soon as the patient complains of dryness with difficulty of swallowing, and 
a sense of constriction, or choking in the throat, which, on examination, is 
observed to be swollen, and to present a florid, red appearance. Belladonna 
is additionally indicated when the fever continues to run high, when the 
face is bloated, and the eyes are much inflamed, when there is considerable 
delirium and a disposition shown to leave the bed, or commit some act of 
violence, or when the rash, which sometimes attends this disorder, shows 
a scarlet hue. 

Dose: Of a solution of eight globules in each two tablespoonfuls of 
water, give one teaspoonful every two hours, until improvement or 
change. 

Pulsatilla may be given with good effect, in cases in which the 
symptoms are mild, and an increased secretion of phlegm has taken the 
place of the dryness usually present in the early stages, while the patient 
is at the same time afflicted with nausea and bilious vomiting. 

Dose : As for Belladonna. 

Nux-v. is preferable to Pulsatilla when the phlegm is very viscid, and 
is secreted in such a quantity as to create a feeling of threatening suffoca- 
tion. 

Dose : As directed for Belladonna. 

The progress of matters in the throat must, however, be carefully 
watched, and 

Mercurius should be prescribed as soon as the presence of small 
ulcers, or, still better, their incipient formation can be detected. 

Dose: Three globules, in a teaspoonful of water, repeated in two 
hours, and again in two hours more, unless the pain and extent of 
the ulceration should continue to increase, when proceed at once 
with the next remedy. 

Acidum-nitricuni should be administered two hours after the last 
dose of Mercurius, when, from the increasing' size and painfulness of the 
ulcers, the latter remedy does not promise to arrest their progress or cause 
them to assume a healthy aspect. 

Dose: Three globules, as directed for Mercurius. 

In the milder forms of this disease, the two last named remedies will, 
frequently, be found sufficient to conduct it to a speedy and successful ter- 
mination. 

But in those much more dangerous forms, which the complaint so 
readily assumes, when it rages as an epidemic, and when the patient at the 
commencement is seized with vomiting and purging, attended with such 
prostration of strength as to render it impossible for him to leave the 
recumbent posture, without feeling faint and being compelled to fall back 
exhausted by his efforts; where, moreover, the ulceration spreads with 
15 



-226 DISEASES OF THE MOUTH AND THROAT. 

alarming rapidity, and early take on a sloughing character — in such cases 
the conducting of the disease to a happy issue becomes, obviously, a much 
more serious and difficult task. 

Arsenicum will, in the majority of such cases, be promptly required, 
although sometimes advantageously preceded by a single dose of Pulsatilla, 
(as before directed,) if called for by the predominance of bilious vomiting. 
Arsenicum is distinctly indicated by that marked prostration of strength, 
so characteristic of this disease, accompanied by nausea or vomiting; or 
when the ulcers present a livid hue. This important remedy is, also, indi- 
cated in a more advanced stage of the disease, when the ulcerations are 
covered with dark sloughs, surrounded by a livid margin ; the teeth and 
lips incrusted with a brownish, fetid discharge; the pulse small and irreg- 
ular, and there is delirium or constant muttering, with frequent hanging 
of the lower jaw ; laborious respiration; acrid discharge from the nostrils, 
causing excoriations ; the eyes dull and glassy; the skin hot and dry, the 
thirst excessive, yet the patient drinks but little at a time, and appears to 
perform the act of deglutition with great pain and difficulty; finally, when 
the prostration of strength is so extreme, that the patient seems rapidly 
sinking, and a rash of a livid color breaks out in blotches, here and there 
intermingled with purple spots. 

Dose: Of a solution of six globules, to two tablespoonfuls of water, 
give a teaspoonful every hour, until amelioration or change, contin- 
uing the administration at intervals of four hours, when the more 
urgent aspect of the disease has been overcome. In very serious 
cases the doses may be required similarly every ten, fifteen or twenty 
minutes. If in alternation with any other remedy, two doses of 
Arsenicum should be followed by a pause of two hours, and then by 
two doses of the other remedy in like manner. 
China will often be found of service when the tendency to gangrene 
continues, and the patient is still affected with considerable prostration of 
strength; accompanied with debilitating sweats. 

Dose: Pause at least two hours after the last dose of any other rem- 
edy, and then of a solution of six globules, to two tablespoonfuls of 
water, give a teaspoonful every two hours, until amelioration or 
change. 
Nux-vomica is frequently serviceable after Arsenicum, when the 
diarrhoea has been checked, but numerous small, foul, offensive ulcers, are 
seen in the mouth and throat. 

Dose: Three globules in a teaspoonful of water every hour, until ame- 
lioration or change, proceeding with the next remedy, if the sub- 
joined symptoms ensue. 
Carbo-veg. should be administered after a pause of six hours after 
the last dose of the foregoing remedy, should a copious, fetid, watery 
secretion be discharged from the ulcers, attended with extreme exhaustion 
and small, indistinct, or scarcely perceptible pulse. 

Dose: Six pills every hour, until amelioration or change. 
Acidnm-nitricum may be employed with great advantage when, 
from the beneficial effects of Arsenicum, or any of the other remedies 
above mentioned, the strength of the patient becomes invigorated, the 
countenance more animated, and the sloughs are thrown off in a satisfac- 
tory manner, yet the ulcers threaten to become indolent; under the influ- 
ence of this remedy, these will, in most cases, very speedily acquire a clean 
and florid bottom, and begin to heal. 
Dose : As for Belladonna. 



DirilTIIEKIA. 227 

DIPHTHERIA. 

This disease generally commences with unimportant symptoms of 
fever, and most commonly without any local appearances. Only in a few 
cases may be observed symptoms of a not very intense inflammation of 
the tonsils. Hence, the case is usually neglected at this important point, 
because neither the patient nor the family are disturbed or uneasy about 
the matter. At first, there is a slight redness of the back of the mouth, 
(fauces,) the vessels in one or more places being full or injected. Itishere 
that in a few hours you may first see traces of the patches of mucus (exu- 
dation). Atthesame time the redness increasesconsiderably, without, how- 
ever, spreading to the front part of the mouth. One or more snow-white 
membranous patches seem to be laid loosely upon a deep-red or bluish-red 
or violet base ; they have exactly the appearance of a layer of cream spread 
upon the mucous membrane (skin of the mouth). But yet the general 
health is not very much disturbed; the fever is slight, the pulse not very 
much increased in rapidity, the skin is not very dry, even a slight per- 
spiration breaks out from time to time, swallowing is not much hindered, 
the pains at the affected part of the throat are not very acute. Only a 
general feeling of lassitude shows that the local appearances have a 
deeper significance than one would suppose. The affection may, (if not 
prevented by remedies,) thus remain unchanged for the first seven days, 
only the exudation at most, invades a few other parts, in addition to the 
former. In the most fortunate cases the membranes become detached at 
the end of this period, leaving sores on the surface, (where they were at- 
tached,) with shaggy borders, which heal rapidly and leave the patient 
restored to perfect health. If the disease does not take this favorable turn, 
it assumes a much more serious form in the second week. The formation 
of the membranes keep spreading; they assume rather a dingy, blackish 
hue; the constitutional disturbance is more marked; the pulse remaining 
about the same. The prostration increases, yet the patients, even in 
violent cases, are not always compelled to lie down. Sleep is generally very 
much disturbed. The pains in the throat are intense, swallowing and 
speech are very much impeded ; the patients often complain of violent 
earache, which is not constant, but comes on by spells. This stage, also, 
lasts a week (if not prevented by remedies) and maybe followed by re- 
covery ; the ulcerative process, however, is much sharper than at the end 
of the first week. The further progress of the disease in the third week, 
consists in an increase of the constitutional symptoms, but principally in 
gangrenous destruction of the affected parts in the fauces. There arise 
deep ulcers of vaiious sizes, with a gray or blackish bottom, with shaggy 
borders and having a horrid smell. The loss of substance may be very 
considerable. The salivation is copious and very fetid ; the patients look 
very ill, although they may yet be capable of walking about. The termin- 
ation in recovery is a very slow process, in so far, at least, as recovery 
depends upon the healing of the ulcerated surface; for the constitutional 
symptoms show a marked improvement at a period when the ulcers still 
retain their malignant appearance. The return of the appetite is the 
most favorable symptom, likewise the decrease of the salivation and the 
fetor from the mouth. It takes several weeks before the ulcerated surfaces 
are completely healed. It is peculiar to this disease, that as the local 



228 DISEASES OF THE MOUTH AND THROAT. 

symptoms disappear, a more or less universal paralysis sets in ; this is not 
always the case, but very frequently. 

In the preceding description we give the pictr.re of an attack of moder- 
ate violence, and running a favorable, but very protracted course. This 
case may be regarded as a fair illustration of most cases of diphtheria. 
Under certain circumstances, the disease offers a very different group of 
symptoms, which the importance of the subject demands should be faith- 
fully portrayed by us. In the more violent cases, the preliminary stage is 
often very short. The disease sometimes enters the system so rapidly and 
with such extraordinary intensity, that the patient is at once attacked 
with excessive prostration, a small pulse, death-like pallor, and death 
takes place as soon as the membranes begin to form. In other cases, the 
disease begins quite suddenly with vomiting and an intensely sore throat, 
violent fever, heavy sleep, stiffness and external swelling of the neck and 
extraordinary frequency of the pulse. 

The speech is peculiarly altered, on account of the difficulty of moving 
the tongue. The vomiting consists of a thin, yellowish liquid, and is 
very often accompanied by a similar diarrhoea. The formation of the 
membranes takes place very rapidly, spreading almost simultaneously 
over the entire mouth and throat, even extending to the nose. The swel- 
ling of the adjoining parts and of the external neck becomes quite con- 
siderable, so that it extends like a thick pad around the lower jaw. At 
this time the fever symptoms are not very high, even if they had run ever 
so high at the commencement of the attack ; but the strength decreases 
very rapidly. When the attacks are so violent, the formation of the 
membrane extends towards the lungs, where it occasions all the symp- 
toms of true croup, induces, at an early period, suffocative paroxysms and 
stupor, and usually terminates fatally, death being preceded by very vio- 
lent vomiting. Very seldom consciousness remains undisturbed until 
the moment of death. After such violent attacks, death generally follows 
in two to four days. In certain conditions of the system, the affection 
runs a chronic course, the membranes being frequently detached and 
renewed again, and at the same time being confined within definite local- 
ities. In this way the strength of the patient vanishes by degrees, and 
death is almost always the end of this chronic form of the disease. If 
the constitution of the patient is, at the outset, thoroughly tainted with 
scrofula, consumption or other diseases, the membranes evince, from the 
commencement, an extraordinary tendency to decomposition, and death 
results at an early period, although the extent and intensity of the disease 
may not yet seem very far advanced. Unfavorble external circumstances, 
such as damp dwellings, a crowd of persons living together in small 
rooms, insufficiency of fresh air, likewise exert a deleterious influence, on 
which account the worst forms of the disease are more frequently met 
with among the lower than among the higher classes. 

The prognosis of diphtheria is always doubtful, for the disease may 
terminate fatally, no matter what course it may take. If the disease sets 
in accompanied by symptoms of violent constitutional disturbance, the 
danger of a fatal termination is very great, since we may be almost sure 
the more unfavorable the constitutional and domestic conditions of the 
patient, the more general the spread of the poison, the more rapid the 



DIPnTIIERIA. 2:9 

prostration, the less the chances of recovery. The extension of the diph- 
theritic process to the larynx and lungs, is almost always fatal. Nor 
should the protracted and mild course of the disease superinduce a feeling 
of security, for even then a malignant aspect may supervene. One of the 
most threatening symptoms is a deposit in the urine, that, when heated, 
changes like the white of an egg (albumen,) especially if there is a large 
amount of it. 

When the disease has subsided, it is found that paralysis, either gen- 
eral, or of special parts, or derangement of the special senses, such as 
hearing, smell, taste, etc., remain as sequelae of this formidable malady. 

ALLOPATHIC TREATMENT. We have to contend with a constitu- 
tional disease belonging to the same category as small-pox, scarlet fever, 
and other infectious diseases, and, like them, due to a special virus, or 
blood poison. This, of late years, has become more generally recognized. 
The trouble in the throat, and the development of a false membrane are 
regarded as special lesions (local disorders) characterizing the disease. 
The treatment will then be both general, or addressed to the condition of 
the system, and local or addressed to the local lesions, the former being 
regarded as supreme. 

In the great majority of cases which prove fatal, the mode of dying 
is by asthenia, (failure of the powers of life). This, fact calls for remedies 
of a supporting kind. These, as almost every one who has witnessed 
much of diphtheria must feel, almost alone give any promise of being 
useful. There is no specific for the disease, and all we can reasonably 
hope from treatment is, to guide the patient safely to the end. It is true 
some practitioners report almost uniform success in treating this disease, 
but as the same plans of treatment have not proved more than usually 
successful in other hands, it is to be inferred that the cases reported were 
largely or wholly a disease less dangerous, probably follicular sore throat 
which have, by mistake, been called diphtheria. 

In local treatment, the great objects to be kept in view are, to favor 
the separation of the false membrane and prevent its extension, and give 
relief, as far as possible, from the suffering experienced from the affection 
in the throat. Of the external applications to the throat, they are all 
either injurious or useless. Blisters, leeches, and remedies of that class, 
are powerful for harm, while poultices and other mild applications fail to 
give relief, though it cannot be said that they are productive of harm. 

In selecting local remedies, it should be borne in mind that the pro- 
gressive extension of the false membrane and local inflammation is not a 
spreading of the same, properly considered, but the successive invasion of 
the different parts is due to the agency of an internal determining influ- 
ence, and that influence is the special morbid condition which consti- 
tutes the disease. If that is true, topical treatment will be likely to 
exert but little influence in controlling the extent of the local disease. In 
conformity with this view, many, if not the great majority of practition- 
ers, have abandoned the use of cauterizing and irritating local applica- 
tions to the throat (both inside and outside), and are content with the use of 
soothing and antiseptic (anti-putrid) local measures. Hence, the strong 
solution or solid stick of Nitrate of Silver, Sulphate of Copper, Alum, 
Hydrochloric Acid, and the astringent preparations of Iron are not to be 



230 DISEASES OF THE MOUTH AND THROAT. 

used. So far as my own opportunities for observation enable roe to decide,' 
the milder measures are to be preferred. 

The remedies which enjoy a reputation for meeting the ends desired 
in local applications, are: Carbolic Acid, Sulphurous Acid, Lactic Acid, : 
Chlorate of Potash, and Permanganate of Potash. I usually combine 
Carbolic Acid with a solution of Chlorate of Potash, as follows : 

Take of Chlorate of Potash four drams, dissolve in eight ounces of hot 
water, and when cold, add one dram of Carbolic Acid. This is a useful gar- 
gle, or it may be applied with a soft linen mop, or by a spray-producer, 
in cases not old enough to gargle. 

Sulphurous Acid, one or two drams to an ounce of water, is, also, use- 
ful, and may be applied by a mop, or in atomized spray; the usefulness 
of this remedy is attested by high authority, and is so grateful to the 
natient. that its use is frequently asked for every few hours. 

Lactic Acid enjoys a reputation of being an excellent solvent of the 
false membrane, used in the same way as before mentioned, in the 
strength of three and a half drams of the Acid to two ounces of distilled 
water; if the spray is used, the eyes should be protected by a bandage or 
napkin; if used as a gargle, it should be diluted until the water is dis- 
tinctly sour. 

One or two grains of Permanganate of Potash to the ounce of water, 
is the proper strength for the use of that drug, and the methods of using 
it are the same as above mentioned. 

Bromine five grains, Bromide of Potassium two grains, water one 
ounce, is a mixture highly extolled by some practitioners. It should be 
applied by mop, camel's hair brush, or in spray. 

Probably, as useful an application as can be found at hand, in domes- 
tic practice, is common Lime Water. It may be used in any of the ways 
before named. Small pieces of ice, held in the mouth; or, in young 
children, a teaspoonful of ice water, swallowed occasionally, give relief. 

When tlie false membrane is removed, and the local inflammation 
begins to decline, all local applications should cease. 

The greatest danger from the local affection, is from its invasion of 
the larynx (the organ at the top of the wind-pipe); it is accompanied by a 
croupy cough. As soon as respiration is interfered with, an emetic 
should be given, which produces but little prostration. 

The end is to expel the false membrane from the wind-pipe. For 
this purpose, the Yellow Sulphate of Mercury, in three to five-grain doses 
rubbed up with sugar, may be given ; Sulphate of Zinc in doses of five to 
ten grains, repeated every fifteen minutes, until vomiting is produced; or 
Powdered Alum in doses of a teaspoonful, mixed with syrup or honey, 
repeated every half hour, until the patient vomits, meets the end 
required. 

The patient should, also, breathe steam constantly, either from Rou- 
fiheti's Croup Kettle, or by keeping the room filled with steam from boil- 
ing water. Quinine, given internally to the extent of reducing the pulse, 
is thought useful by most physicians. A grain may be given to a child 
from three to five years old, every two hours, or five grains to an adult. 
If the respirations become greatly embarrassed, and lividity of the face 
occurs, the case will, probably, prove fatal in spite of all efforts; but the 



DIPHTHERIA. gag 

physician ought, at once, to perform tracheotomy (opening the wind- 
pipe, that the air may enter the lungs through the opening). Sometimes 
life is saved, and, at all events, the last hours are rendered more com- 
fortable. 

Regarding general treatment, there should be no prostrating remedies 
used. Emetics or cathartics are not to be given ; but if the bowels are 
constipated, they are to be moved by an injection of a dessertspoonful of 
Castor Oil, or a couple of Compound Cathartic Pills. The line of treat- 
ment should embrace tonics, nourishment and stimulants. Of remedies, 
the Sulphate of Quinine, the Tincture of the Chloride of Iron, Chlorate of 
Potash, and Brandy, are, especially, to be named as having been found 
useful. In my opinion, Quinine should be given from the beginning of 
the disease to the extent of tolerance, i. e., until the pulse is slowed and a 
slight ringing of the ears is produced — in doses of one grain, to a child, 
and five grains to an adult, from two to four hours apart, and then con- 
tinued in a dose just less than is necessary to produce this effect. In 
debilitated patients, there is no doubt of the benefit of Iron ; it should be 
given from the first, and is well combined witli Chlorate of Potash. I con-- 
sider this a useful mixture: Take of Tincture of Iron two drams, Chlorate 
of Potash two drams, Simple Syrup two ounces. Mix. 

Dose: A teaspoonful to an adult, or fifteen or twenty drops to a child, 
in water, every four hours. 

Nourishment forms an important point in the treatment. It should 
be concentrated, highly nutritious and varied. Milk, cream, eggs, and 
animal essences best meet these requirements. They may be used in the 
forms described in the article on the treatment of scarlet fever. A seri- 
ous difficulty in the treatment often arises from the refusal to take food, 
possibly from repugnance, and from vomiting. Owing to this difficulty, 
in some cases, and sometimes from a failure to appreciate the importance 
of feeding, death takes place from starvation. Food should be given from 
four to six hours apart, night as well as day. 

Should the fever run high, or prostration be noticeable, brandy should 
be given at once, without reference to other medicines, as a means of sup- 
porting the powers of life. There is, also, reason to believe that both brandy 
and Quinine protect the system against the action of the disease poison. 
A teaspoonful of the former, for a child, and a tablespoonful for an adult, 
properly diluted in sweetened water or milk, from two to four hours 
apart, is the usual method of administration, though double these quan- 
tities have been given hourly with good effect, and without producing 
excitement. Permanganate of Potash, two grains to the ounce of water, 
given in teaspoonful doses every three hours, is thought by many to be 
useful. Bisulphite of Soda is thought by some to have special powers over 
the disease, but probably its usefulness is overrated. It may be given as 
follows: 

Take of Bisulphite of Soda four drams, Tincture of Orange Flowers one 
ounce, Water four ounces. Mix. Give a child three years old one teaspoonful, 
and an adult one tablespoonful every two or three hours. 

The Bulpho Carbolate of Soda, in closes of two to five grains, according 
to the age of the child, four to six times a day, is highly recommended by 
some physicians, on account of its antiseptic action. Du. Holiday, of 



282 DISEASES OF THE MOUTH AND THROAT. 

Burlington, Iowa, speaks quite warmly in its favor. It is to be given 
instead of the Bisulphite of Soda. The fetid odor in the breath disappears 
rapidly under its use. 

Incidental symptoms demand attention. Vomiting is to be relieved 
by Bismuth, in five grain doses, Creosote in doses of a drop in water, or 
Hydrocyanic Acid in doses of three drops, repeated hourly. Diarrhoea 
calls for astringents, and, if severe, for opiates (see article on the treat- 
ment of Diarrhoea). Anodynes may be required to relieve restlessness; 
for this purpose equal parts of Paregoric and Tincture of Plyoscyamus is 
useful for children, and may be given in doses of from ten drops to a tea- 
spoonful, according to age. For adults ten to fifteen drops of Deodorized 
Tincture of Opium may be given with a teaspoonful of Tincture of Hyos- 
cyamus. Hemorrhage may be relieved by Persulphate of Iron, used in 
doses of ten to fifteen grains, locally, and Gallic Acid, or Fluid Extract of 
Ergot internally, in doses of a teaspoonful every two or three hours. 

Under all circumstances, the patient should be kept in bed, and in the 
recumbent posture. The disease is so weakening, that slight exertion has 
been known to cause fatal syncope (fainting). The room should be kept 
warm, and the air moist with steam. The room should, occasionally, bo 
disinfected by burning Powdered Sulphur upon a shovel of coals, or by 
evaporating a few drops of Carbolic Acid on the surface of hot water. 
Ozone (active oxygen,) may be generated in the room, by pouring three 
parts strong Sulphuric Acid upon two parts of Permanganate of Potash, 
in a deep glass dish, with benefit. Cleanliness is absolutely necessary, and 
the management should be similar to that for contagious diseases. See 
article on Scarlet Fever. 

Children not affected, being specially liable to the disease, should, if 
possible, be removed to a neighborhood free from the disease. 

In a disease so serious as diphtheria, where physicians are not content 
to trust their own judgment alone, in case of its occurring in a member of 
their family, without calling in the aid of a physician, I hardly presume 
that any intelligent person will take the responsibility of managing the 
disease in his family, without the guidance of a skilled physician, even if 
the directions in this article are never so plain. 

HOMOEOPATHIC TREATMENT. Belladonna is frequently of great 
value in the early stage of mild cases, more particularly when the disease 
sets in with marked febrile symptoms, and there is marked redness and 
inflammation of the tonsils; the patient is uneasy and restless, and com- 
plains of the throat; is drowsy, and cannot sleep, or starts up suddenly 
out of every sleep. 

Dose: Of a solution of twelve globules to five teaspoonfuls of water, 
give a teaspoonful every two hours, until amelioration or change. 
Many mild cases, with the above characteristics, will be properly 
relieved and cured, by this remedy alone; and should amelioration he 
noticed, the interval between the doses should be lengthened to three 
or four hours, according to circumstances. Should the symptoms 
recur with violence, however, after having been once mitigated under 
the action of Belladonna, do not resort to that remedy again, but 
select one of the subjoined. 

Acidum Muriaticum. This remedy has proved of great efficacy in 
a number of cases of simple diphtheria, and may very generally be admin- 



DIPHTHERIA. 233 

istered as soon as the membranous deposit begins to appear, and particu- 
larly when there is not much glandular swelling, but considerable prostra- 
tion of strength and fetid breath, with little fever, but marked lassitude 
and weariness. 

Dose: Three drops of the second decimal dilution in a teaspoonful of 
water, every hour, until relief or change. In the event of improve- 
ment, lengthen the intervals to two hours, then to three hours, and 
so on, until the cure is complete; but if the exudation spreads to 
fresh surfaces, in spite of the employment of Acid Muriaticum for 
twenty-four to forty-eight hours, another remedy must be selected. 
3fercurius Protiodatus. One of the best remedies. Should the 
throat present a deep-red appearance, and the tonsils and surrounding parts 
be considerably swollen and studded with specks of exudation; and if, 
moreover, there be cold in the head, accumulation of mucus in the throat, 
and excessive secretion and flow of saliva of a fetid odor, Mercurius is a 
useful, if not an indispensable remedy. It is an important remedy in all 
forms of the disease. 

Dose: One grain of the third trituration in six teaspoonfuls of water, 
a teaspoonful every two hours; or as much of the trituration as can 
be carried on the point of a penknife, administered dry (undissolved), 
at the same intervals, until amelioration or change; but if, after the 
lapse of forty-eight hours, or even a shorter period, the exudation, 
fetor, and swelling increase, proceed to select another remedy. 
Kali JRichroniicum. In the event of no improvement, from thirty- 
six to forty-eight hours after the employment of Mercurius Protiodatus, 
and particularly when the disease extends into the posterior parts of the 
throat, and thence into the nostrils, Kali Bichromicum should be selected. 
It is, moreover, indicated by a tough and stringy discharge from the nose 
or mouth ; pain in the left ear; swelling of the glands under the ears; 
croupy cough; measle-like eruption, and red and shining tongue. 
Dose : As directed under Mercurius Protiodatus. 

Acidum Nitricum, When, notwithstanding the employment of 
Acidum Mar., or Mercurius, superficial patches of exudation continue to 
present themselves; and when the throat, in place of healing, becomes 
painful and of a vivid-red color ; also, when there is a tendency to ulcera- 
tive complication, and the gums are disposed to bleed, this remedy may be 
employed with advantage. It is further indicated by the presence of ulcers 
on the mucous membrane of the mouth, and by an acrid, corrosive dis- 
charge from the nose. 

Do.se.- Two drops of the third decimal dilution in a teaspoonful of 

water, every two hours, until relief or change. 
Kali Chloricam. When, after a period of not longer than forty- 
eight hours, the above described symptoms either remain stationary, or 
become aggravated; or when the gums are more or less red and swollen, 
and the exudation is extensive, but confined to the mouth and palate, Kali 
Chlor., may be substituted with the best results. 
Dose : Same as directed for Acidum Nitricum. 

Phytolacca is a remedy which has been promptly curative in many 
cases of diphtheria, particularly in the mild, or non-malignant variety. 
It is indicated, more particularly, when there is considerable febrile mani- 
festations; headache; violent, aching pains in the back and limbs; great 
weakness, so that the patient cannot stand, and gets faint and dizzy, even, 
when rising up in bed. 

Do.se: As directed for Acidum Muriaticum. 



234 DISEASES OF THE MOUTH AND THROAT. 

Lachesis will prove useful when the inflammation and the diphthe- 
ritic deposit commence on the left side of the throat, and either remain 
there,or spread to the right side. It is further indicated, when the patient 
is always worse after sleeping, and cannot bear the slightest pressure on 
the throat. It is frequently useful after the previous employment of 
Belladonna, and in malignant forms of the disease, when mortification or 
sloughing of the parts threatens. 

Dose: As directed for Belladonna. 

Lycopodiam should be given in mild cases, when the right side of the 
throat is first invaded, and the soreness is aggravated by warm drinks; 
the nostrils are stopped up, and the patient cannot breathe with his mouth 
closed; starting and jerking of the lower limbs; dread of being left alone. 

Dose: As directed for Belladonna. 

Apis Mellifica should be given when there is great debility from 
the commencement of the disease; the false membrane presents a dirty- 
grayish hue; there is puffiness around the eyes,, pain in the ears when 
swallowing j an itchy, stinging eruption on the skin ; numbness of the feet 
and hands. 

Dose: As directed for Belladonna. 

Cantharides will prove very efficacious in many cases when the 
diphtheritic exudation appears in patches; the adjoining surfaces of the 
mucous membrane being of a bright-scarlet redness, with intense burning 
and dryness of the throat, and great thirst, the burning resembling that 
produced by the application of a blister. It is further indicated by 
derangement of the urinary organs, manifested by burning and scalding 
on urinating; or by a suppression or increased discharge of urine; as well 
as by extreme prostration, and an irritable looking rash upon the skin. 

Dose: As directed for Acidum Nitricum. 

HOME REMEDIES.— Frequently gargle or wash the mouth and throat 
with a solution of Salt, Pepper, and Vinegar; or a solution of Saleratus in 
water; or Borax and Alum in a solution of water with a little Brandy 
added, if at hand. The patient should be removed to a clean bed, in a 
dry, well ventilated room, kept sweet and clean, and no one should be 
allowed to sleep in the room except the attendant. All visitors or callers 
should be positively kept out of the sick room. 



MUMPS— PAROTITIS. 

We comprehend under this designation two tolerably distinct condi- 
tions, which have, however, this in common: that the salivary glands are 
the seat, or rather the starting point of the disease. Consequently we 
shall first describe parotitis proper, or an inflammation of the parotid 
gland, together with the non-malignant inflammation of the other salivary 
glands, and afterwards the malignant form of the disease, attended with 
gangrene of the cellular tissue. 

Mumps is generally preceded for a few days by febrile symptoms. 
The patients feel languid, sleep is uneasy, the appetite is gone; headache, 
with a feeling of stiffness in the muscles of the back of the neck, is, 
scarcely ever absent; a slight catarrhal irritation of the digestive tract is, 
likewise, generally present. After these preliminary symptoms have 



MUMPS. 235 

lasted for a short period, sometimes even for several days, the region 
below the ear on one side begins to swell, the swelling spreading very 
rapidly over the cheek and under the jaw ; in a short time the face looks 
very much disfigured by the swelling. The swelling is not very painful 
even to rather hard pressure ; the color of the swelling does not differ 
from that of the surrounding skin, except sometimes a slight redness ; the 
swelling is at times of a stony hardness, at times it is soft, and at other 
times has an uneven feel. The movements of the head, more especially of 
the jaws, are very much impeded. With the appearance of the swelling, 
the general symptoms usually improve, the fever abates rapidly, and the 
patients, in spite of their great disfigurement, feel tolerably well. In 
most cases the swelling spreads to the other side in one or two days, but 
here never attains the same size as on the former side. If the swelling 
runs a normal course, it generally reaches the climax on the fifth day, after 
which it gradually begins to disperse, so that between the tenth and four- 
teenth day no trace of the swelling remains visible. With a higher grade 
of inflammation, or under otherwise unfavorable circumstances, the red- 
ness assumes an inflammatory erythematous character, and suppuration 
may take place, which, in comparison to the size of the swelling, remains 
inconsiderable, but protracts the course of the disease very greatly. The 
swelling takes this course more frequently in the case of adults than 
in that of children; in the case of the former, an inflammatory hardness of 
greater or less extent frequently remains for some time. Only in rare 
cases, or if the affection assumes a certain degree of malignancy, as it 
sometimes does in certain epidemics, the brain may become involved in 
the process. What is more frequently the case is, that the testicles, or the 
labia majora, swell suddenly, while the swelling about the neck disap- 
pears; both swellings may, however, co-exist. 

Secondary parotitis occurs in the course of many acute diseases, par- 
ticularly typhus; in some typhus epidemics it is a constant sequelae of the 
disease, whereas, in other epidemics, it is entirely absent. The appear- 
ance of the swelling is not bound to any definite period of the disease; at 
times we see it break out at the commencement, at other times during the 
period of convalescence. It is generally preceded by local pains, in- 
creased congestions of the head, even delirium and chilly creepings ; its 
rapid development is seldom attended with abatement of *the fever. The 
further course of the local process is similar to that of the genuine mumps; 
the swelling either scatters or else it terminates in violent inflammation 
with suppuration, which, during a state of great constitutional prostra- 
tion, may assume a malignant form, with the discharge of pus. Whereas, 
in the former case, parotitis always indicates a favorable course of the 
general disease; the formation of pus, on the contrary, always portends 
danger, and is, at least, a disturbing complication. It is difficult to deter- 
mine beforehand of what character the swelling will be ; but when paro- 
titis sets in at the acme of the disease, it is always more dangerous than 
when it occurs at the commencement or during convalescence. Here, 
too, as in the case of mumps, an induration may be left behind for a long 
time. In isolated cases, of either variety, the ear seems to be affected, 
hardness of hearing, and discharge of pus from the ear, remaining after 
the disappearance of the swelling. 



286 DISEASES OF THE MOUTH AND THROAT. 

The cause of parotitis is involved in obscurity, in so far as we are 
unable to determine by what atmospheric or other influences the disease 
is caused. Its epidemic character leads us to adopt the existence of some 
peculiar miasm, similar to the miasm of typhus, cholera, etc. We know 
that the common epidemic mumps prevail most frequently in the fall and 
spring. But it is a mystery why the parotid gland should be invaded in 
acute diseases of the general organism, in one epidemic quite frequently, 
in another scarcely ever ; or why, at one time, it should be harmless, and 
at another time a phenomenon portending great danger. This difference 
accounts for the circumstance why some consider this form of parotitis a 
dangerous, and others a trifling, disease. 

An inflammation of the other salivary glands often accompanies par- 
otitis as an accessory disorder. Numerous facts lead us to believe that 
each separate salivary gland may become the seat of an affection like 
mumps. After very acute diseases, we have often noticed stony swellings 
of the lesser salivary glands of a very obstinate character, and running 
their course amid a general prostration of strength. 

ALLOPATHIC TREATMENT. The treatment of parotitis (or mumps.) 
only requires soothing applications, as warm fomentations and wool, flaru 
nel, or cotton batten to the neck. Severe pain will call for an anodyne 
for its relief. Opium combined with Hyoscyamus is generally the best 
for this. A pill of a grain each of Extract of Opium and Hyoscyamus at 
night, and repeated once or twice in the twenty-four hours, will generally 
be effectual. Generally, when warm applications are used, the addition 
of a little Laudanum to the fomentation will suffice. The bowels should 
be kept regular. The diet should be light. Milk is the one article which 
seems best suited. 

HOM(EOPATHIC TREATMENT. In ordinary mumps, which run a 
very rapid and painless course, it makes very little difference what medi- 
cine is given ; indeed, the affection might safely be left to take its own 
course. However, inasmuch as we cannot well know what the final ter- 
mination of the affection may be, it is best to always give the suitable 
remedy, since we can rest assured that under its use suppuration will only 
take place exceptionally. The best remedy is Mercurius. The specific 
action of Mercury upon the salivary glands is well known. It not only 
increases the secretions of these glands, but likewise causes a real inflam- 
mation in the body of the glands, which may readily terminate in suppu- 
ration, as is often seen in the violent treatment of diseases with large 
doses of Mercury. No remedy prevents suppuration as certainly as 
Mercurius. Belladonna deserves a preference, if the constitutional symp- 
toms are very severe, and the swelling assumes an erysipelatous char- 
acter. 



TOOTHACHE.— ODONTALGIA— PAIN IN THE TEETH. 

When we find a constant disposition to this painful condition of the 
teeth on the slightest exposure to cold, or indiscretion in diet, without 
any other presumable cause, or what is generally called rheumatic tooth- 
ache, we are warranted in concluding that some taint lurks in the consti- 
tution which must be sought for, and, if it can be, eradicated. Otherwise, 
the best selected remedies will frequently fail in affording relief where 



TOOTHACHE. 237 

most expected, or, if relief is obtained, it is only temporary. By common 
consent, this, and all other diseases of the teeth, are turned over to the 
dentist, and as they are now generally educated and fully prepared for 
their professional duties, this custom is becoming more and more general, 
and now it is safe to depend on them to do the best that can be done 
for you. 

ALLOPATHIC TREATMENT. Toothache maybe neuralgic, and if so, 
will be treated as described for that disease. When resulting from a 
decayed tooth, a drop of Carbolic Acid, or Tincture of Opium (Laudanum,) 
Aconite or Belladonna usually gives relief. Rinsing the teeth with a 
solution of baking soda sometimes accomplishes the result. Often in 
instances of old, decayed teeth, inflammation of the fang has occurred. 
Heat may then relieve, or the discharge of a little blood may accomplish 
the result. Generally, however, the advice of a dentist should be fol- 
lowed. 

HOM(EOPATHTC TREATMENT. Mcrcurius holds a front rank 
among medicines, being indicated by pains in decayed teeth, or in the 
roots of the teeth, frequently occupying one whole side of the head and 
face, extending even to the ears, loosening of the teeth, and a feeling as if 
they were too long. The pain becomes worse towards evening, and espe- 
cially at night in the warmth of the bed, is worse after eating or drinking 
anything cold. Swelling and inflammation of the gums. This medicine 
is, especially, useful to persons who are subject to swelling of any of the 
glands of the body. 

Dose : Four pills or a small powder of the 3d x potency, every two or 
three hours until improvement or change. 

Belladonna. When the pains are very severe, of a drawing, tear- 
ing or shooting nature in the teeth, face, and ears, with swelling of the 
cheek, dryness of the mouth or excessive secretion, like salivation ; great 
thirst. Pains come on suddenly, and leave just as suddenly ; face flushed 
and eyes red. 

Do.se: Six pills every two or three hours. 

Bryonia. Pains in sound teeth. Sensation of being too long, with 
drawing, jerking pains. Worse at night, and from taking anything warm 
in the mouth. Constipation, stools dry and hard as if burnt. Improved 
by being still, and cold applied in the mouth. 

Dose : As for Belladonna. 

Chaniomilla. After taking cold when in a perspiration. The pains 
are drawing, jerking, beating or stitching. Intolerable pains at night, 
driving one to despair. One cheek red and the other pale. Becomes 
almost furious about the pains. Worse in the open air. Very impatient. 

Dose: As for Belladonna. 

Pulsatilla. Suited to persons of a mild disposition, easily moved to 
tears. Toothache, with earache or headache. Pains as if the nerve was 
put on the stretch and suddenly let go again, like a piece of rubber. Bet- 
ter from cold things, and worse from warm. Chilliness, even in a warm 
room . Scanty or suppressed menses. 

Dose: Five pills every three or four hours. 

Sepia. Toothache during pregnancy, where there is sallow complex^ 
ion, with spots on the face. 

Dose: As directed for Mercurius. 



■238 DISEASES OF THE MOUTH AND THROAT. 

Nux-vomica. Sore pains or jerking, drawing stitches in the teeth 
and jaw. Worse early in the morning. Where the result of mental labor, 
sedentary habits, or constipation, or the use of intoxicating drinks. 

Dose: As for Belladonna. 

Sulphur. Where Nux. appeared indicated, but failed. Pains in hol- 
low teeth. Made worse by cold drinks. Burning heat on top of the head. 

Dose: As for Pulsatilla. The thirtieth potency is best. 
o 

SC UB VY-SCOBB UTIS. 

Scorbutis (scurvy) will scarcely be met with in the history of the fam- 
ily that is even moderately well supplied with a variety of food; 
though lack of food in proper quantity and quality is the chief cause of 
the disease, exposure to wet and cold, bad ventilation and depression of 
spirits causing indifference to food, may be added as causes of the disease. 
For its prevention, and also its cure, these causes may be removed. The 
diet should be composed of articles which will supply the system with its 
needed elements. Of these, I believe, milk stands first. Fresh meat and 
fresh vegetables, in great variety, with fresh fruits and starchy food, are 
to be freely given. The apartments should be warm and well ventilated. 
When the skin is dry, warm baths are called for. Constipation is to be 
relieved by injections or mild laxatives. Diarrhoea will call for the 
astringents directed in the treatment of that disease. 

ALLOPATHIC TREATMENT. Pains in the limbs or joints can gen- 
erally be relieved by rubbing them with a mixture of Laudanum and 
Turpentine in equal parts. If it is too irritating, a little Sweet Oil may 
be added. Or a liniment of equal parts of Tincture of Aconite and 
Chloroform, and two parts Soap Liniment, maybe used. 

Tonics are generally called for. The Citrate of Iron and Quinine in 
doses of two or three grains, meet the end required. Bitter infusions 
made with an ounce of the crude drugs (Peruvian Bark, Gentina, Quassia, 
etc.), to a pint of hot water, in doses of half a wineglassful, before meals, 
will answer the purpose. If this be used, the Tincture Muriate of Iron 
should be given in doses of ten to twenty drops, in sweetened water, 
after each meal. 

The juice of lemons, oranges, or limes should be given to the extent 
of the patient's wish. Cream of Tartar (Bitartrate of Potash) may be 
given quite largely, as having a direct effect on the disease, in doses of a 
teaspoonful several times a day. A couple of teaspoonfuls four times a 
day, is thought, with reason, capable of preventing the disease, when the 
supply of fresh vegetables, etc., is deficient. 

A solution of Alum will generally suffice as a mouth wash, called for 
by the condition of the gums. Other astringents may be used. 

Hemorrhage will be met by scruple doses of Gallic Acid, or teaspoon- 
ful doses of Ergot, or Turpentine in doses of fifteen drops, given on sugar. 

A similar condition of the system to that existing in this disease, 
which results from continued prostrating disease, is to be met with the 
same remedies. 

Much of the so called scurvy of the gums results mostly from neg- 
lect of cleaning the teeth, "tartar'' accumulates on them, and the gums 
become unhealthy. The proper course is, to have the tartar removed by 
a dentist, and then kept off by frequent and thorough brushing. 




the digestive TRACT. (See page 23fl 



THE HUMAN TEETH. 

VIEW OF THE HUMAN TEETH. 



239 




NAMES OF THE HUMAN TKETH. 



1, 1. Middle incisors. 

2, 2. Lateral incisors. 

3, 3. Canine. 



3, 7, 



4, 4. First bicuspidate. 

5, 5. Second bicuspidate. 
Molars. 8, 8. Wisdom. 



THE DIGESTIVE TBACT. 

The Alimentary Canal, the principal portion of which is showm opposite, 
is a most important factor in the physical economy, and in proportion to its 
performance of the function belonging to it is the general health of each 
individual. The liver is shown lifted up from its normal position on the 
stomach V in order to bring to view the latter organ, and expose the gall 
bladder III. The gall is discharged from the bladder into the alimentary 
canal, and there performs its important functions. That part of the human 
organism here represented is subject to many diseases. The abused stomach 
V often punishes its possessor by Dyspepsia in its many forms. The liver 
is frequently inflamed or ulcerated and in other ways affected, but is not 
the part really affected in one-half the cases where it gets the credit of being. 
"Liver Complaint" is most frequently a false name for dyspepsia. The 
ulcers which give rise to the excessive pain and tenderness in Typhoid fever 
{•re found in the glands in that portion of the small intestines indicated by 
TX, the illium. The bladder XI also has to bear its share of the ills flesh is 
heir to. 



PART FIFTH. 

o 

THE DIGESTIVE FUNCTIONS. 

«> 

CHAPTER XII. 



DISEASES OF THE STOMACH AND INTESTINES. 



BILIOUS COMPLAINTS, OR DYSPEPSIA. 

Bilious complaints have, of late years, become the popular term for 
almost all derangements of the digestive functions. The truth is, how- 
ever, that in affections of this nature, although in very severe cases, the 
liver or biliary system is more or less powerfully affected, yet it is gener- 
ally so only by sympathy; and the real seat of the disorder is in the 
stomach and bowels, except, indeed, amongst natives of the temperate 
zone, resident in tropical climates, or, who have recently left the tropics. 

In considering the various forms of the derangement of the stomach 
under the general, more appropriate, and more comprehensive designation 
of indigestion, therefore, we shall have occasion to include the majority of 
those symptoms, which are ascribed to the two opposite causes of derange- 
ment, inactivity of the liver, and too great a secretion of bile. 

Indigestion, ok Dyspepsia. Nausea, Eructations, Depression of 
Spirits, and other Sympathetic Affections. What is termed Indigestion, 
may be identified as the prolific parent of Chronic Disease. 

This disease, however, appears in so many forms, that we shall simply 
content ourselves here with sketching out a general outline of its chief 
distinguishing features, and enumerating some of the principal predis- 
posing and exciting causes to which it may usually be traced, directly or 
indirectly. 

Predisposing Causes. Close, unhealthy, ill-drained, ill-ventilated 
dwellings; the atmosphere of some factories; hereditary or other constitu- 
tional defects ; the influence of the atmosphere of particular climates and 
localities; exposure to unhealthy exhalations; the water of particular local- 
ities, which is impregnated with mineral substances, (such as lead) and in 
which the diseases of this nature assume an endemic character, etc 

Exciting Causes. Irregularities in diet— such as an over-indulgence 
in the pleasures of the table, partaking of rich and indigestible food and 
stimulating soups; excess in the quantity of food; excessive use of wine, 

240 



DISEASES OF THE STOMACH AND INTESTINES. 241 

malt and spirituous liquors, tea, coffee, and other stimulants; imperfect 
mastication of food, irregularity of, or too long fasting- between meals; 
indolent or sedentary habits; exhaustion from intense study; keeping late 
hours; mental emotions; reaction from the external surface, etc. 

The foundation of this disorder is frequently laid in early life, by the 
frequent and copious administration of aperients, calomel (in large doses) 
and other deleterious drugs ; and the evil is perpetuated in more mature 
age, by a continuance of the same absurd and injurious system. 

An abuse of coffee and tea is a frequent cause of many descriptions of 
sick and nervous headache, attended with excitement and symptoms of 
deranged digestion, which will frequently disappear of themselves, on the 
disuse of these beverages. If, however, the troublesome symptoms should 
continue, a course of treatment should be adopted, in conformity with the 
following regulations. 

Indigestion, or that which we understand by the term, is not, how- 
ever, necessarily associated with physical suffering of any kind, much less 
with sensation of pain, or any distinguishable sensation in the stomach or 
intestinal region itself. It very frequently occurs in its worst organic 
forms, without, so far as observed, exhibiting any symptoms whatever, 
developed in the digestive organs themselves. But in such cases, it has 
reacted upon some other portion or portions of the organic structure, and 
may be distinguished in the affections occurring in other organs, and 
which, therefore, very frequently becomes susceptible of mistaken inter- 
pretation. Therefore, in such complicated cases, the most careful review 
of the antecedent course of life, constitution, circumstances, and the like, 
as well as very minute inspection analysis of every symptom, becomes 
necessary to come to a correct conclusion, and thereby to pursue a correct 
course of treatment. In the great majority of cases of chronic disease, in 
fact, which daily occur in civilized life, the original seat of disturbance 
may be identified in the digestive and nutritive functions, whence the pro- 
gress of disease may be traced through the organic apparatus in which 
such functions are lodged to the centers of vital action, and throughout 
the system. 

Abstractedly, the primary disease consists— first of local increase of 
the natural irritability, that is, of irritation, and afterwards, (when this 
irritation has expended itself in exhausting the natural irritability) of com- 
parative deficiency of irritability, that is, of weakness or debility, with 
susceptibility to irritation. But it is worthy of notice, that whilst this 
irritative process, at first purely local and superficial, has exhausted the 
vital energy of the particular organs in which it was first developed, it 
may (even without having possessed sufficient violence to alter the organic 
structure of such parts) have been conveyed through the medium of the 
communicative nerves to the center of sensation — the brain — and conse- 
quently, also, to the mental and moral faculties:— to the center of motive 
impulse— the spinal cord; by regurgitation, or other interference with the 
biliary discharge, or by nervous affinity, etc., to the liver, by insufficient or 
altered supply of material to the blood, through the channels of that fluid 
to the heart; and, owing to similar irregularities, as well as from the 
deteriorated condition of the center of the nervous system to the lungs, 
the skin, and to the motory muscles of the frame. 
16 



242 DYSPEPSIA. 

It is, of course, understood, that the derangement of the stomach, of 
whatever description, may readily be communicated to the intestines, 
and that, more or less, the whole of the apparatus of nutrition, and its 
appurtenances, are directly affected, and, in general, necessarily involved. 

The just appreciation of these facts, pursued by the progressive dis- 
ease, is of paramount importance, because, should affections be developed 
in one or more of these organs which occur sympathetically, and as the 
result of primary derangement of the stomach, it is needless to argue that 
a perfect cure (if yet possible) can only be attained by attacking the original 
seat of disease. The important observance of accessory measures, such as 
the appropriate diet, exercise, habits, and the like, may be materially qual- 
ified by the accurate discrimination of the original derangement. And, 
inasmuch as the original character of functional derangement, or organic 
disease of the stomach, consists of an increase of the natural irritability, 
or of irritation, and the subsequent character consists of a morbid sensi- 
bility (whether there be increase or decrease of sensation), and of conse- 
quent susceptibility to irritation, and as the recurrence of active irritation 
will, in each successive instance, subtract more from the vital energy, or 
sooner or later unhinge the organic structure, and do irreparable mischief, 
—it is sufficiently obvious, that in every disease which owes its origin to 
the stomach, any internal, external, or inducted cause of irritation will 
have a tendency to confirm the disease. Whence, it may be deduced that 
the accessory treatment resolves itself in the most perfect avoidance of every- 
thing stimulating or irritating, whether in the department of diet, in that 
which involves mental or corporeal exercise, or in that which affects the 
mind in its moral capacity, including all emotions, whether productive of 
immediate pleasure or pain. Everything which may tend to engender or 
sustain excitement of any kind, especially, if it operate suddenly, should 
be strictly prohibited. 

Sympathetic Affections of other Functions or Organs. As 
the primary organs of digestion are readily and materially influenced by 
disturbances of the brain and its tissues, so in like manner do we as fre- 
quently find that the brain and the nervous systems in general, sym- 
pathize immediately with the stomach, and are subject to the induction of 
derangement from that source, whether the primary cause affect merely 
the lining membrane, or the tributary nerves:— or, again, whether the 
disturbance in either case be merely functional (affecting the operation of 
such organs) or organic (affecting their substance). There is, however, 
some difference in these derivative sympathies, both as regards variation, 
intensity, and locality. 

1. Mental derangement upon a given point, or general aberration of 
mind, extreme and restless anxiety, with visionary fears, or apprehension 
without foundation, alternation between extreme excitement and utter- 
prostration or inaction, both of will and of impulse, uncontrolable irasci- 
bility and excitability, morbid impatience, wretchedness with agitation, 
thoughts confined to self, and generally clouded, unaccountable dread of 
undefined ills, conveying an intense inclination to engage actively in the 
investigation of such supposed misfortunes, fitful and capricious temper 
and disposition, and a highly suspicious disposition, etc., may be distin- 
guished as an affection of the tributary nerves of the apparatus of nutrition. 



DISEASES OF THE STOMACH AND INTESTINES. 24o 

2. Pains in various parts of the head, expansive, darting, or spas- 
modic pains of various descriptions and often indescribable, giddiness, the 
multitude of sensations of weakness, of heat or cold, of expansion or con- 
traction, of trembling or uneasiness, convulsive and involuntary move- 
ments of particular limbs or muscles, local or general cramp or spasm, are 
also amongst those symptoms which may be traced to an affection of the 
tributary nerves., 

8. Gradual deterioration of nervous vitality amounting to palsy, and 
temporary or permanent loss of control by volition over the muscles of 
voluntary motion, owing to the nervous implication of the spinal cord, are 
attributable to a similar originating cause. 

4. Sudden arrest of the functional operation of the brain, and tor- 
pidity, numbness, or suspended sensibility of the nervous structure — 
locally or generally— as well as dullness of thought, aversion to exercise 
of the mind or body, general torpor or indolence, listlessness, drowsiness, 
depression of spirits, characterized by constant stupor, sluggishness of the 
perceptive or reflective faculties, vacancy, listlessness, incapability of fixing 
the attention, imbecility without mania, confusion of ideas, irresolute, 
yielding and dependent (submissive) disposition — which arise from deter- 
mination or accumulation of the blood— are associated with derangement 
of the (mucous) lining membranes. 

5. Pains in the head, of a dull, obtuse description, pain in the forepart 
of the head, sick-headache, numbness or dullness of the head, heaviness of 
the head, sensations of smell— whether pleasant or unpleasant— which are 
merely morbid, deficiency, dullness, or suspension in the sense of smell, 
sensations of unnatural tastes in the mouth, and the like are, also associa- 
ted with morbid condition of the lining membrane. 

6. Palsy, occurring suddenly and without premonition, which is attrib- 
utable to an oppressive accumulation of blood, is also amongst the affec- 
tions of the nervous system, which are attributable to the same conditions 
as the last. 

[When both portions of the nutritive organs are simultaneously affected, 
these results may appear in combination]. 

The Lungs and Respiratory Apparatus are liable to be organi- 
cally affected by sympathy with the stomach, when thetributary nerves of 
the organs of nutrition are affected. 

The Liver may be fitfully or occasionally implicated in the general 
derangement, resulting from such affection of the nerves of the stomach; 
but important functional or organic derangement of this organ is gener- 
ally associated with disturbance of the stomach, consisting of morbid con- 
dition of the lining membrane. 

The Heart is, necessarily, more or less affected by both conditions of 
disturbance in the digestive apparatus, because in both there is either defi- 
cient, irregular, or morbid assimilation and distribution of the constituents 
of the blood. 

1. Accelerated action, with, however, imperfect, incomplete, and irregu- 
lar operation of the circulative process, with too abrupt, sudden contraction, 
and, analogically, a spasmodic condition, characterized by quick, pointed 
pulse; or, generally, identified by sudden flushes of heat, or chills, is asso- 
ciated in the generality of cases with disturbance of the nerves of the 
stomach. 



244 DYSPEPSIA. 

2. Retarded action, with, at the same time, the distribution of vitiated 
blood, or with deficient supply of the constituents of the blood, and, con- 
sequently, insufficiency of the volume of that fluid, generally character- 
ized by a slow and tardy, but hard pulse, and attended with coldness of the 
extremities, and general deficiency of the animal heat, may usually be 
attributed to derangement existing in the lining. membrane. 

[When both portions of the nutritive organs are simultaneously 
affected these results may appear in combination]. 

The skin almost immediately sympathizes with the stomach when 
the slightest derangement occurs, being doubly susceptible of the effects of 
impaired circulation of the blood, and of irregular nervous action or sen- 
sibility. Whether one or the other, or both portions of the organs of 
nutrition be affected, and, whether functionally, or organically, the skin 
manifests its immediate sympathy, either in sensation, appearance, feel 
ing to the touch, or all three. 

1. Extreme susceptibility to sensation of cold (or chills,) is more or 
less associated with every variety of derangement of the stomach. 

2. . Sensations of pricking, tingling, crawling, shuddering, itching or 
irritation, burning (flushes of heat,) with redness, further characterized 
by the appearance of marked spots, pimples, and other eruptions, etc., are 
generally associated with derangement of the nerves of the stomach. 

3. Turgid, sallow, dirty hue of the skin, without loss of softness, 
moisture, or elasticity, though usually associated with derangement whose 
seat is in the lining membrane, may be observed in both varieties. 

4. Flaccid or withered, or deadened skin, having the appearance of 
parchment, with general deficiency of sensation, though usually attribut- 
able to the continuance of derangement of the membrane, may also be 
identified in cases in which every other indication identifies the nerves of 
the stomach as the seat of the affection. 

5. Dryness of the skin may be associated with derangement, whether 
functional or organic, of either portion of the apparatus of nutrition. 

The eyes and sight readily sympathize with the stomach, owing to 
the uninterrupted continuity of the mucous membrane of the various pas- 
sages to that which comes into contact with the external portions of the 
eye. Whence watery eyes, dark appearance around the e3 r es, redness of 
the edges and inner surfaces, or swelling of the eyelids, bloodshot eyes, 
glutinous discharge from the eyes (adhesive gum,) which occur as mani- 
festations of irritation or accumulation of blood about the membranous 
surfaces— extending along such membranous surfaces from those of the 
stomach— may generally be associated with disturbance of the lining 
mucous membrane. 

1. Even blindness, from palsy of the nerve of sight, is generally 
dependent upon pressure occasioned by similar local accumulation of 
blood, and is, therefore, associated with a similar cause; although in some 
cases, it may result from affections of the nerves of the stomach. The 
association of other symptoms will be distinctive in such cases. 

The ears and hearing are, also, most frequently affected by irritation, 
accumulation of blood, or dryness (deficiency of wax) extending to these 
organs from the lining membrane of the stomach. It is, however, obvious 



DISEASES OF THE STOMACH AND INTESTINES. 245 

that excessively acute hearing, or total deafness, etc., might result from 
affection of the nerves acting sympathetically on the brain. 

2. Excessive dryness of the ears, sometimes characterized by increased 
sensibility of the organ of hearing, and sometimes by sensation of heat, 
or by burning pain, is usually attributable to derangement of the lining 
membrane of the stomach ; and the same may be said of a sensation as if 
the ears were muffled, a deadness of sound, the internal passages being 
swollen, and the orifice being, consequently, lessened. 

Distinctive Classification of Varieties. It is apparent from 
the foregoing remarks, that we should distinguish five modifications of 
that form of disease which is popularly termed indigestion or dyspepsia: 
namely — 

1. That which is merely functional, or which consists in irregularity 
in the operation of the organ involved. 

2. That which is organic, or which consists in some change in the 
structure of the organ affected. 

3. That which affects the lining membrane of the organ — which is 
at first evidently superficial, and is generally conveyed to contiguous or- 
gans by the irritation extending along the uninterrupted surface of the 
membrane — but which, inasmuch as it embraces the extremities of the 
nerves, may sooner or later become complicated with — 

4. That which is seated in the tributary nerves of the organs of nutri- 
tion — which may therefore be conveyed directly to the substances of the 
brain and spinal cord, through the medium of the nerves which are in 
direct communication with these concentrating points, and from which 
we may anticipate a more immediate development of sympathetic mani- 
festations in the nervous system generally. 

5. That in which the nerves and membranes are both implicated. 
The third and fourth distinctive varieties are those which require the 

most particular investigation; not only because they may or may not 
involve the first two, but, more particularly, because, whether the disease 
be organic or merely functional, the distinction between the nervous and 
membranous varieties will afford the real clue to, or at all events materi- 
ally facilitate, the treatment. 

The initiatory condition, both of nervous and of membranous derange- 
ment of the stomach, is the same; it consists in determination and accu- 
mulation of inactive blood in the vessels associated with the tributary 
nerves on the one hand, or in those connected with the lining membrane 
on the other. In both cases, the first unnatural condition is increase of 
the natural irritability — that is, irritation— respectively of the portion 
affected; and in both cases the exciting cause is something which impedes 
or unduly hurries the natural operation, and consequently excites an irri- 
tative effort in the organ, either to repel the matter which oppresses or 
disturbs it, or to fulfill its functions with that degree of acceleration to 
which it is impelled. 

Disturbance or oppression of the functions of the tributary nerves 
may, therefore, be occasioned (chiefly) either: 1. By the reception of irri- 
tating, stimulating, or indigestible substances into the stomach. 2. By 
superabundance of food, however plain and digestible, too suddenly cram- 
med into the stomach. 3. By the imperfect preparation of the food (by 



246 . DYSPEPSIA. 

mastication, etc.,) before it is conveyed to the stomach. 4. By over-exer- 
tion of the mental faculties of the brain, which operates directly to the 
medium of the communicating nerves. 5. By sudden depression or 
excitement of the moral faculties of the brain (as by passions or emotions 
conveying pleasure or pain). 6. By deficiency of physical muscular action 
(as in sedentary habits), whereby the evacuation of matters rejected (se- 
creted) from the nutritive apparatus is impeded, and whereby, therefore, 
the organs whose function consists in the appropriation of the aliment 
and the expulsion of the residue are opposed with the latter, which gives 
rise to an irritative effort to expel the obnoxious matters. 7. By excess of 
physical muscular action, which compels the organs of nutrition to make 
an undue effort for the supply of the necessary sustenance over and above 
what is ordinarily required. 8. By the abstraction or undue discharge of 
animal fluids (such as blood, sweat, etc.,) which equally renders an undue 
effort necessary for the supply of the deficiency. 9. Generally — by irreg- 
ularity of habits, or by deviation from habitual method, whereby the 
organs of nutrition are either checked or accelerated, or otherwise com- 
pelled to provide for the disturbed balance between the tributary functions 
and the vital energy to which they are subservient. 10. By external 
influences (such as cold, heat, etc.,) whereby the circulating and secreted 
fluids are either too quickly absorbed or dispersed, etc., or, on the other 
hand, are arrested or suspended in their progress, and consequently driven 
back upon the secreting organs, or left to impede the channels through 
which the successive course of secretions, etc., should be circulated or 
dispersed. 11. Which may be superadded to the foregoing general causes 
— by abuse of bitter tonics, sal-volatile, sedatives generally, opium, iodine, 
and mercury, as also by depletive measures in nervous fevers — all of com- 
mon occurrence. 

Respecting disturbance or oppression of the functions of the lining 
membrane ; it may be said in general that the conditions 1, 2, 3, 6, 7, 
8, 9, and 10, just mentioned, operate as exciting causes; but that con- 
ditions 4 and 5 more rarely (if ever) operate as direct exciting causes. A 
twelfth class of causes may, however, be added with regard to this 
variety ; namely— 12. By abuse of arsenic and other mineral tonics, and 
still more frequently of saline purgative medicines. 

Respecting disturbance, implicating both the nerves and the mem- 
branes, it will readily be distinguished that any or all of the conditions 
above mentioned may operate as exciting causes. 

General Symptoms Exhibited by Irritation, etc., of the Lin- 
ing or Mucous Membrane. This variety of the disorder is more 
apt to be developed at the stage of maturity, or within the period of life 
which is termed middle age; and in general, individuals who are little 
susceptible to excitement, whose sensations are not acute, and whose 
temper is even, or whose disposition is indolent or listless, are more 
likely to become thus affected. Distinctively it consists of tardy, insuffi- 
cient, or oppressed functional operation, and of inactive accumulation of 
blood in various parts. The first characteristic manifestation which 
springs from it is acidity— usually, however, attended with little pain; 
regurgitation of food, insipid or acrid risings in the gullet, and heartburn; 
occasionally nausea, but more rarely vomiting; habitual deficiency of 



DISEASES OF THE STOMACH AND INTESTINES. 247 

appetite ; Habitual or continued predominance of thirst, especially in 
obstinate and continuous cases ; dryness of the mouth and throat from 
deficiency of saliva, or thick, adhesive saliva or phlegm in the mouth; 
bitter, sweet, or salt taste in the mouth ; — or, again, insipid, clammy, or 
metallic taste; extreme susceptibility to change of temperature and 
weather, affecting the throat and nostrils, and consequently to relaxed 
or inflammatory so re- throat, or to cold in the head, excessive discharge 
from the nostrils, or continual dryness or itching in the nose, with or 
without altered or diminished sensation of smell ; offensive breath, inter- 
nal dryness with heat of the ears and acuteness of hearing, or internal 
swelling with impeded hearing; humming or buzzing in the ears; red 
suffusion of the eyes and bleared appearance, especially on waking in 
the morning ; dark rim around the eyes, with redness and swelling of 
the inner side and margin of the eyelids ; watering of the eyes: oscillation 
as of fluctuating vapors before the sight ; flashes of light or appearance 
of sparks before the eyes; dark shade as of clouds or flickering of black 
spots before the eyes; adhesion of the eyelids — especially on waking in 
the morning ; yellowish or waxy appearance of the eyelids — with glutin- 
ous matter; in recent or casual cases, and when the affection is neither 
severe nor inveterate, the tongue may be flabby or coated with a brown- 
ish-white fur, but neither very dry nor enlarged; in cases in which the 
liver and first portion of the intestinal tube are affected, the tongue will 
generally be coated in the center with a yellowish fur, somewhat dry, 
the tip and margins being of a bright-red color and free from fur; in 
cases in which the affection is confined to the stomach, but is of a severe 
character and of long standing, the tongue will usually be covered in 
the center with a slimy fur, the margins and extremity being in this 
state, also, free from fur, and exhibiting bright redness; in cases in 
which the nerves of the stomach are also implicated, and in which the 
irritation of both portions is of a most severe and inveterate character, 
the tongue will usually be enlarged, and will exhibit a glistening, white, 
and thin coating in the center, the margins and extremity being free 
from fur and of a bright-red hue; or, again, it may be so much swol- 
len as to become indented along the lateral margins by the impression 
of the teeth ; progressive decay of the teeth ; constant or casual toothache, 
or predisposition to toothache; accumulation of brownish and offensive 
matter on the teeth; yellowness, or blackness, or other discoloration of 
the teeth; offensive exhalation from the gums ; soreness or tenderness of 
the gums; unhealthy and spongy puffiness, or redness and swelling of 
the gums; the gums bleed spontaneously, or are easily provoked to bleed; 
unhealthy, spongy puffiness, or excessive redness and swelling of the lips, 
indicative of recent affection, when associated with such symptoms as iden- 
tify the lining membrane as the seat of disease, but occurring irrespective of 
degree and length of continuance, when associated with such symptoms as 
identify the nerves as the seat of the disease; scaliness of the lips; in cases 
in which the liver and first portion of the intestines are implicated in the 
derangement, we may notice the mottled appearance of the lips; in similar 
cases of longer standing, and of the most inveterate and incorrigible char- 
acter, especially if continual excess in the use of fermented liquors, and 
particularly of ardent spirits, has been the exciting cause of disease; sallow 



248 DYSPEPSIA. 

whiteness and hardness of the lips may be exhibited, or what lias been 
oppositely described as a waxy appearance; pressive headache, seated in 
the anterior part of the head, or what is called sick headache ; dull or 
intense, fixed, aching pains in the head, with sensation of confusion, heavi- 
ness, and sometimes, also, with giddiness or numbness; general uneasy 
sensations about the head, or as if the contents were expanded; determina- 
tion of blood to the brain, and sudden attacks of apoplexy, without 
premonitory symptoms; dullness and confusion of thought; general 
dullness of sensation ; tardiness of conception ; reflection and motion ; 
vacancy and incapability of fixing the attention for any length of time; 
drowsiness, or even lethargy, general indolence and inaction, or even torpor 
of mind and body; excessive reluctance to move or exert one's self in any 
way; deep depression of spirits, with listlessness; deficient vigor of will, 
and consequent irresolution and indecision ; hard but tardy pulse, generally, 
also, decreased in frequency; unhealthy pufiiness of the body, morbid accu- 
mulation of fat ; flabby skin; muddy, sallow complexion; and, in severe 
and obstinate cases, chippy,deadened, parchment-like skin; inaction, or 
even torpor of the bowels; and, therefore, suspension of evacuation; slow, 
tardy evacuations, or evacuated matters paler than in health ; habitual 
constipation. 

General Symptoms Exhibited by Irritation of the Nerves. 
This variety of the disorder is more apt to be developed amongst females 
and young persons ; and, in general, individuals of acute sensibility, of 
active, restless habits, of quick impulses, excitable and irritable disposition, 
choleric temperament, and of spare, wiry frames, are not liable to be thus 
affected. Distinctively, it consists of inordinate, irregular functional oper- 
ation, resulting in defect in the distribution of. blood, or even of the quality 
of the blood distributed. The first characteristic manifestation which 
springs from it is flatulency ; this variety of the disorder being, also, char- 
acterized by the multiplied development of pain, and painful or otherwise 
acute sensations — or, in the worst and incurable cases of organic disorder, 
total suspension of pain, which has previously been acute, and of w r hich 
the cause is not removed ; intense and pressive pain at the lower part of 
the chest, sometimes extending through the body; wrenching, gnawing 
pain at the pit of the stomach; sinking at the stomach; heart-burn very 
predominant; nausea, and generally vomiting; irregular, fitful, capricious 
appetite, either inordinately voracious and insatiable, or very deficient, or 
more generally greater than in health, but sometimes, also, in very severe 
cases, totally suspended; eating provokes or aggravates the suffering; 
stimulants, and even hot plain drinks, have the same effect; eructations 
and hiccough, and, in fact, all manifestations of spasmodic contraction of 
the muscles, connected with and operating upon the stomach; conse- 
quently, general spasm of the stomach ; thirst usually absent, occurs fitfully 
or irregularly, but sometimes of excessive temporary intensity; morbid 
taste in the mouth, chiefly the metallic ; thin, acrid saliva ; fitful or period- 
ical pains in the teeth, of the most intense and distressing description; 
lips habitually of an over-vivid redness, or spongy ; morbid acuteness of 
the senses of smell and hearing ; occasional darting, fugitive or distracting 
pains in the cavity of the ear, and deep in the head ; the tongue generally 
free from coating, but of a bright red, fiery hue; in cases which are of 



DISEASES OF THE STOMACH AND INTESTINES. 2-^9 

recent occurrence, there will not, usually, be either swelling or dryness of 
the tongue, but the extremity will exhibit a species of roughness from 
papillary elevations ; in more severe and old established cases, the redness 
of the tongue will be further qualified by dryness and glistening appear- 
ance (glossy surface); in cases in which the intensity of the irritation may 
have become complicated with sympathetic affection of the brain, the red- 
ness of the tongue will be further qualified by general swelling, and, 
sometimes, also, by aslight degree of white coating, not sufficient, however, 
to conceal the characteristic redness of the surface beneath; the tongue 
much swollen, and deeply intersected with fissures, indicates a very serious 
advancement of the disorder ; the swollen tongue, with a bright, glistening, 
white surface, whereby is conveyed a distinct indication of severe sympa- 
thetic affection of the brain, as in highly hypocondriacal subjects, especially 
those who have been treated with large doses of mercury ; the co-existence 
of both varieties of the disorder of considerable duration, is evinced in the 
swollen tongue, of which the margins and extremity are red, but the center 
is slightly covered with a glistening white coating; the tongue quivers on 
protrusion (whereby is identified a sympathetic affection of the spinal cord). 
The change from vivid redness, with or without swelling, but without 
coating, to brownish hue, and more or less thick coating, implies a modifi- 
cation of the disorder, or progress towards cure. In general, moreover, 
we may notice every variety of hysterical or hypochondriacal excitement; 
unaccountable uneasiness and restlessness; sudden fits of laughter, or the 
contrary, the one terminating in, or alternating with the other, apparently 
without a cause, or provoked by very slight causes ; sudden starting or 
shuddering; incessant tossing about, or moving from place to placp; general 
or local convulsive movements of every description, such as trembling, 
jerking of the limbs, coughing; convulsive cough, difficult respiration, and 
sensation as of a ball rising in the throat; cramps in the muscular parts; 
chattering of the teeth, or clenching of the hands and teeth, or grinding of 
the teeth during sleep; an interminable variety of erroneous impressions, 
upon which the mind harps with persistency, and which appear to haunt 
the patient more painfully at stated periods ; intense and restless anxiety 
about one's self, one's affairs, one's health, with impulses even to self- 
destruction; extraordinary exaggeration of every feeling; intense sensi- 
tiveness of temper and disposition ; intense impatience, not only of contra- 
diction, disapp intment, vexation or pain, but even of one's own moral 
feelings; excessive irrascibility and excitability; temporary suspension of 
control over the muscles of voluntary motion ; sudden local and temporary 
paralysis; apoplexy ; pains in the head, of various descriptions, giddiness, 
sensation of weakness in the head ; Tic-Douloureux, or nerve-pain in the 
face, etc.; pains on one side of the head; darting pains, starting from one 
point, and piercing the head in every direction; pains in the back of the 
head; darting pains in the eye balls; pains which seem to run from one 
extremity of the body to the other, leaving an indescribable sensation after 
them ; palpitation of the heart; quick, and sometimes small and frequent 
pulse; anxiety and oppression of the chest; flushes of heat, with patchy, 
circumscribed, or suffused redness; crawling, pricking sensations in the 
skin ; redness and swelling of the gums and lips; spare, meager, or even 
withered frame ; great deficiency of flesh ; scanty and wiry flesh ; irregular 
operation of the bowels, both as to the frequency and the nature of the 
motions, which vary in color and consistency. 



250 DYSPEPSIA. 

ALLOPATHIC TREATMENT. Exemption from inconvenience, with 
the mind pleasantly occupied during eating and digestion, as is the case 
when in agreeable company, frequently enables the patient to indulge the 
appetite freely, without inconvenience, but when they dine alone they 
experience trouble during or after the meal. In the latter case, they watch 
carefully the sensations of digestion, while in the former case, the diver- 
sion of the mind causes the unpleasant experiences to disappear. Good 
cheer and a good moral are valuable both in the way of prevention and 
cure of dyspepsia. 

As to diet, there is no doubt that when the dyspepsia succeeds over-in- 
dulgence of the appetite, one of the first things to be done is to give the 
stomach rest for a time, by abstaining from food or by taking less than the 
patient requires. The period to which this is appropriate is of short dura- 
tion, and must not be continued long enough for the system to become 
reduced. This abstinence may, of itself, become a cause of dyspepsia, as 
is the case when persons attempt to live on as little and as coarse food as 
possible. 

The food should be simple, but nutritious, and taken in ample quanti- 
ty and variety. Often it is an object of treatment to overcome the errone- 
ous idea, that various healthy articles of food do not agree with him. Food 
which is wholesome for most people cannot be harmful for any. It is often 
said that " what is one roan's meat is another's poison," but there is scarcely 
a maxim which is more generally untrue. Almost all cases of dyspepsia 
can, and should conform to the ordinary rules of diet, and not to any parti- 
cular rules. He should take, from time to time, any and all articles of 
wholesome food, and aim to eat like a well person without the need of 
selecting food to suit his particular case. In most cases of dyspepsia lean 
meat is digested the best, especially, from mature fat animals. It 

should be plainly but well cooked, never fried. Sometimes milk with 
starchy articles of food, such as bread, rice and the like agree best. Doubt- 
less milk is not healthy when taken on a full stomach, in large quantities, 
but if taken with the understanding that it is hearty food, it will almost 
never disagree. Bread, to be in its best condition, should be in that state 
between fresh and stale. Corn meal, oat meal, and cracked wheat or Gra- 
ham mush, and boiled rice, are easily digested. Ripe fruits partaken of 
moderately are beneficial. Pastries, rich puddings and sweetmeats are 
inappropriate. 

The kind of food most appropriate will vary, as it is found that the 
digestive derangement is in the stomach or intestines. If in the former, 
starchy articles and fat will agree best, but if in the latter, meats, eggs, 
and milk will be found most appropriate. 

The habits regarding eating should be regular, but at the same time, 
the dyspeptic ought never to go hungry. If no breakfast or an insufficient 
one has been taken, a lunch in the early part of the day is desirable. His 
most hearty meal should be at an hour that can be followed by leisure and 
recreation. Often a little food had better be taken before retiring at 
night. No one ought to go to bed hungry. Hearty indulgence of the 
appetite is not to be permitted, but moderation is to be practiced until the 
digestive powers increase, when food may be taken in larger quantities. 



DISEASES OF THE STOMACH AND INTESTINES. 251 

Only a moderate amount of liquid should be taken at the meals, but liquids 
may be freely taken between meals. 

Regular habits of life, early hours, plenty of sleep and such changes in 
the occupation as will secure sufficient bodily exercise and relieve from 
harrassing care and troubles of business, a rest of one day in seven, horse- 
back riding, a daily cool or tepid sponge bath, and abandoning the use of 
tobacco and alcohol, will cure most cases of dyspepsia. 

It is a common, and truthful saying in the main, that exercise will 
cure dyspepsia, but if taken simply for exercise it becomes neglected and 
tends to keep the mind of the patient on his disorder, which is harmful. 
It is, therefore, desirable that the mind of the patient may be turned 
from his dyspeptic trouble, that he adopt such a mode of life as will, of 
itself, require a requisite amount of exercise in the open air. Most, if not 
all these requisites are secured by an overland tour in our own country 
and mountains, or by foreign travel. 

I believe exercise never should be carried to the point of exhaustion, 
but should be sufficient to have earned a good sleep of eight hours at 
night. 

The benefit which can be derived from medicines is secondary, but 
important. The uneasiness of the stomach may sometimes be relieved 
by a counter-irritant over the stomach, as a small blister, or rubbing the 
skin with a liniment made of equal parts of Ammonia water, (hartshorn,) 
Turpentine and Olive Oil, or a couple of drams each of Croton Oil, Tur- 
pentine, and Olive Oil. 

If the blood is impoverished, and the appetite is poor, bitter infusions 
(teas), made of Colombo, Gentian, Cinchonia Bark, or Quassia,etc, in the 
strength of one ounce of the crude (dry) drug to the pint of hot water. 

Dose: Two or three tablespoonfuls before eating. 

The Tincture Muriate of Iron may be given in doses of fifteen drops 
in sweetened water, after eating. The Citrate of Iron and Quinine, in 
doses of two to five grains, in solution, in water or syrup, almost always 
answers the same purpose as both the foregoing. 

Digestion is often greatly helped by the use of Lactic or Hydrochloric 
Acids and Pepsin; the liquid Pepsin made by Sheffer's formula, combines 
both the Hydrochloric Acid and the Pepsin: Take of Sheffefs Sacehurated 
Pepsin a hundred and twenty grains, water Jive ounces, Hydrochloric Acid 
a dram, after solution is made, add of Glycerine three ounces. 

Dose: A dessertspoonful before eating. 

When Lactic Acid is given, it may be combined with Elixir of Pepsin. 
Take of Lactic Acid one ounce, Elixir Pepsin, seven ounces. Mix. 

Dose: A dessertspoonful. 

Or, a good formula, is this: Take of Glycerole of Pepsin three ounces, 
Lactic Acid an ouivx. Mix, and give a ttaspoonful after each meal. If 
Iron is required, half a dram Lactate of Iron can be added to this mixture. 
In case the Hydrochloric Acid is used, if Iron is also given, it should be 
the Muriate Tincture of Iron. In case of acidity and heartburn, the acid 
mixture should be given before meals, instead of after. 

Should this not relieve, Bismuth, in doses of fifteen or twenty grains, 
with a little baking Soda or Saleratus, may be given after meals, upon the 
development of this symptom. Soda is to be preferred in doses of five or 



252 DYSPEPSIA. 

ten grains repeated as often as the acidity (heartburn) occurs. The Soda 
may be given alone. 

Flatulence and wind in the intestines is best relieved by the continued 
use of Nux-vomica. Ten drops of the Tincture of Nux-vomica, in water, 
or a quarter of a grain of the Extract in pill, or, a thirtieth to a twentieth 
of a grain of Strychnine, may be given three times a day. If Strychnine 
is used, sugar coated pills containing a thirty-second part of a grain may 
be given. Care should be used, that the pills are soluble; they should be 
soft under the sugar-coating. In solution, it is intensely bitter. For its 
administration, take of Sulphate of Strychnine a grain, or, a grain and a 
half water thirty-two drams. Mix. 

Dose; A teaspoonful three times a day. 

In extreme instances, when everything is vomited, the so-called milk 
cure is often appropriate. In its use all other food is omitted. A couple 
of tablespoonfuls with lime-water, is given every three hours during the 
day, and the quantity gradually increased until the invalid can take one 
or two glassfuls four times a day. One or two quarts is generally the 
amount that can be taken in the day. It is best given a little warm. The 
quantity of lime-water should be one-fourth that of the milk. If neces- 
sary, the milk can be flavored with a little coffee. Other useful proceed- 
ures are counter-irritation, as above suggested, a drop of Cresote in water, 
after each act of vomiting. Bismuth and Nux-vomica, also, as above 
directed, etc. 

HOMCEOPATHIC TREATMENT. Nux-vomica is particularly appli- 
cable to the treatment of indigestion in hypochondriacal subjects. It 
covers the following symptoms, either when they have arisen in conse- 
quence of sedentary habits, excessive mental exertion, or loag watching, or 
of overloading the stomach, of excessive draughts of milk, or even water, 
or of eating or drinking acid things, or of using spices and seasoning to 
excess ; or, again, in cases in which all food or drink, however plain, light 
and digestible, provokes indigestion ; or from the abuse cf coffee, tobacco, 
wine or ardent spirits ; or, again, when the irregularity of digestion has 
been induced or confirmed by loss of animal fluids (profuse sweating, 
bleeding, and the like,) or by habitual recourse to aperients ; the head con- 
fused, with, occasionally, a feeling as if resulting from intoxication, and 
giddiness, with sensation of turning and wavering of the brain ; headache, 
unfitting for, and increased by mental exertion; tearing, drawing, or jerk- 
ing pains in the head or cheeks, and pulsative pains, and a sensation as if 
a nail were driven into the brain; congestion of blood to the head, with 
humming in the ears. The headaches are often deeply seated in the brain 
or in the back part of the head, frequently confined to one side, or over the 
eyes, and at the root of the nose, coming on chiefly in the morning, after a 
meal, or in the open air. Yellowness of the lower part of the white of the 
eyes, with a mist before them ; a sensation as if one were about to fall; 
sparks, or small gray or black spots before the eyes; short-sightedness ; pale 
or yellowish color, or redness of the face, especially, about the mouth and 
nose; frequent headache, and impaired powers of digestion, with insipid- 
ity of food ; foul, dry white or yellowish tongue; vivid redness of the mar- 
gins of the tongue ; thirst, with water-brash, particularly after acids or 
rich food; accumulation of slimy pJdegm or water in the mouth; metallic, 



DISEASES OF THE STOMACH AND INTESTINES. 253 

salt,sulphurous, herbaceous, bitter, sour, sweetish or putrid taste, chiefly in 
the morning, or after meals; bitter eructations, or continued nausea, espe- 
cially after meals, or even after drinking cold water or milk— or on going 
into the open air after a meal, or after partaking of acids ; heartburn, hic- 
cough, acidity, flatulence, frequent and violent vomiting of food, phlegm, 
or bile, ineffectual efforts to vomit; distention and fullness in region of the 
stomach, with excessive tenderness to the touch ; a feeling of tightness of 
clothes round the upper part of the waist; cramps of the stomach ; constipa- 
tion; reddish urine, with brickdust- colored sediment; sleep unrefreshing 
and restless, either from suffering or otherwise, with disagreeable dreams, 
and drowsiness in the morning; tendency to exacerbation of symptoms 
during the prevalence of a northerly or easterly wind, or when the atmos- 
phere is loaded with vapor; better after warm food. 

One of the mosc distinctive indications for the employment of this 
remedy, in preference to the next mentioned, is the temperament, which is 
restless, irritable, lively and choleric. A disposition to piles is, also, a good 
indication. 

Dose: Three globules, in a teaspoonful of water, night and morning, 
for a week; then pause four days, resuming the same remedy in a 
similar course, or suspending treatment, or proceeding with another 
medicine, according to the circumstances which are present. 

Cocculus is appropriate to the treatment of highly bilious subjects, or 
when the derangement can be traced, however remotely, to long watch- 
ing or intense application to study; or when coffee, tobacco, or brandy, 
can be traced as the exciting cause. It may, generally, be employed in 
cases in which moroseness and hypochondriacal disposition are marked 
characteristics, either before, after, or in alternation with Nux-vomica, 
according as the characteristic effects of the one or both most clearly cor- 
respond with the case. 

Dose : Three globules, in a teaspoonful of water, every twelve hours, 
until amelioration or change. Or if, again, Cocculus be apparently 
inadequate to complete the cure, consider the next remedy. 

Carbo-veg. is, especially, appropriate to the treatment of derange- 
ments of this nature, occurring amongst persons of advanced years: or 
when the derangements can be distinctly traced to long-watching, to 
abuse of wine, of ardent spirits, of coffee, to milk-diet or casual use of 
milk, to excessive use of butter, or to rancid butter, to fat and greasy 
things, such as pork, to fish, especially, if tainted, or to shell-fish in partic- 
ular, to flatulent vegetables, etc., to pastry or acid things, to excessive 
use of salt, or unguarded use of ices, or very cold drinks. This remedy is 
particularly indicated by excessive and constant flatulence, with heavy 
respiration, repugnance to animal food, or, especially, to fat or greasy 
things, or to milk, and when acidity is constantly provoked by such food ; 
bitter taste in the mouth; accumulation of phlegm in the gullet and 
stomach ; frequent empty, sour, or fitter eructations, etc. 

Dose: Three globules, in a tablespoonful of water, every twelve hours. 

Pulsatilla is indicated by a series of symptoms very analogous to 
those which have been enumerated under the head of Nux-v., but with 
this distinction, that it is particularly adapted for females generally, (es- 
pecially for hysterical subjects,) children, individuals with light hair, and a 
marked predisposition to purulent exudations at the edge of the eyelids, 



254 DYSPEPSIA. 

or to styes, and for mild or phlegmatic dispositions. Under such condi- 
tions it is appropriate to the treatment of derangements of the stomach, 
occasioned by excessive application to study, overloading the stomach, 
abuse of wine, spirits, beer, coffee, or rich chocolate, by excessive draughts 
of milk, or even of water, by new, slack-baked, or otherwise unwholesome 
bread, or butter, fat or greasy things, tainted or unwholesome meat (pork 
especially,) by eating oysters or tainted fish of any kind, by pastry, flatu- 
lent vegetables, fruits, or by ice cream ; or even when an external injury 
(as a strain) has been the exciting cause of the ailment. Amongst its 
characteristic indications, we more frequently find a want of thirst, than 
thirst; a repugnance to fat and rich meat, and suffering after taking pork 
or pastry; general chilliness, or great difficulty in keeping the hands and 
feet sufficiently warm ; deficient sense of smell, sometimes accompanied 
by increased secretion from the nostrils; frequent and loose, or difficult 
and loose, or sluggish evacuations ; hypochondriasis, and convulsive fits 
of laughing and crying. 

Dose : Three globules as directed for JXux-v. 

Ignatia may, in some cases, be employed twelve hours after the fourth 
dose of Pulsatilla, if the latter has failed in affording permanent relief, 
and does not promise to complete the cure. It may, also, in some cases, 
be employed before or instead of Pulsatilla, when there is a tendency to 
alternations of exuberant and depressed spirits, or particularly, if grief be 
associated with the derangement. Ignatia is, also, appropriate for the 
treatment of derangements of digestion occurring amongst highly hys- 
terical females; or of cases which result from abuse of coffee, beer, bran- 
dy (or even ardent spirits, in general,) milk, sweet things, or tobacco. 

Dose: Three globules in a teaspoonful of water, three times a day. 

^Bryonia is often appropriate to the treatment of derangements of 
the stomach, associated either with a hypochondriacal or hysterical dis- 
position, or with habitually sedentary habits ; or when occasioned by 
depressing emotions, by chocolate, milk, new or slack-baked bread, 
tainted sausage meat, flatulent fruit or vegetables, or pastry; the 
indicative symptoms are as follows: Headache, burning or expansive, 
particularly after drinking, attended with bewilderment of the head 
and giddiness; tongue glazed, dry, and red, or covered with a whity- 
yellow fur; sometimes the aversion to food is so strong, that the 
patient cannot bear the smell of it; loss of appetite, alternately with 
unnatural hunger; craving for acid drinks; great thirst; insipid, 
clammy, putrid, sweetish, or bitter taste in the mouth ; acidity and 
flatulence, or bitter risings after every meal, or after partaking of 
milk. Hiccough, nausea, water-brash, vomiting of food or bile, par- 
ticularly at night ; tenderness in the region of the stomach to the touch, 
sensation of swelling in the pit of the stomach, especially after a meal, 
or on walking; sensation of burning in the pit of the stomach, especially 
when moving. Constipation, temper, restlessness, irascible and obsti- 
nate ; also, when want of exercise or anger are frequently the exciting 
causes of the derangement, or the means of aggravating the indigestion. 
The indigestion is more apt to manifest itself in summer, or in damp 
weather, with a northerly or easterly wind, and is frequently accom- 
panied with chilliness. 



DISEASES OF THE STOMACH AND INTESTINES. SSOO 

Dose; Three globules in a teaspoonful of water, every twelve hours, 
until amelioration or change. In cases in which the sufferings are 
very great, the like dose should be repeated every three hours 
during the attack, until the symptoms subside or change. 
Rhus-tox., which is particularly appropriate for the treatment of 
indigestion resulting from mechanical injuries (such as a strain), or when 
beer, spirits, coffee, milk, copious draughts of cold water when heated, 
new or slack-baked bread, taiuted sausagc-nieat or fish (especially shell- 
fish, as muscles,) may directly have provoked the attack. The specific 
symptoms are as follows: Flat, sticky, sweetish, bitter, or foul taste in the 
mouth ; drowsiness, eructations, and sensation of fullness, languor or gid- 
diness, after eating ; a sensation of repugnance to food, especially, to meat, 
bread, etc., or sensation of satiety ; or want of appetite, with hankering 
after dainties; continued-, empty, painful and noisy eructations ; offensive 
and very abundant flatulency; the derangements of the digestive func- 
tions more apparent and troublesome at night ; distention and pressure in 
the region of the stomach. Extreme depression of spirits, despondency, 
insuperable anxiety, and uneasiness respecting affairs. 

Dose: Three globules, in a teaspoonful of water, every four hours, 
until the symptoms are modified, and then every twelve hours, until 
positive change. 
Natrum-m. is particularly appropriate to the treatment of chronic 
eases occurring amongst hypochondriacal subjects, or, sometimes, of preg- 
nant females; or when habitual excess in the use of fermented liquors has 
been the chief cause of derangement; or when milk diet, mineral waters 
of particular localities (unless brackish,) or the water of hard springs and 
mountain streams — or unwholesome bread, or fat and greasy food (especi- 
ally pork,) — or excess in the use of fruit or tobacco, may be distinguished 
as associated with the origin of the affection. Natrum-m. is generally 
useful in such obstinate chronic cases as have resisted the operation of 
Bryonia, Nux-vomiea, etc., and which are characterized by frequent 
attacks of morning sickness, or by heartburn after every meal, water- 
brash, constant nausea, occasional sensations of faintness, pressure in the 
stomach, or intractable humor after eating, and Obstinate costiveness, or 
when milk, and liquids in general, invariably disagree. 

Dose: Six globules in a tablespoonful of water, every morning, the 
first thing (fasting,) ten days (unless earlier improvement ensues,) 
then pause four days, resuming the same course, if necessary, and 
so on. 

Kali-bich. is particularly applicable to the treatment of chronic cases 
in which milk, bread, fish, or pastry, constantly disagree with the 
patient. The distinctive symptoms are as follows : 

Indigestion, with aggravation of symptoms in the morning and dur- 
ing movement, relieved after eating (sometimes, however, a distressing 
feeling of weight is experienced after a meal ;) mouth and tongue dry ; 
thick yellow fur on the tongue; conflux of water in the mouth ; metallic, 
acid taste; want of appetite, nausea, flatulence, frequently accompanied 
by colic. Constipation or hard stools, attended with straining and burn- 
ing in the outlet; alterations of hard and relaxed motions, great sensibil- 
ity to cold air, complications with affections of the liver and spleen; 
extreme depression of spirits, hysterics. 

Dose: As directed for Natrum-m. 



256 DYSPEPSIA. 

Chamomilla is of great service in some derangements resulting from, 
or associated with, excess in the use of coffee or sweet things ; or more 
especially depressing emotions, such as vexation, disappointment, a fit of 
passion, and the like ; or again, if the derangement has been provoked by 
check of perspiration. The characterizing symptoms are as follows : 

Headache, with, sometimes, semi-lateral pulling, shooting, fullness, 
and beating in the head ; giddiness and staggering in the morning, when 
getting up ; oppressive heaviness, swimming in the head, and sensation 
of a bruise ; headache, felt sometimes during sleep, with obscuration of 
the eyes, and yellow color of the whites ; tongue dry and cracked, with a 
thick and yellowish coating; mouth dry, with occasional presence of 
frothy phlegm ; excessive thirst and desire for cold drink ; bitter taste of the 
mouth and of food; want of appetite and dislike to food. Acidity or 
sour risings, regurgitation of food, nausea, vomiting of food, phlegm and 
bile; oppressive pain in the region of the heart, distention at the pit of the 
stomach and upper part of the waist, chiefly after eating and at night, 
attended with disquietude and terror ; burning pain in the pit of the 
stomach; uneasiness, and feeling of sinking in the stomach ; crampsinthe 
stomach, especially when traceable to coffee; sometimes constipation, but 
generally relaxation of the bowels. 

Dose: In casual cases, of a solution of six globules to three table- 
spoonfuls of water, give a teaspoonful every three hours, until ame- 
lioration or change. In chronic cases, three globules in a teaspoon- 
ful of water night and morning, until similar variation occurs. 
Ipecacuanha is available for the treatment of indigestion, occurring 
amongst children and pregnant females, or when occasioned by overload- 
ing the stomach, imperfect mastication of food, hurried and voracious 
feeding, or by irregularity of meals, or by abuse of tobacco, or even of 
coffee; or in cases in which veal or other young meat particularly disa- 
grees ; or when cold, nervous excitement, late hours, or over-application 
to study in particular, are to be traced as the exciting causes of derange- 
ment. The distinctive symptoms are: face pale and yellowish ; tongue 
sometimes clean, at others coated white or yellow ; aversion to food, and 
particularly to fat or rich indigestible food, such as pork, pastry, etc., or 
suffering from indigestion on partaking of such ; vomiting of drink, food, 
phlegm, or bile, sometimes after a meal ; retching, easy vomiting, gener- 
ally attended with coldness of the face and extremities, and sometimes 
alternation with watery looseness of the bowels, feeling of emptiness and 
flaccidity, and sensation of sinking at the stomach. Headaches attended 
with nausea and vomiting ; shooting pains, with heaviness and painful 
pressure on the forehead. 

Dose: Against the acute symptoms, when present, of a solution of 

eight globules to a wineglassful of water, give a teaspoonful every 

hour, until amelioration or change; against the chronic aspect of 

the affection, that is, the recurrence of the acute symptoms, give 

three globules in a teaspoonful of water, night and morning until 

distinct change. 

China is appropriate to the treatment of derangements of this kind, 

according to the subjoined indications, when occurring in aged persons, 

or in patients of a hypochondriacal disposition, particularly if the loss of 

animal fluids, or mental affliction be distinguishable as the predisposing 

cause, or when the suffering can be attributed to overloading the stomach, 



DISEASES OF THE STOMACH AND INTESTINES. 257 

to excessive indulgence in strong tea, or, in some cases, to abuse of spirit- 
uous liquors or coffee, to milk diet, or to unguarded or too copious 
draughts of water; or again, when bread, butter, fat and greasy things 
generally disagree, or when tainted fish has been the immediate cause of 
derangement; or, again, if the symptoms can be traced to flatulent food, 
over-indulgence in fruit or spices and other seasoning, or, in some cases, 
to tobacco ; or, again, when every kind of food provokes an attack. This 
remedy is a valuable auxiliary in the treatment of this derangement, 
when there is impaired appetite with great weakness of digestion, which 
is more liable to be experienced on partaking of supper ; flatulence, bitter 
taste, languor, hypochondriacal disposition, and particularly when we 
can trace the affection to debilitating losses of fluids, such as the abstrac- 
tion or loss of blood, too great a drain upon the resources when nursing, 
prolonged use of aperient medicines, etc., also in disorders arising from 
the abuse of tea, or from a residence in impure atmospheres, especially 
such as are overloaded with the exhalations of decayed vegetable matter, 
where the drainage is insufficient, the cultivation imperfect, where stag- 
nant pools or ditches, charged with rank matters, abound, more particu- 
larly in the midst or vicinity of half-dried marshes, or on a level with 
them, or in such position in relation to them as exposes the habitation to 
the current of prevalent winds from them, or near the beds of periodical 
streams, when the water ceases to flow, and the bed appears to be dried 
up (especially in warm climates,) or when the rays of the sun have great 
power; or, again, in districts which are habitually dry and well drained, 
but which have been extraordinarily saturated by a wet season, and are 
beginning to dry up again. 

Dose: Six globules, night and morning, one week; wait four days, 
and if still indicated by the symptoms present, resume the admin- 
istration of the same remedy night and morning, every fourth 
day. 



DEBAXGEMEXT OF THE STOMACH ABISIXG FROM 

CASUAL CAUSES-XOT HABITUAL. 

This should be understood to apply to those who are only casually 
affected, but whose digestion is habitually unimpaired. 

Causes. — The ordinary causes of this derangement are, hurried, im- 
perfect mastication ; overloading the stomach; f ac, greasy, indigestible 
or tainted food, flatulent vegetables, ices, stimulants, and others equally 
well known. 

HOMOEOPATHIC TREATMENT. When the symptoms of approach- 
ing derangement of the stomach declare themselves immediately, or a few 
hours after a repast, which has been too freely partaken of, a cupful of 
strong coffee, without milk or sugar, is frequently a sufficient restorative. 

Should, however, this fail to relieve, and sick headache and inclina- 
tion to vomit be present, we should assist nature by various artificial 
means— the milder, if sufficient, the better— such as tickling the throat 
with a feather, and by giving te./id water to drink until the stomach has 
completely evacuated its contents. 
17 



258 DERANGEMENT OF THE STOMACH. 

Bryonia is very serviceable, when the following symptoms are pres- 
ent: bitter eructations; fever, alternately with coldness and shivering, a 
redness of the face, heat in the head, and thirst with coldness and shiver- 
ing; also, when looseness of the bowels or constipation, and peevishness 
or excessive irritability are present. In derangement of the stomach, 
arising from succulent vegetables, and attended with excessive flatulence, 
this remedy is frequently productive of speedy relief. 

Dose : Of a solution of six globules, to two tablespoonfuls of water, 
give a teaspoonful every two hours. 

Arsenicum. When there are acrid and bitter eructations with nau- 
sea and vomiting; also dry tongue, excessive thirst, salt taste in the 
mouth, and burning or violent pressure in the stomach, with diarrhoea 
or colic, and griping in the lower part of the belly, particularly when 
arising from the effects of an ice which had been partaken of, the patient 
being warm, or from fruit, stale vegetables, or acids. 

Dose: Three globules, in a teaspoonful of water, every three hours, 
until amelioration or change. 

Carbo-vegetahilis is a very valuable remedy in this affection, either 
for the initiatory treatment, or after the previous administration of one 
or more of the other remedies, according to indications, for the purpose 
of removing any symptoms that may remain ; it is, moreover, particu- 
larly useful where great susceptibility to the influence of the atmosphere, 
particularly to cold, exists at the same time; or in suffering arising from 
abuse of wine, ices, or salt ; further, in derangement of the stomach, aris- 
ing from having partaken of game or fish which has been too long kept, 
or meat that has been re-cooked whilst in a state of fermentation, which is 
liable to occur in warm weather; in the latter instances, Carbo-v is to be 
preferred to any other medicine, and will rarely fail to afford relief. 

Dose: Of a solution of twelve globules, to three tablespoonfuls of 
water, give a teaspoonful every four hours, until amelioration or 

change.* 

Nuoc-vomica is indicated bj- offensive or acrid eructations, constipa- 
tion, and confused headache, particularly, when arising from previous 
intoxication, or even slight over-indulgence in wine or other stimulants ; 
when possible, it should be taken the same night, as when taken in the 
morning, although eventually relieving, it frequently causes an aggrava- 
tion for a few hours. In derangement of the stomach, with heartburn, 
flatulence, more or less nausea and headache, etc., in consequence of a 
chill or of indulging in mental or corporeal exertion immediately after a 
meal, this remedy commonly affords speedy amelioration. 

Dose: Four globules, in a teaspoonful of water. 

Arnica is indicated in cases of derangement of the stomach, charac- 
terized by eructations resembling rotten eggs. 

Dose: Of a solution of eight globules, to two tablespoonfuls of water, 
give a teaspoonful every three hours, until amelioration or change. 

Pulsatilla, in recent cases of deranged digestion, with rising of food, 
tongue foul, and covered with phlegm; chilliness, and lowness of spirits; 
and, also, when a rash has been thrown out, in consequence of the 

*A small quantity of finely powdered charcoal, in a little good French brandy, or water, will be 
found an equally efficacious mode of administering this remedy, as a corrective against derangement of 
the stomach, arising from having partaken of tainted meat or fish. 



DISEASES OF THE STOMACH AND INTESTINES. 259 

derangement. This remedy is almost specific, when the disturbance has 
arisen from the effects of rich food, such as pork, or pastry, or eveu tainted 
meat, or from the effects of ices, cold fruits, or crude vegetables, acid or 
impure wine, etc. 

Dose: Four globules, in a teaspoon ful of water. 

Obstinate Chronic Cases of Functional Derangement.— In 
cases of derangement of the functions of digestion, which, though modi- 
fied, are extremely difficult of removal, the remedies hereinbefore noticed 
will be required for initiatory treatment; but, in the majorty of instances, 
the patient will have to be subjected to an appropriate course of such 
remedies as those hereto subjoined, in order to complete the cure. 

Sulphu r is one of the most important remedies for administration 
after the previous exhibition of Nux-vomica or Pulsatilla, and in cases 
which would otherwise correspond with the indications for either of those 
medicines, but when either of them has been inadequate to effect a perfect 
cure. 

Dose: Six globules in a wineglassful of water, every morning the first 
tiling (fasting) for ten days, (unless there be earlier improvement or 
change,) then pause four days, resuming the course similarly, if 
necessary, and so on, from time to time, until positive amelioration 
or change. 

Hepar Sulphnris is also of great value in cases in which the diges- 
tion is naturally weak, and sour vomiting, with burning sensation in the 
throat, colic and looseness of the bowels, are liable to be provoked by the 
slightest error in diet, and particularly when anything of an acid nature 
has been partaken of; or especially in cases in which the patient has previ- 
ously taken blue pills, or any other mercurial preparation, for a considera- 
ble time. 

Do.se : If singly, three globules in a teaspoonful of water, night and 
morning, for a week, (unless earlier and decided improvement or 
change ensue,) pause four days, and resume the course, if necessary, 
and so on, from time to time, until amelioration or change ensues. 

Sepia is also indicated by a sensation of coldness, and is to be preferred 
to either of the preceding remedies, when this symptom is associated with 
a multiplicity of other equally characteristic indications, particularly if 
there be no appetite, or voracious appetite, and aversion to meat or milk, 
water-brash, especially after drinking; constant acidity of the stomach, 
aggravated by eating, and, if fat things, milk, etc., continually disagree. 

Dose: Four globules night and morning. 

Silicea is, especially, indicated when the patient entertains a repug- 
nance to cooked food, and is particularly averse to meat; when the patient 
is subject to severe pains in the stomach, attended with excessive thirst 
and water brash, bitter taste in the moutli in the morning, vomiting after 
drinking, and habitual nausea predominating after a meal, or upon rising 
in the morning. 

Dose: Six globules in a wineglassful of water, every morning the first 
thing (fasting,) until amelioration or change. 

Carbo-vef/. Here, again, this remedy is peculiarly valuable when 
annoyance or inconvenience is felt after every meal, amounting to nausea 
and vomiting, attended with excessive flatulency, and when the pit of the 
stomach is tender on pressure. 

Dose : Three globules in a teaspoonful of water, until amelioration or 
change. 



260 DERANGEMENT OF THE STOMACH. 

Obstinate Chronic Cases of Organic Derangement. In cases 
in which organic disease has been established, that is, in such cases as 
assume the critical aspect described in the general description of symptoms 
at the commencement of this article, it were desirable, if possible, that the 
interference of an experienced Homoeopathic practitioner should be 
invoked. 

General Derangement of the Stomach in Children. The fore- 
going particulars, applying to general cases, are equally to be kept in view 
in considering this affection, more particularly amongst children ; but as 
the causes and features of such derangements are necessarily far less com- 
plicated amongst children than amongst adults, it may save the adminis- 
trator much trouble to extract and render in a summary form, such details 
respecting the treatment of this affection amongst children, as will other- 
wise be gathered only in scattered portions of this article. 

Ipecacuanha, Pulsatilla or Carbo-veg. These medicines are of 
chief importance, either for independent, alternate, or successive adminis- 
tration, in cases in which hurried feeding (bolting the food,) imperfect 
mastication, and overloading the stomach, or rich, indigestible food, can 
be distinctly traced as the exciting causes of derangement. The particular 
indications for each may be gathered from those details v/hich have already 
been afforded. 

Dose: If singly or successively of either remedy, two globules in a 
teaspoonf ui of water, every three hours, until amelioration or change. 
If in alternation, dissolve eight globules of each remedy, separately, 
in a wineglass of water, and give a teaspoonf ul, first of one solution, 
then of the other, so that an interval of four hours shall elapse 
between the doses, and so on, until amelioration or change. 

Pulsatilla, Arsenicum or Carbo-veg. These are in like manner 
appropriate in cases in which ices or cold fruits have been the exciting 
causes of derangement. In this instance, also, the particular indications 
f<u each may be gathered from the foregoing part of this article. 

Dose : In every respect as directed in the forgoing prescription. 

Pulsatilla, China or Carbo-veg, These medicines selected accord- 
ing to the indications afforded in respect of each, in the former part of 
this article, are particularly appropriate to the treatment of derangements 
of digestion, occurring amongst children, in consequence of having eaten 
tainted meat or fish. 

Dose : In every respect as directed in the foregoing prescription. 

Carbo-veg. 9 or Arsenicum. These medicines, respectively, accord- 
ing to the indications hereinbefore afforded, respecting each, are most 
appropriate, in the generality of cases, to the treatment of derangements 
of digestion occurring amongst children, as the result of excessive use of 
salted articles of diet, especially salt meat. 

Dose : Of either medicine, give two globules in a teaspoonf ul of water, 
every four hours, until amelioration or change. 

Aconitum, Arsenicum or Carbo-veg. These again occur as the 
most important remedies whence a selection should be made according to 
the special indications for each, which have already transpired in previous 
portions of this article, when acids (such as vinegar, etc.,) are identified as 
the exciting causes of derangement. 

Dose: Of the remedy selected as directed in the last prescription. 



DISEASES OF THE STOMACH AND INTESTINES. 261 

SYMPATHETIC AFFECTION OF THE BRAIN AND NERVOUS SYSTEM. 

Depression of Spirits. — Hysterical and Hypochondriacal Affections. 
These most distressing results of long-continued or very severe derange- 
ment of the digestive functions, are almost invariably associated with 
what is termed "chronic indigestion," and not un frequently afford an 
important clue to the treatment of the primary seat of disease. But 
nothing can be a greater source of error in most cases, than to deal with 
them as primary diseases of the brain and nervous system. Depression 
of spirits may occur as the consequence of derangement, either of the 
nerves or lining membranes of the stomach, but with very different char- 
acteristic features ; for when the nerves are the seat of the disease, restless 
and uneasy anxiety, sudden fits of violent excitement, extreme irritabil- 
ity, impatience and despondency with violent impulses, are the result; 
when, however, the lining membrane is the seat of disease, extreme depres- 
sion of spirits occurs associated with languor, utter prostration, indolence, 
and listlessness. 

SulpJiur is appropriate to the treatment of both varieties, but is 
more especially indicated by the indolence of mind and body, or by the 
vacancy of thought, or absence of mind and irresolution, which character- 
ize the latter ; it is, however, also appropriate when the depression of 
spirits is associated with painful anxiety of mind, extreme solicitude con- 
cerning the future and respecting one's health and affairs, erroneous or 
exaggerated notions on given subjects, general wretchedness without any 
ascertainable reason, sudden fits of violent excitement and periodical 
return of extreme impatience, restlessness, irritability and impatience, 
when the following symptoms are also present : — sensation of fullness and 
weight at the pit of the stomach; habitual constipation, headache, and 
particularly pain at the top of the head; dullness and heaviness of the 
head, the patient being unable to exert his mental faculties, or becoming 
exceedingly weary and exhausted after any application of this kind; 
disposition to piles; or when chronic eruptions and affections of the skin 
are associated with the complaint. 

Dose: Repeated doses are generally required, administered thus : For 
adults six globules, or for young persons four globules in a wine- 
glassful of water, every morning the first thing (fasting,) for ten 
days (unless new symptoms or a change in the nature of the symp- 
toms be sooner developed) then pausing for a week, and resuming 
the like course, if necessary ; and so on until distinct amelioration 
or change; if in alternation with Calcarea, commence with three 
doses of Sulphur, as just described; pause four days and then 
administer three doses of Calcarea likewise, and so on until amelior- 
ation or change. 
Calcarea is indicated by depression of spirits, with disposition to 
tears ; flushing of blood to particular parts associated with attacks of inde- 
scribable anguish, and generally palpition of the heart, or painful sensa- 
tions in the region of the heart ; general uneasiness with aversion to 
mental or physical exertion ; despondency respecting one's health, and 
apprehension of death ; dread of mental aberration — or of contagion, or 
other causes of disease, or of imaginary misfortune ; and when there is 
intense acuteness of all the senses. 

Dose: In every respect as directed for Sulphur, whether singly or in 
alternation. 



262 DERANGEMENT OF THE STOMACH. 

Natrum-m. is indicated by depression of spirits accompanied with 
apprehensive foreboding, and with fretful, tearful disposition with des- 
ponding expression ; love of solitude, which, however, nourishes the disease, 
and dread of society, whereby, however, it is alleviated ; occasional bursts 
of violence; disgust of lite; habitual moroseness and incapacity of mental 
labor ; weakness of digestion characterized by aggravation of the suffer- 
ings, mental as well as bodily, and by general and indescribable uneasi- 
ness after a meal, and until the proper maceration of the food is completed 
in the stomach and has been conveyed to the bowels, or by susceptibility 
to the recurrence of such symptoms provoked by the least excess or irre- 
gularity ; headache and want of appetite ; nausea occurring every morn- 
ing, etc. 

Dose : Six globules, or for young persons four globules, in a wineglass- 
ful of water every morning, the first thing (fasting,) until amelior- 
ation or change. 

Auram-met 9 is indicated by incapability to concentrate the reflective 
faculties, and want of power of combination in the mind, characterized by 
crushing headache after the least exertion of the mind, or attention, and a 
sensation as if the brain were dashed to pieces; painful anxiety of mind 
and excruciating restlessness; whining, fretful disposition and dread of 
death. This remedy is often of great service against the hysterical attacks 
of females. 

Dose : As directed for Natrum-m. 

Lachesis is particularly indicated when the patient is haunted by the 
idea that he is the object of dislike, suspicion, or even hatred amongst his 
friends. 

Dose : Three globules in a teaspoonf ul of water, morning and evening, 
until amelioration or change. 

Nux-vomica is indicated by almost every variety of nervous,hysteri- 
cal or hypochondriacal derangement, either characterized by indolence, or 
excitability, but especially the latter ; deep despondency with disgust of 
life, moroseness, and aversion to labor or exertion of any kind, character- 
ized by the following symptoms : excessive sensitiveness, and aversion to 
the open air ; fainting Jits, after the least exertion, especially after motion 
in the open air, or giddiness, sensation of being stunned, and sparks or 
black spots before the eyes under the like circumstances; sensation of 
heaviness in the body, with weariness, languor, and great desire to assume 
or retain a recumbent position, by which the symptoms are alleviated; 
emaciation, and wiry condition of the flesh; intense sensation of lassitude 
and fatigue,, even in the morning after rest, and often excitability which 
renders the patient reluctant to retire to rest at night : drowsiness in the 
morning, after meals, or in the evening, followed by sleeplessness at night; 
sallow, pallor or yelloioness of the skin ; heaviness, with pressive, tensive 
and expansive pain in the head ; intense headache seated in the fore part 
of the head along the brows; or pain — often acute and piercing, as if some 
sharp instrument were lodged there— deep in the brain; swelling and 
redness of the eyelids, and red suffusion of the eyes, particularly in the 
morning; cramp-like, contractive gnawing or pressive pains in the region 
of the stomach and below the ribs, and at the pit of the stomach ; extreme 
sensitiveness of the pit of the stomach to pressure; constipation, character- 
ized by slow and sluggish action of the bowels, with dark, hard, dry, and 



DISEASES OF THE STOMACH AND INTESTINES. 263 

large but unfrequent evacuations— or by intermingled, loose, and lumpy 
evacuations; particularly appropriate, if there be disposition to piles; 
frequent discharge of pale, watery urine — dragging and rheumatic aching 
pains in the back towards night; contused pains in the loins and back ; 
numbness of the arms at night. 

Dose: Three globules in a teaspoonful of water, night and morning, 
until a degree of good effect results, and then four globules in a tea- 
spoonful of water every night, until positive amelioration or change. 
After which a course of Sulphur, as above directed, will usually be 
beneficial. 

Phosphorus is particularly appropriate for the treatment of delicate 
and highly hysterical females, and fair subjects of a spare and slender 
frame, and is indicated by sadness, alternated with apparently good spirits 
(with mirth) ; attacks of indescribable anguish, affright — and even distres- 
sing hallucination, when left by one's self or during stormy weather; timid 
disposition, startled at every sound and apprehensive of thieves and acts 
of violence, etc., painful anxiety, or uneasiness respecting one's health. 

Dose: Four globules in a teaspoonful of water every night, until 
amelioration or change. Suspending treatment for four days after a 
a weeks course. 

China is indicated by distress, languor, or dullness of mind, the 
patient being easily disheartened and laboring under the impression that 
insuperable combinations are devised against him by adversaries to frus- 
trate every undertaking ; the patient gives way to despondency, and is 
overcome by a prevailing idea, that he is doomed to be unfortunate — symp- 
toms which are characterized by the following: weakness of digestion, with 
recurrence or aggravation of symptoms generally, and with indolent dis- 
position, ill-humor and distention of the belly, after eating; chronic 
relaxation of the bowels; loose, yellowish, or slimy evacuations, or char- 
acterized by discharge of undigested food ; or pale evacuations with dark 
urine ; small, detached evacuations with slow and sluggish discharge, and 
with deficiency of muscular vigor in the intestines ; sometimes the organs 
of sense are acutely sensitive; sleeplessness occasioned by the crowding of 
ideas upon the mind, and by visionary projects, or sleep much disturbed 
by anxious, painful dreams, which continue to haunt the patient when 
awake, and attended with frequent change of position and tossing. 

Dose: Three globules in a teaspoonful of water, night and morning, 
until amelioration or change. 

Sepia is of pre-eminent service in many confirmed and inveterate 
cases, particularly in females, and when complicated with severe hyster- 
ical affections; the patient being wholly abandoned to despondency and 
weary of existence, anxious respecting her own health, but averse to the 
consideration of household or other affairs, and often indifferent to every 
one but herself. 

Do.se : As directed for China. 

Silicea is of great service, generally, in obstinate cases of hypochon- 
driacal affection, resulting from stomach derangement, particularly, if 
noise easily frightens or startles the patient, or if there be constant 
anxiety and agitation, weakness of the memory, incapability of reflection, 
moroseness and taciturnity, intense irritability and tendency to be pro- 
voked to violence by contradiction, or excessive weariness of existence, 
further characterized by confusion of the head, or of ideas; pain ascend- 



264 NAUSEA. 

inyfrom the nape of the neck to the top of the head; headache recurring 
every morning ; heat in the head, particularly in the forehead ; lacerating 
or darting pains in the head, or pulsating headache, with flushing of 
blood to the brain ; temporary defect or suspension of vision ; confusion 
and mistiness of sight when reading; redness of the eyes and adhesion 
of the eyelids at night; the strong light of day is painful to the eye; 
bleeding at the nose; continued and watery discharge from the nose ; con- 
stant sneezing; hardness of hearing; scabby eruption on the lips, or 
swelling of the glands of the lower jaw; toothache at night, aggravated 
or provoked by hot or cold things ; soreness of the tongue, or dryness of 
the mouth ; deficiency of taste, or bitter taste; acid risings and water- 
brash, or pains in the stomach or bowels, or even vomiting after eating ; 
nausea every morning ; colicky pains associated with constipation ; pierc- 
ing or nipping pains in the bowels ; puffing of the belly, and difficult 
expulsion of very fetid flatulency; hard stools with constant urging, or 
constipation characterized by hard, knotty, detached motions, evacuated 
slowly and with difficulty; wetting the bed; looseness; suffocating cough 
at night ; aching pain in the chest, and impeded breath ; numbness of the 
arms induced by lying upon them; trembling of the knee; offensive 
smell from the feet; cold feet, sweating of the feet, or lastly, cramps of 
the legs, particularly during rest and after exertion. 

Dose: As directed for China. 

Accessory Treatment and Diet.— In no class of disorders is it 
more requisite to adhere strictly to dietetic regulations, than in those 
which consist of derangement in the digestive system, whether so-called 
functional or organic; the patient should, therefore, in such cases, regu- 
late his regimen as closely as possible, by the rules laid down at the com- 
mencement of this treatise (pp. 73, 74,) carefully avoiding, moreover, all 
such articles as he may find disagree with him, even if they be allowable 
as a general rule. 



NAUSEA. 

With respect to this affection, which must be considered purely as a 
symptom, the reader is referred to the foregoing portions of this article, 
wherein directions have been given for the treatment. In the majority of 
simple and casual cases, however, it might suffice to consider the indications 
afforded for Ipecacuanha, Cocculus, Nux-vomica. Bryonia, Chamomilla, 
Pulsatilla, and Aconitum, following the same regulations respecting the 

dose. 

In inveterate cases, however, in which this symptom occurs continu- 
ously, the accurate investigation of all symptoms associated with it, and 
of the whole of the foregoing details, becomes necessary, and one or more 
of the following remedies, according to the directions hereinbefore offered, 
may become necessary. Natrum-m., Arsenicum, Lycopodium, Lachesis, 
Carbo-veg., Rhus-tox., or Silicea. 

Five grain doses each of Oleate of Cerium and Sub-Nitrate of Bismuth 
every hour. 

One drop of Carbolic Acid or Creosote in water, every hour, or 

Five drops Prussic Acid in water, every hour, until the nausea ceases, 
are quite effectual remedies. 



DISEASES OF THE STOMACH AND INTESTINES- 265 

Cold applications, or mustard plasters, may be applied over the stomach, 
and are useful. 

If irritating substances are known to be in the stomach, an emetic 
should be given at once ; twenty grains of Ipecacuanha, with water, is most 
suitable. After free emesis lias been produced, some of the above remedies 
should be given to quiet the stomach. A sixth or a fourth of a grain of 
Morphine should be given, if there is pain or cramp in the stomach. 



ERUCTATIOJSS. 

H03HE3PATHIC TREATMENT. With reference to eructations, as 
well as to nausea, as they must be considered purely as symptoms, the 
reader is referred to the foregoing portions of this article, wherein more 
distinct indications have been afforded, to facilitate the selection of the 
appropriate remedy. In most cases of a simple and uncomplicated char- 
acter, the consideration of such indications as are afforded for the admin- 
istration of the following remedies (chiefly) both as to selection and dose, 
will be sufficient to meet the requirements of the case: Arnica, Nux- 
vomica, Pulsatilla, Sulphur, Bryonia, Carbo-veg., Chamomilla, Cocculus, 
China, Antimonium-crudum, and Antimonium-tartaricum. In cases of 
an inveterate nature, and which are evidently associated with complica- 
tions involving the whole of the digestive and nutritive system in more or 
less continual derangement, it may be advantageous to consider the indi- 
cations afforded for Sepia, Acidum-sulph., etc. 

ALLOPATHIC TREATMENT. Pyrosis. Sour eructations after meals 
may generally be prevented by taking fifteen drops of Dilute Hydro- 
chloric or Lactic Acid, in sweetened water, before meals. Sulphurous 
Acid, in doses of twenty drops, in sweetened water, before meals, will 
sometimes have a better effect. Either of these Acids often has a better 
effect when given in a teaspoonful of Glycerole of Pepsin. 

Alkalies, to be useful, should be taken when the sour eructation begins 
to appear in an amount sufficient to correct the symptom. Bicarbonate of 
Soda (Baking Soda) is best suited to this end. It is best given in milk or 
water. Alkalies are beneficial when the amount taken can be gradually 
diminished with relief of the symptoms. 

Bismuth is a very useful agent in most of these cases. It is best given 
with a little Carbolic Acid, as in this formula : Take of Sub-nitrate of Bis- 
muth three drams, Carbolic Acid four grains, Mucilage or Gum Arabic one 
ounce, Peppermint Water three ounces. Mix. 

Dose: Shake the vial and give a tablespoonful three or four times a 
day. 

When Bismuth is given alone it is best given in milk. The dose is 
from five to fifteen graius. 



BILIOUS OR SICK HEADACHE. 

In ordinary cases, in which sick headache is evidently the result of a 
casual cause, it will suffice to consider the indications afforded for Anti- 
monium-crudum. Ipecacuanha, Nux-vomica, Pulsatilla and Sulphur; or 
Bryonia, if this symptom be associated with costiveness. 



266 VOMITING OF BLOOD. 

ALLOPATHIC TREATMENT. Bilious or sick headache is, generally, 
relieved by correcting the acidity of the stomach by the use of alkaline 
remedies. The use of the Aromatic Spirits of Ammonia, in doses of a 
teaspoon half full, well diluted in water, is the most generally effectual. In 
cases in which no stimulant is required, the ordinary domestic alkalies, as 
Soda or Saleratus, or a half teaspoonful of Magnesia, may be used in doses 
of from five to ten grains. 

In some cases relief is only obtained after a free vomiting. In such 
cases the quickest relief is procured by giving an emetic of twenty grains 
of Ipecacuanha, or a tablespoon nil of pulverized Mustard in a glass of 
water. 

Ergot has proved, in some hands, to be useful. The Fluid Extract 
may be given in doses of half a teaspoonful to two teaspoonfuls, three or 
four hours apart. 



HJEMATEMESIS, HEMORRHAGE FROM THE STOMACH. 
VOMITING OF BLOOD. 

This is scarcely ever an original affection, but almost always symp 
tomatic of some other disease. 

Vomiting of blood may depend on a variety of causes, and if it 
inclines to become profuse and threatening, it is of the utmost import- 
ance, in practice, to investigate, with accuracy and care, the precise cause 
in each attack. As a complicating symptom, bleeding occurs, more par- 
ticularly, in diseases characterized by a peculiar alteration of the whole 
mass of blood, such as typhus, scurvy, yellow fever, etc. The hemor- 
rhage may be very copious, although none of the larger vessels are rup- 
tured. A second cause of the bleeding is, a rupture of the walls of ves- 
sels. It may be caused by excessive accumulation of blood in the stomach, 
depending upon disturbances, engorgements, etc., of the vena porta, liver, 
spleen — hence, it is not of unfrequent occurrence in the case of individ- 
uals afflicted with piles; or the hemorrhage may be caused by menstrual 
suppressions and stoppages, on which accountit occurs more frequently at 
the climateric age ; it sometimes seems as if the hemorrhage took place 
as a substitute for the menstrual discharge- The vomiting during preg- 
nancy is very frequently stained with blood. The worst kind of bleeding 
arises from injuries of the stomach walls, consequent upon ulcerations of 
the mucous membrane. It is met with in chronic dyspepsia and cancer 
of the stomach. If there is a disposition to bleeding, it may be provoked 
by a blow upon the stomach, a fall, or violent emotion. 

The symptoms of hsematemesis differ, according as the bleeding is 
more or less copious, and arises from different causes. If the bleeding is 
but slight, and the blood is not vomited up, the accident remains some- 
times entirely unnoticed. If the vomited substance only contains a few 
streaks of blood, it has no particular significance, at the time, but the 
patient has to be watched with more care, because we can never be sure 
whether a more dangerous hemorrhage is not threatening. The blood 
should likewise be examined, with a view to discovering disease changes 
that had remained latent heretofore. The bleeding likewise acquires 
importance from the circumstance, whether the blood is discharged 



DISEASES OF THE STOMACH AND INTESTINES. 267 

with violent straining, or is vomited up easily; in the latter case, the 
bleeding is much more significant, on account of its indicating ulceration 
of the mucous membrane, or some important change, dilatation, etc., of 
vessels, whereas a little blood may be discharged in consequence of vio- 
lent straining, even if the vessels are perfectly intact. 

As soon as a somewhat considerable quantity of blood is vomited, a 
series of characteristic symptoms appear. The morbid symptoms that 
already happen to be present, become associated with a constantly increas- 
ing dull pressure in the pit of the stomach, and a distressing feeling of 
distention of the stomach, generally attended with nausea. If the bleed- 
ing takes place slowly, the preliminary symptoms may be confined to 
these few; on the contrary, if the blood is expelled with rapidity and 
force, the patient experiences the usual symptoms of a considerable loss 
of blood, such as anxiety, paleness, cold sweat, cold skin, vertigo, and 
even fainting. A large quantity of blood is vomited up at once, and 
with great force. The action of the gastric juice imparts to it a blackish 
hue, and has the consistence of coagulated sour milk. The quantity dis- 
charged at one vomiting often exceeds one quart, so that it seems scarcely 
possible that the stomach could have contained such a large quantity 
at once. Immediately after the vomiting the patients feel faint and 
exhausted, and are tormented by an almost unquenchable thirst; at 
the same time a visible throbbing occurs in the pit of the stomach, of 
which the patient himself is conscious. After this paroxysm, a period 
of rest and comparative ease sets in, until another attack of bleeding 
occurs. The interval to the next bleeding, lasts from a few hours to 
several days ; in violent cases, four or five attacks may occur on the same 
day; of course, in such a case, severe symptoms of anaemia may set in, 
even unto convulsions, and death may be the immediate consequence. 
If so much blood is expelled from the stomach, the stools are likewise 
black as coal, and very thin; it may even happen that the blood 
is not vomited up first, but that the black stools may be the first sign of 
the bleeding. 

Regarding a return of the bleeding, we cannot speak with certainty; 
it depends entirely upon the primary exciting cause. If there is a fre- 
quent return of the bleeding, anseniia and dropsy are unavoidable 
results. Recovery from a single attack usually takes place slowly, the 
patients being at the same time tormented by a variety of gastric dis- 
orders, such as a burning distress in the region of the stomach, foul 
taste, sweetish or foul eructations, horrid thirst, and by a long-continued 
abdominal pulsation. Under all circumstances, there is great danger 
lest the bleeding should return, hence the patient cannot be too careful 
in not overtaxing the stomach. Bleeding, resulting from ulceration, 
may not afford much relief, but in cases of hcematemesis, of which we 
are unable to discover the exact cause, or which depend upon the sup- 
pression of other hemorrhages, the relief afforded by such bleedings may 
be quite considerable. 

As regards diagnosis, two circumstances may deceive us. In the first 
place a violent paroxysm of haemoptysis may be mistaken for vomiting of 
blood, and the deception may be kept up, if a physician does not himself 
examine the vomit, since patients often are so overwhelmed with anxiety 



268 VOMITING OF BLOOD. 

that they lose all calmness and presence of mind. In other respects the 
black color of the vomit, and the absence of the bloody expectoration, 
which always follows a paroxysm of bloody cough, furnish the surest indi- 
cations regarding the true character of the attack. It likewise happens, 
that a person may have a violent attack of nose-bleed over night, and that 
the blood may be swallowed; if the quantity of the swallowed blood 
becomes excessive, it awakens the person, and the blood is then vomited 
up, and may look precisely as it does when true haematemesis takes place. 
It is difficult to distinguish one from the other; our diagnosis has to be 
more particularly determined by the absence of all precursory symptoms, 
and subsequent gastric derangements. The- use of whortleberries, and 
similarly colored fruit, may likewise occasion a momentary deception, 
more particularly, if the patients are very anxious. 

As a general rule, the prognosis, in all ordinary cases, is favorable, 
except where the hemorrhage is at once so excessive that death results 
from mere loss of blood. The prognosis, however, is always doubtful, in 
so far as a first bleeding leaves an inclination to a renewed attack, and the 
bleeding always indicates the presence of dangerous alterations in the 
stomach. Hence, a permanent cure is never absolutely certain. 

ALLOPATHIC TRE1TMENT. Hjematemesis (vomiting of blood,) is a 
symptom of some other affection, the most serious of which are an ulcer 
or cancer of the stomach. It may be well to enumerate the symptoms 
of hemorrhage of the stomach and hemorrhage of the lungs, inasmuch, as 
by so doing, needless fears may be allayed by fully understanding the 
contrast between the symptoms accompanying each. The distinction may 
be more clear, if given in this table : 

In bleeding from the lungs 

Difficulty in breathing. 

Pain or heat in the chest. 

Blood coughed up by mouthful*. 

Blood frothy. 

Blood of a bright red color. 

Blood mixed with spittle. 

Symptoms refer to lungs and bronchial tubes. 

The first efforts in treatment will be to arrest hemorrhage. The patient 
should be confined to the bed ; cold may be applied over the stomach ; small 
pieces of ice should be swallowed. If the bleeding is excessive, there 
should be entire rest of the stomach, and nourishment should be given by 
injection. Among the most suitable for this purpose is strong beef tea 
and milk. 

From four to six ounces may be used at each injection, four times a day. 
The addition of half a teaspoonful of Pepsin will aid its digestion. If the 
rectum should be especially sensitive, and does not retain the injection, 
twenty or thirty drops of laudanum should be added, and after the injec- 
tion firm pressure should be made upon the anus, with a napkin under the 
hand, until all efforts to expel it cease. It sometimes happens that vomit- 
ing of blood takes the place of the menstrual flow. If this is the case it 
should not be immediately arrested, but kept within proper limits. The 
swallowing of ice, cold over the stomach, and hot foot baths, are permissi- 
ble. Pain will require an anodyne; twenty drops of Laudanum, or a third 
of a grain of Morphine, every hour or two, until relief is obtained. 



In bleeding from the stomach. 
Sickness of the stomach. 
Fullness in vicinity of stomach. 
Blood vomited freely. 
Blood not frothy. 
Blood dark colored. 
Blood mixed with food. 
Symptoms refer to stomach. 



DISEASES OF THE STOMACH AND INTESTINES. 2G9 

Remedies addressed directly to the flow of blood, may be called for. 
Those most likely to be in the house, ready for an emergency, are: Acetate 
(sugar) of Lead, Turpentine and Alum. Acetate of Lead may be given in 
powder, in doses of a sixth or eighth of a teaspoonful, and repeated in an 
hour, if necessary. The dose of Turpentine is ten to twenty, or thirty drops, 
given on sugar, or in mucilage or syrup. Alum may be given in powder, 
in doses of a quarter of a teaspoonful. Cathartics or emetics must not be 
given. 

Monsel's Solution of Subsulphate of Iron is the best remedy known to 
staunch hemorrhages. In these cases ten drops of the solution should be 
given in ice water, and, after the first two or three doses, can be given fre- 
quently, from ten to thirty minutes apart, if the bleeding does not cease. 

Tannin is a useful remedy; the dose in this disease is from ten to 
twenty grains. It should be given in powder. 

Excluding the existence of ulcer, cancer or other lesion of the stomach, 
treatment will have reference to the debilitated condition of the system, 
and the prevention of a recurrence of the hemorrhage. To this end, easily 
digested food, which is nutritious, as beef essence, milk, raw eggs, and 
broths. Ten drop doses of Aromatic Sulphuric Acid may be given before 
meals, in an ounce or two of some of the simple bitter infusions (teas,) as 
Colombo, Gentian, Quassia,Peruvian Bark, etc., made with an ounce of the 
drug to the pint of hot water. 

The Tincture Muriate of Iron may be given in doses of from ten to 
twenty drops, in sweetened water, after meals. The Citrate of Iron and 
Quinine frequently answers the purpose better than anything else. It 
should be given in solution, in water, or syrup of orange flowers, in doses 
of two to five grains. 

HOMCEOPATHIC TREATMENT. Aconitum should be given when 
the premonitory symptoms detailed declare themselves, and, particularly, 
when a considerable degree of fever precedes the attack. 

Dose: Dissolve six globules in two tablespoonfuls of water, and give 
a teaspoonful of the solution, repeating the dose in half an hour, and 
then every hour, till positive amelioration or change. In this mode, 
if taken in time, we may often, by calming the circulation, prevent 
an attack. 

Ipecacuanha. For a first attack we know of no better remedy than 
this ; unless some very peculiar symptoms should render some other medi- 
cine necessary, we would use this. Against following attacks it is not so 
good. The less the vomiting of blood, depends on some previously existing 
disease, the more this remedy is indicated. 

Dose: This must be large; five or ten drops of the tincture, and fre- 
quently repeated every thirty to sixty minutes, if the case is urgent. 

Nux-vomica. In a full habit of body, with a marked tendency to 
congestion of the stomach and bowels, particularly, when arising from 
suppression of haemorrhoids, or of the menstrual discharge, or, from indul- 
gence in vinous, sprituous, or fermented liquors; this remedy is still 
further indicated by irritability of temper, and liability to constipation. 

Dose: Four globules in a teaspoonful of water, every four hours, until 
amelioration or change. 

Pulsatilla. The value of this remedy is noticed in the diseases of 
females above mentioned ; it is, also, in many cases, found more suitable 



270 VOMITING OF BLOOD. 

than Nux-mmica for males, when of lymphatic temperament and mild dis- 
position. Distinctive derangement of the digestive or menstrual functions 
constitutes the general indication for this medicine. 
Dose : As directed for Nux-vomica. 

China. When a quantity of blood has been already vomited, this 
remedy, from its power of restoring the energy of the system after debili- 
tating losses, is clearly indicated; it should, also, be chosen when the 
patient has had a severe attack of vomiting of blood, which has ceased of 
itself, but still left great weakness. 

Dose: Six globules in a teaspoonf ul of water, every two hours, until 
improvement or change; if, however, there be very palpable ameli- 
oration after the first dose, the repetition may be suspended until 
the symptoms recur, or for twenty-four hours. 
Arnica. One of our most important remedies in severe cases, and 
especially when occurring in individuals of a robust constitution, of a san- 
guine temperament and choleric disposition. It is further indicated when 
the patient complains of pains, resembling the results of a contusion in 
all the extremities. 

Dose: Dissolve six globules in two tablespoonfuls of water, and give 

a teaspoonful of the solution every hour until distinct improvement 

or change. 

Sulphur is useful in scrofulous habits, or when the affection has 

arisen from suppressed haemorrhoids ; its value, also, in cases of unhealthy 

menstruation will be pointed out in the proper place. 

Dose : Three globules in a teaspoonful of water, every four hours, for 
the first day, or until the violent symptoms subside. Then six glo- 
bules in a wineglassful of water, every morning the first thing, (fast- 
ing) for ten days; pause four days, and resume the course, and so on, 
from time to time, when no acute symptoms are present. 

ACCESSORY MEASURES. The application of dry cupping-glasses to 
the stomach and under the ribs — or of a cloth, which has been dipped in 
moderately cold water, to the lower region of the belly— sometimes forms 
a useful auxiliary in arresting the discharge of blood. See also the article 
on " Discharge of blood from the Lungs" 

Diet and Regimen. The rules hereafter given under Spasm of tpie 
Stomach should be enforced, with the utmost rigor; solid food cannot be 
permitted, and all drinks should be cold ; animal jellies, preparations of 
milk, light puddings and broths, merely tepid, may be allowed in cases 
where the patient may require such nourishment, but nothing more must 
be taken than is absolutely necessary for that purpose; immediately after 
the attack, no food should be given for some hours, and then very cau- 
tiously, and in small quantity. It is evident that, in such cases, absolute 
rest, both mental and bodily, is essentially requisite. 



CABDALGIA— SPASM OF THE STOMACH. 

Symptoms. Contractive and spasmodic, or gnawing pains about the 
region of the stomach, extending to the chest and back, attended with 
anxiety, nausea, eructation or vomiting, with faintness and coldness of 
the extremities : the patient is sometimes relieved by emission of ascend- 
ing wind, and when complicated with heartburn, by a discharge of a quan- 



DISEASES OF THE STOMACH AND INTESTINES. 271 

tity of limpid fluid ; occasionally headache and constipation are present. 
In some cases the pain is very slight, (but there is always more or less,) 
and a degree of anxiety, with nausea, often increased by taking food. 

Complications. The disease is frequently accompanied by a disease 
of the liver, spleen, or of the pancreatic gland, or even by cancerous degen- 
eration of the stomach, or first portion of the small intestines, in its 
advanced stages. It is a frequent attendant on gout. 

Age, Sex, etc. It is a more frequent affection in the female than 
the male sex, often occurring after the cessation of the usual monthly dis- 
charge, or from any interruption of its usual course; in such instances it is 
frequently accompanied with hysterics and fainting, and may pass on to 
vomiting of blood. It very rarely occurs before the age of puberty. 

The paroxysms last for a longer or shorter time, according to the vio- 
lence of the affection, and return in many instances periodically; and 
may be brought on by partaking of improper articles of diet, or, in severe 
cases, by any solid food whatever. 

Origin. This disease originates in an unhealthy state of the nerves of 
the stomach. 

The Exciting Causes are: Long fasting between meals, very hot 
or cold drinks, an habitual use of ardent spirits, or of indigestible food, 
worms, and, in some instances, exposure to cold or damp weather. But 
coffee is the article to which most persons owe this pain. 

Precautions to be observed by those who are subject to spasm of tJie 
stomach. The chief articles to be avoided by an individual suffering from 
this malady, are: Crude, uncooked vegetable substances (such as salads,) 
cheese, new bread, sweet meats, cherries, nuts, olives, and roasted chest- 
nuts, and stimulants of all kinds, whether tea, coffee, alcoholic or 
fermented drinks. 

ALLOPATHIC TREATMENT. Spasm or Cramp in the Stomach. 
If the trouble occurs suddenly upon the ingestion of some article of 
food, which is plainly irritating the stomach, the organ should be relieved 
by an emetic of twenty grains of powdered Ipecacuanha in a glass of warm 
water. If the trouble is not plainly referable to such a cause, neither eme- 
tics nor cathartics should be given, but the pain must be relieved. This 
is done most quickly by giving thirty drops of Laudanum, and repeating 
the dose at intervals of half an hour to an hour, until the pain is relieved ; 
or a third of a grain of Morphine may be given at the same intervals. A 
laxative of a couple of Compound Cathartic Pills may be needed after the 
pain is relieved, to prevent constipation from the opiate. 

In cases subject to frequent returns of the pain, it is not advisable to 
give opiates, on account both of the liability of producing the "opium 
habit," and of the disturbance its frequent administration produces in 
digestion. 

Sometimes cold and sometimes hot applications, over the stomach, 
relieves the spasm and pain . Rubbing the skin over the stomach with a 
liniment made of an ounce each of Chloroform, Tincture of Aconite, and 
Soap Liniment, or laying a flannel, wet with equal parts of Turpentine 
and Laudanum, and covering it with oiled silk. Tincture of Belladonna 
in doses of ten drops, or Tincture of Hyoscyamus in doses of one or two 
teaspoonfuls, taken internally, is useful in relieving pain. 



272 SPASM OF THE STOMACH. 

When pain occurs in the stomach, with spasms, the same procedures 
are useful, but some remedies seem to have especial benefit. If there is 
indigestion and irritation of the mucous membrane, Bismuth, in doses of 
a scruple three or four times a day, may be given. In these cases the fol- 
lowing is a good formula: 

Take of Sub-nitrate of Bismuth two drams. Pepsin one dram, Dilute 
Hydrocyanic Acid half a dram, Mucilage of Gum Arabic, and Peppermint- 
water each two ounces. Mix. 

Dose: A tablespoonful three times a day. 

The Purified Black Oxide of Manganese, in doses of ten to twenty 
grains, is also a beneficial remedy, and can be used in case of failure with 
the Bismuth. 

Cases accompanied with the formation of gas, should be treated with 
Nux-vomica, in doses of ten drops of the Tincture, or one-fourth of a grain 
of the Extract in pill, three times a day; or Strychnine, in doses of one- 
thirtieth of a grain, may be given instead. 

The Elixir of Bark, Iron and Strychnine, or Elixir of Quinine, Iron 
and Strychnine, in doses of one or two teaspoonfuls three times a day, 
are appropriate to these cases. 

In cases resisting other remedies, Fowler's Solution (Solution of the 
Arseniteof Potash,) in doses of one or two drops, in water, after eating, 
is almost always beneficial. 

Some change in the mode of life may be particularly important, as 
from inactive pursuits indoors to an active life in the open air; as, also, 
in some instances, change of scene and climate may be of the greatest value. 

In the use of stimulants, the advice of a conscientious physician 
should be rigidly followed. Harm will result from their use if taken at 
other times than with the meals, and in small quantities. The symptoms 
of dyspepsia should be met as is directed in that article. 

The tonics recommended to be of use should be taken for a long time. 
Each recurrence should be met as directed in the first part of this article. 

HOMOEOPATHIC TREATMENT. Notwithstanding the usually intrac- 
table nature of this affection, it has been treated with marked success by 
the method about to be pointed out. 

Nux-vomica is one of the principal, and, in a large number of cases, 
the most appropriate of remedies against spasms of the stomach, and 
particularly in cases where this affection can be attributed to the long- 
continued use of strong coffee, or an excessive indulgence in spirituous 
liquors; it is of essential service in many cases of the same disorder, 
which have arisen after the suppression of chronic or hemorrhoidal dis- 
charges, or when the party affected is liable to fits of hysterics or nervous 
despondency. The following are the immediate symptoms which call for 
the administration of this medicine: 

Constriction, pressure, squeezing or spasm in the stomach, accompa- 
nied with a sensation as if the clothes were too tight at the waist, or as if 
wind were pent up in the sides, beneath the lower ribs. This sensation, 
as well as the pains before mentioned, become generally increased after a 
meal, or after partaking of coffee; in addition to which, a feeling of de- 
pression or constriction is experienced at the chest, which, in many cases, 
extends to between the shoulders and the lower part of the back. Fre- 



DISEASES OF TIIE STOMACH AND INTESTINES. 273 

quently, also, we find nausea, accumulation of clear water in the mouth, 
or risings of sour bitter Quids, attended with a sensation of burning in the 
throat and gullet (heartburn); the tongue tremulous, cracked or fissured; 
clean, of a vivi.l red; coated yellow, or covered with a white mucus; lips 
and gums white, red and swollen; blanched, yellowish, and somewhat 
indurated lips; eyelids inflamed at the margins; sour or putrid taste in 
the mouth; vomiting of crude materials; flatulent distention of the bow- 
els ; constipation ; aching in the forehead ; palpitation of the heart, and 
anxiety. When these symptoms are liable to be excited by a fit of pas- 
sion, or become aggravated in the morning, or when the patient is occa- 
sionally awakened out of his sleep by the spasmodic attack, this remedy 
is still more certainly indicated. 

Dose: In severe cases, of recent origin, three globules in a teaspoonful 
of water, every three hours, until amelioration or change. In chro- 
nic cases, with more or less acute pain after every meal, six globules 
every evening until positive amelioration or change. When the 
spasin of the stomach returns periodically, three globules should be 
taken in a teaspoonful of water, three hours before the expected 
recurrence of the symptoms. This rule applies in respect of any of 
the remedies herein prescribed, which have been administered with 
success against former attacks. If temporary relief only, followed 
by more intense suffering, has ensued, and continues three hours 
after a second dose of Nicx-ojmica, proceed with the next medicine. 
Carbo-vegitabills should be given three hours after the second dose 
of Xux-vomica, if that remedy has produced only partial good effect, and 
will generally complete the cure, provided the affection be not one of long 
standing, and, consequently, too deeply seated. 

Dose: Three globules in a teaspoonful of water, morning and even- 
ing, for four days. 
Chaniomilla. For the employment of this remedy, the principal 
indications are: Pressure, as if from a stone in the pit of the stomach, or 
painful pressure and flatulent distention at the same part, as, also, of the 
region beneath the lower ribs and the belly itself, with shortness of breath, 
anxiety and throbbing headache; mitigation of the above symptoms on 
partaking of coffee — a distinguishing mark between the indications of this 
remedy and those of Xux-vomica; on the other hand (as in the case of 
the latter,) it is also indicated when the symptoms as described are liable 
to be brought on by a fit of passion. 

Dose: Three globules in a teaspoonful of water, every four hours, 

until amelioration or change. 
Belladonna ought to be substituted for Chamomilla, or should be 
administered four hours after the third dose of the latter, when it has 
not been followed by relief, notwithstanding the apparent similarity of 
these symptoms ; farther indications for Belladonna consist of gnawing, 
pressure, or spasmodic tension in the pit of the stomach, relieved on 
bending backward and holding in the breath; or, further, spasm of the 
stomach, which recurs daily during dinner, or else pain of so violent a 
nature as to deprive the patient of consciousness; tremulous, vivid-red 
and sh ! ning tongue, or redness of the tongue and elevation of the papillae; 
red and spongy lips. 

Dose: Three globules in a teaspoonful of water, every four hours, 
until the indicative symptoms are removed. If followed by more 
suffering after the third dose of Belladonna, proceed with Gelsemi- 
num. as directed for Belladonna. 

18 



274 SPASM OF THE STOMACH. 

Cocculus, in many cases of this complaint, is particularly indicated, 
when, in addition to the usual symptoms, there are constipation and con- 
strictive pains over the entire stomach, with flatulency, and accumulation 
of water in the mouth, and alleviation of the sufferings on the recurrence 
of the latter symptoms. 

Dose: Of a solution of six globules to two tablespoonfuls of water, 
give a teaspoonful every three hours, until amelioration or change. 

Pulsatilla is useful in cases with shooting pains in the stomach, 
which are aggravated by movement, and particularly by making a false step. 
Pulsatilla is, also, one of the most appropriate remedies when the attacks 
are followed by vomiting, or accompanied by violent tension and squeez- 
ing, or throbbing and sensation of anxiety about the pit of the stomach, 
increase of pain after eating, or more particularly a feeling of pressure 
and pinching after dinner, with a relaxed state of the bowels, or a disposi- 
tion thereto. Disposition to hysterics or nervous despondency. This 
remedy is very serviceable in cases of this affection, arising from suppres- 
sed menstruation. 

Dose : Of a solution of twelve globules to four tablespoonfuls of water, 
give a tablespoonful every six hours, until amelioration or change. 

Sepia is an efficacious medicine in spasm of the stomach, arising 
from suppressed or difficult menstruation, and may, in general cases, 
advantageously follow Pulsatilla; it is indicated when most of the suffer- 
ings arise after a meal, by pressure in the stomach as from a stone, and by 
a burning pain in the pit of the stomach ; and by restoring singly, or in 
conjunction with Pulsatilla and Sulphur, the menstrual flux, it frequently 
removes the spasm at the stomach and hysterics consequent upon this 
derangement, or, at least, places the affection in such a position that it is 
easily cured by some other medicine, closely corresponding to the remain- 
ing symptoms. 

Dose: In recent (not chronic) cases, of a solution of eight globules to 
two tablespoonfuls of water, give a teaspoonful every four hours 
until amelioration or change. In chronic cases, give three globules 
in a teaspoonful of water night and morning for a week, then pause 
four days, and resume the course, suspend treatment, or change the 
remedy according to circumstances, the thirtieth potency is best. 

China is of great service in most cases of spasms of the stomach with 
general weakness, arising from loss of humors, the result of blood-letting, 
or repeated loss of blood, abuse of emetus or aperients, too long continued 
suckling, etc.; and it is further indicated by great weakness of digestion, 
distention, and uncomfortable weight, pressure or pains in the stomach 
after eating, so that the patient feels much easier when fasting ; these 
latter symptoms are the more immediate indications for the employment 
of this medicine. 

Dose: Of a solution of six globules to two tablespoonfuls of water, 
night and morning for three days; and afterwards three globules in 
a teaspoonful of water every third night, until positive improve* 
ment or change. 

Bryonia, This medicine is more particularly adapted to the milder 
cases of spasm in the stomach, with painful pressure, or a feeling of disa- 
greeable fullness in the stomach after a meal, which occasionally becomes 
converted into a feeling of constriction, cutting or pinching, and is relieved 
by eructation and external pressure. This remedy is, moreover, still more 



DISEASES OF THE STOMACH AND INTESTINES. 275 

clearly indicated when the symptoms are generally accompanied by 
severe headache or painful compression in various parts of the head, and 
particularly at the temples, which is liable to be excited whenever any 
article of diet disagrees in the slightest degree; increase of the suffer- 
ings by movement; habitual costiveness. 

Dose: Three globules in a teaspoonful of water every two hours, 

until amelioration or change. 
Arnica-montana, in spasms or pains in the stomach, which have 
originated in the effects of a strain, or from a blow, etc., will be found 
specific. It is, however, also an excellent remedy when there is a sense 
of fullness and constrictive pain in the stomach and in the fore part of 
the chest, shooting pain in the pit of the stomach, with painful pressure 
as from a stone, or aching, extending to the back, and tightness of the 
chest, increased by eating, drinking, and external pressure. 

Dose: Of a solution of four globules to two tablespoon fuls of water, 
or in the like proportion, give a teaspoonful night and morning, 
until amelioration or change. 
Arsenicum is required for periodic pains in the stomach, chiefly 
consisting of a burning character, and attended with acrid, sour eructa- 
tions, vomiting of crude materials, or of mucus, sometimes even of blood; 
tremulous, swollen, or glazed, red and fissured tongue; blanched, waxy, 
and somewhat indurated lips ; want of appetite; extreme debility; ema- 
ciation. 

Dose: Two globules in a teaspoonful of water, every three hours, 
until amelioration or change ; or in very acute cases characterized 
by excessive prostration and livid aspect, give one globule in a tea- 
spoonful of water immediately, repeating the dose after half an 
hour, and again every two hours, until positive amelioration or 
change. But if little or no permanent relief ensue within two hours 
after the sixth dose, consider the various other remedies herein 
named. In chronic cases, give three globules in a teaspoonful of 
water, night and morning, until distinct amelioration or change. 
Calcarea. In obstinate cases, occurring in individuals who are, 
habitually addicted to the abuse of wine or ardent spirits, Calcarea will 
generally, be found of great service, especially, after the previous employ- 
ment of Nux-v. It is further a valuable remedy in the cases of females of 
full habit of body, subject to discharge of blood from the nose, or to exces- 
sively copious menstruation; and is, generally, indicated when the parox- 
ysm of pain comes on usually at night, or after a meal, in which latter 
instance vomiting sometimes results, or nausea and acidity, with painful 
sensibility on pressure at the region of the stomach. Constipation, hem- 
orrhoids, or chronic looseness of the bowels are additional general 
indications for the employment of this remedy. 

Dose: Six globules in a wineglassful of water, every morning the 

first thing, for a week (unless earlier relief* or change ensue); pause 

four days, and then, if necessary, resume the course as before, and 

so on, until positive amelioration or change. 

Diet and Regimen*. These are subject to the same general rules as 

have already been afforded in the article on Indigestion. 

HEARTBURN. BLACKWATER. WATER-BRASH. 

This is not an affection of the organ whose name it bears, but a painful 
or uneasy sensation of heat, or acrimony, about the pit of the stomach, 
sometimes extending upwards. It is frequently accompanied with anxi- 



27ft DIARRHCEA. 

ety, nausea, and vomiting; or a violent, gnawing, spasmodic pain in the 
region of the stomach, from which the patient experiences no relief, until 
he succeeds in ejecting a quantity of limpid fluid. 

Treatment. As heartburn is, strictly speaking, a mere symptom, 
emanating from derangement of the stomach, the general articles on 
*' Indigestion," and its subordinate affections, should be considered. 



THE ZABGE INTESTINES. 

The cut on the opposite page, showing the location, direction and shape 
of the large intestines, with their curves and convolutions, is important 
from the fact that in this part many diseases are liable to occur which to a 
greater or less degree endanger life. Dysenteria — flux — is an inflammation 
and at times ulceration of the lining mucous membrane of the bowel at 
X V, and desperate cases can often be cured by thoroughly washing out 
the bowel by large injections of water as hot as can possibly be borne. 
Chronic diarrhcea is a chronic inflammation of this membrane, but often ex- 
tending further up the bowel than is usual in dysenteria. Constipation is 
also a natural result of inflammation of this mucous membrane, drying up 
and preventing the secretion and discharge of the mucus that in health 
assists in the evacuation of the feces. A large injection forced up the 
bowel until it reaches X— the patient lying long on the right side so as to 
have the assistance of gravitation in holding in the fluid until it has had 
plenty of time to soften the feces which have been dried by the fever in the 
parts— will overcome the most obstinate case, and is much better than dosing 
with a long list of medicines. This large intestine is known as the Colon, 
and is divided into the ascending, up the right side ; transverse, across the 
abdomen about 2 or 3 inches above the umbilicus— navel ; descending, down 
the left side to the place of discharge, emus. Parts of the liver and stomach 
are seen in the upper part of the cut. The part where the small intestines, 
illium, empty into the colon is shown at VI. Gastric or Bilious Fever is 
another of the diseases of which these organs furnish the seat. 




THE LARGE INTESTINES. 



DIARRHOEA. 277 



CHAPTER XIII 



DISEASES OF THE INTESTINES, 



DIARRHOEA. 



Diarrhoea, or looseness of the bowels, is a disease of frequent occur- 
rence, manifesting itself, more especially, during the warm months of the 
year, though it may take place at any season. All persons are, alike, sub- 
ject to it when exposed to the causes. 

Symptoms. Diarrhoea consists in frequent evacuations from the bow- 
els, of a more fluid nature than usual, each discharge being, usually, accom- 
panied with, or preceded by a rumbling in the bowels, together with a 
sense of weight, or pressing down, and, commonly, relieved as soon as the 
evacuation takes place, but are renewed before the one, which is to suc- 
ceed, ensues. More or less griping is present, and not unfrequently nau- 
sea and vomiting. Fever is not, usually, present in diarrhoea. When the 
discharges are very frequent, or in large quantities, they rapidly reduce 
the strength of the system; emaciation takes place; the functions of the 
system become impaired; the skin becomes pale, dry, rigid, and eventu- 
ally, sallow ; and if the disease continues, the feet and legs become drop- 
sical. The discharges become more and more offensive, a slow fever 
ensues from the exhaustion, and the patient dies. 

According to the character of the evacuations and the exciting causes, 
diarrhoea lias been divided into several varieties, thus: 

1. Lienteric Diarrhoea, in which the food is rapidly passed into the 
bowels, and appears in an undigested condition in the evacuations; and is 
due to an impairment or suspension of the'functions of the stomach, with 
great irritation in the intestinal canal. 

2. Chylous or Cceliac Diarrhoea, in which the discharges are of a 
milky white, or dirty white color, and is due either to a congested con- 
dition of the mucous membrane of the small intestines, or to tubercular 
(consumptive) disease of the mesenteric glands (small glands in the mem- 
brane uniting the bowels). 

3. Mucus Diarrhoea, in which considerable mucus is found in the 
discharges, being, occasionally, streaked with blood; due to colds and 
exposures. 

4. Bilious Diarrhoea, in which the evacuations are mixed with much 
yellowish or greenish looking bile, and most generally accompanied by 
nausea and vomiting, due to cold, anger, chagrin, etc. 



278 DISEASES OF THE INTESTINES. 

Causes. Diarrhoea may be caused by improper exposure to excessive 
heat or cold; by the use of acid, unripe fruit; indigestible or other irrita- 
ting food; from the presence of worms; from overloading the stomach 
with food ; sudden frights; fits of anger, grief, and other depressing emo- 
tions ; certain articles of diet occasion diarrhoea, in some personSj which 
are quite agreeable and salutary to others. A very frequent cause of diar- 
rhoea, among infants, is the use of spoon meats, and other gross articles 
of diet; it may, also, arise from the bad quality of the mother's or nurse's 
milk; from the irritation caused by teething, etc., the going-in of cutane- 
ous eruptions ; fermented liquors, etc., are also among the exciting causes; 
changes in the atmosphere, rendering the disease epidemic in certain 
localities; the unwise use of cathartics, is not an unfrequent cause. 

ALLOPATHIC TREATMENT. This disease is, frequently, transient, 
due to temporary indigestion, or following some dietetic error. In these 
instances, little or no treatment is necessary, except guarding indulgence 
of the appetite more carefully. If the contents of the large intestine 
(bowel) is not spontaneously expelled, a cathartic should be given. For 
this purpose, a tablespoon ful of Epsom Salts, with ten drops of Deodor- 
ized or common Laudanum (Tincture of Opium,) to allay irritation, or a 
vSeidlitz Powder, answers a good purpose. A tablespoonful of Castor Oil, 
or five or ten grains of Powdered Rhubarb will, also, meet the indications. 
If the evacuations have been copious, and of a feculant character, a 
cathartic is not required. 

After the bowels have been thoroughly emptied, if diarrhoea and pain, 
or uneasiness, still continue, it should be relieved by an anodyne, one or 
two teaspoonfuls of Paregoric, or ten or twenty drops of Laudanum, in a 
tablespoonful of Chalk Mixture, or Cinnamon Water, with the addition of 
a little Prepared Chalk, or Soda, or five grains of Dover's Powder. 

Whatever the remedy chosen, it should be repeated every six or eight 
hours, if needed. The diet, for a few days, should be simple and restricted. 
A diet, largely composed of milk, is suitable. Care should be used that the 
bowels do not become over confined. If they do not move spontaneously, 
they should be started again by one or two Compound or Improved Cathar- 
tic Pills, twice a day, until an action is produced. It should, also, be stated 
that a free injection of warm water, followed by a small injection of warm 
water, or thin Starch, with half or two-thirds of a teaspoonf ul of Lauda- 
num, will, frequently, cure diarrhoea. 

Should the diarrhoea tend to continue, or frequently return, the prin- 
cipal treatment will refer to diet, and measures to render digestion com- 
plete. Tender meats, cooked rare; eggs, chicken, and milk, are, most gen- 
erally, found to meet the end required; but, in some cases, starchy articles, 
such as Rice, Corn Starch, Tapioca, Sago, Arro\vroot, Wheat or Oatmeal, 
with milk, are found best suited. 

If the patient has been deprived of fresh vegetables, and ripe fruits, 
they should be supplied, in moderate quantities. A moderate quantity of 
fcod, frequently taken, is generally better than a full meal once or twice a 
day. 

In some instances, a change of climate is demanded. A removal from 
the city to the country, is, frequently, curative in the hot weather, partly 
from the tonic effect of the country air, and partly from the use of fresh 



DIARKIICEA. 279 

milk, and ripe fruits, which the system required. In these cases, the use 
of Opium is only of limited and temporary value. It may be used as 
directed before, to relieve pain and irritation, but its continued use impairs 
digestion. 

It should be remembered, that diarrhoeas are, sometimes, prolonged by 
the presence of hardened feces; in these cases, Epsom Salts, or Cascor Oil, 
should be given, in tablespoonful doses, every six hours, until a free motion 
is obtained; or injections of a quart of warm water, frequently repeated 
until hardened feces cease to be discharged. Large doses of Bismuth, 
from twenty to thirty grains, repeated two or three times a day, is a most 
valuable remedy in continued diarrhoea, and is not accompanied by any 
disagreeable effects. It can best be given in some milk. 

Chronic diarrhoea is frequently of malarial origin. In these cases, 
Quinine, in five-grain doses, two to four times a day, is curative without 
any other remedy. Quinine is frequently required, as a tonic, in doses of 
two or three grains, three times a day. For the same purpose, the bitter 
infusion of Quassia.Gentian, or Colombo, alone, or combined, two ounces 
to the pint of boiling water, dose: a tablespoonful, three times a day, are 
useful. One or two grains of Pyrophosphate of Iron may be combined 
with each dose of the bitters, or Quinine, if the patient is much reduced. 
The addition of Pepsin, in doses of five or ten grains, is, frequently, a great 
help to digestion. 

In chronic diarrhoea, Bismuth, given as before mentioned, occupies the 
first rank; anodynes, before described, maybe given with it, but only as 
required to relieve pain or irritation. Sugar of Lead may, in rebellious 
cases, be combined with the Bismuth, with or without the anodyne, in 
doses of one to three grains. 

The vegetable astringents— Blackberry-root, Logwood, Catechu, Kino 
— have been, in their turn, found useful. As their efficacy depends on the 
presence of Tannin, I prefer to use it. It can be given in doses of ten to 
twenty grains, in syrup, and repeated every few hours, and may be com- 
bined with Bismuth, or an anodyne, or both. 

One of the most effective prescriptions in chronic diarrhoea is the fol- 
lowing: 

Take of Sulphate of Copper one grain, Sulphate of Morphine one grain, 
Sulphate of Quinine twenty-four grains. Make a mass and divide into 
twelve pills. Take one pill three times a day. 

In some rebellious cases the following is a highly useful combination: 

Take ofErgotine ( Watery Extract.) twenty grains, Extract of Nux-vomica 
five grains, Extiact of Opium ten grains. Mix well, and divide into twenty 
pills. Take one pill every four or six hours. 

If the druggist is not Jmown to be skillful and careful, probably the 
following had better be used instead: 

Take of Fluid Extract of Ergot two ounces, Tincture of Nux-vomica 
three d tarns. Deodorized Tincture of Opium three drams. Take a teaspoon ful 
four or six houn apart. 

In the treatment of chronic diarrhoea, it becomes necessary to change 
the remedy occasionally, as in some instances the system becomes habitu- 
ated, in a measure, to its use. It is not, however, best to change a remedy 
as long as it is proving efficacious. 



280 diseases of the intestines. 

The Diarrhceas of Children Demand Separate Consideration. 
Those having the appearance of blood in the stools, will be treated under 
the head of dysentery. If the roundness of the figure, and the firmness of 
the flesh is maintained, it shows that nutrition is sufficient, and the diar- 
rhoea is not seriously harmful. On the other hand, if the child is beginning 
to waste, or the flesh becomes flabby, immediate treatment is required. 
Many of these cases are caused from poor food. If the child is at the 
breast, it may be the mother w r orks too hard, and so impairs the quality of 
milk, or it is insufficient, and creamy cow's milk should be given in addi- 
tion. A little penetration, guided by common sense, will discover the cause 
and correct it by better hygiene. A green or irritating stooi shows the 
need of an alkali, lime water by preference, or a little prepared Chalk or 
Soda, one to three grains, is a dose. 

When lumps or mucus pass in the stools a laxative is needed. For 
this purpose half a teaspoonful of Castor Oil, or Syrup of Rhubarb a tea- 
spoonful is suitable. Previous constipation also demands these laxatives, 
Oi the following may be given: 

Take of Epsom Salts one dram, Tincture of Rhubarb one' dram, Syrup 
qf Ginger one dram, Cinnamon Water, or, Water nine drams. Mix. 

Dose: A teaspoonf ul three times a day for a child a year old. 

If there is no improvement from this treatment, we must rely on 
astringents and alkalies. If the evacuations are frequent, and the child 
weak, no laxatives should be given, but astringents should be used from 
the first. Often much precious time is lost by not following this rule. 
The physician finds, generally, when he is called, that opiates and astring- 
ents are needed exclusively, attention being also given to hygiene. The 
Compound Powder of Chalk and Opium answers the indications, and may 
be given in doses of three grains every other hour, to a child a year old. I 
often use the following: 

Take of Compound Powder of Chalk half a dram, Bismuth one dram. 
Mix and divide into ten poicders. 

Dose: One powder three hours apart until the diarrhoea is checked. 

Or the following may be used: 

Take of Paregoric two drams, Tincture of Catechu two drams, Chalk 
Mixture one ounce. Mix. 

Dose: One teaspoonf ul every three or four hours, to a child one year 
old. 

Often the diarrhoea is due to, or aggravated by imperfect digestion; 
it is well to give Pepsin and Sub-Nitrate of Bismuth. Take of Pepsin 
one dram, Sub-Nitrate of Bismuth one dram. Mix, and divide into twelve 
powders. Give one immediately after the child has taken milk or food. 
They can be given in milk or syrup. Pepsin and Bismuth may be given 
in solution. • 

In children over two or three years of age the treatment is similar to 
that for adults, making allowance for age. 

Take of Liquid Pepsin (Sheffer's formula) and Solution of Bismuth, 
(U. S. P.) of each two ounces. Mix. 

Dose: Half a teaspoonful, to a teaspoonf ul, three or four times a 
day. 

Quinine, in doses of half a grain, to a grain, three times a day, is also 
beneficial. 



DIARRHCEA. 2S1 

HOMCEOPATHIC TREATMENT. Dulcamara should be given in 
diarrhoea, occurring in summer, from cold. Particular indications for 
its use are, the relaxation of the bowels, being attended with colic, or, 
cutting pain in the region of the navel; the evacuations being liquid, 
slimy, and yellowish or greenish, generally coming on at night, and some- 
times being attended with nausea or vomiting; want of appetite, and great 
thirst; paleness of the countenance, and lassitude. This medicine may, 
also, be judiciously administered in many cases in which the relaxation of 
the bowels affords no ostensible specific or characteristic indications for any 
particular remedy. 

Dose: For adults, eight globules, to each two tablespoonfnls of water, 
give a teaspoonful after eacli evacuation, until distinct relief or 
change. But if only partial relief should ensue, in acute cases, in 
six hours after the second dose, or in chronic cases in twelve hours 
after the sixth dose, proceed with the next, or, study other medi- 
cines. 

Bryonia should be given in cases of diarrhoea arising from the before- 
mentioned causes, and attended with many of the symptoms noted under 
Dulcamara, when that medicine has failed to afford the required relief, 
particularly if the looseness is liable to be aggravated after a meal, or after 
drinking, and the stools are passed almost involuntarily, and portions of 
undigested food are perceptible in the motions; also, when looseness is 
experienced after partaking of milk. In looseness of the bowels, occurring 
during hot weather, when we cannot trace the cause in any errors of diet, 
requiring other remedies, this medicine is further indicated, and especially 
so in the following instances: diarrhoea, from checked perspiration, or being 
overheated— cold drinks — a chill from remaining in any cold, exposed situ- 
ation, or in draughts— or from exposure to an eastlerly wind. When this 
affection has been produced by passion, particularly in individuals of what 
is called a bilious temperament. Bryonia is, again, a most useful remedy. 
It may, also, be remarked that the relaxation of the bowels, arising from 
drinking impure water, or water strongly impregnated with vegetable 
substances, when heated, has frequently found relief in this medicine. 

Dose: In casual or chronic cases, and in all other respects, as more 
particularly directed for Dulcamara. 

China. Looseness in consequence of indigestion, particularly, if 
occasioned by partaking of fruit, or, flatulent food, such as vegetables; 
evacuations very profuse and sometimes attended with but little pain ; and 
when the discharge comes on immediately after partaking of food, or espe- 
cially during the night; evacuations liquid and brownish, and sometimes 
containing portions of undigested food ; it is, in some instances, further indi- 
cated when considerable spasmodic, or, colic-like pain is present with 
flatulence, want of appetite, thirst and great weakness; and is also valu- 
able after improper treatment of this affection, when considerable debil- 
ity remains. 

Dose: If singly, of a solution of eight globules to two tablespoonfuls 
of water, give a teaspoonful after every motion, until amelioration 
or change. In like cases, for children, a solution of three globules to 
two tablespoonfuls of water, similarly administered by teaspoon- 
fuls. If in alternation with Ferrum, a similar solution (separately) 
of each medicine (as distinctly stated for adults and for children,) of 
each of which the like dose should be given, the one four hours after 



282 DISEASES OF THE INTESTINES. 

the other, in rotation, until amelioration or change. In chronic cases, 
if singly, six globules, in a teaspoonful of water (for adults,) or two 
globules, in a teaspoonful of water (for children,) morning and eve- 
ning, every other day, until amelioration or change. 
Ferrum-m. may be advantageously given, in alternation with China, 
when the evacuations are partly composed of undigested food, and pass 
without pain. This remedy may, however, be administered alone, when 
the discharge from the bowels is unattended with pain, or there are pains 
in the back and posterior passage, paleness of the face, watery evacuations 
— or looseness, particularly, observable at night, or after eating or drinking 
— loss of flesh, alternate absence of appetite and voracious hunger, disten- 
tion of the belly without flatulency, spasm of the stomach, continued thirst, 
and weakness of the eyes, with great weakness of digestion. 

Dose: In all respects, whether for casual or chronic cases, and 
whether singly, or in alternation with China, as directed for the latter 
medicine. 
Chamomilla is a remedy, as already stated elsewhere, particularly 
useful in children, either at the time of teething, or at a more advanced 
period, when the affection has been excited by checked perspiration ; and it 
is further, particularly indicated when the evacuations are watery, bilious, 
green, yellow, or slimy, or of a fetor resembling rotten eggs; when there 
are fullness at the pit of the stomach, severe colic or spasm, pain, disten- 
tion and hardness of the belly, bitter taste in the mouth, foul tongue, thirst, 
want of appetite, bilious vomiting and flatulency (in infants,) attended 
with restlessness and screaming, and drawing up of the limbs towards the 
stomach. 

Dose: Of a solution of eight globules to four tablespoonfuls of water, 
give a teaspoonful, after every motion, until positive amelioration or 
change ; or, in patients of a weakly habit of body, if this appears inad- 
equate to effect a cure (although the symptoms be analogous) and if, 
after repeated administiation and temporary effect, the symptoms 
recur in all their former violence, consider Sulphur. 
Ipecacuanha is indicated by looseness, arising from indigestion, par- 
ticularly, if caused by imperfect mastication, and attended with nausea 
and vomiting, paleness of the face, weakness, and desire to retain the 
recumbent posture (in the case of children). 
Do.se : As for Chamomilla. 

Pulsatilla should be administered six hours after the third dose of 
Ipecacuanha., if the latter affords only partial relief. It is, also, one of the 
best remedies for simple looseness of the bowels, arising from errors of 
diet, such as indulgence in acids, fruits, or rich, indigestible food, attended 
with foul tongue, and other symptoms of deranged digestion, as stated in 
the article on " Indigestion." Another remarkable indication for this rem- 
edy is, one evacuation differing from another in color. 

Dose: Six globules, in a teaspoonful of water, after every motion, 

until amelioration or change. 
Hheuin is to be preferred to Pulsatilla, and should be employed after 
Ipecacuanha, or even before that medicine, when the sour smell of the 
evacuations is a predominant symptom. In general, however, it may be 
advantageously employed, especially, amongst children, when the symp- 
toms, in a great measure, resemble those of Chamomilla, but the pain is not 
so violent, and the evacuations have a sour smell; paleness of the face is, 
also, an indication for this medicine. 



DIARRHCEA. 2S3 

Dose: Six globules, in a teaspoonf ul of water; or, for children, three 

globules in a teaspoon ful of water, after every motion. 
Mercurius, When the diarrhoea arises from a chill, and the motions 
are copious, watery, slimy, frothy, bilious, or greenish, or streaked with 
blood, and cause a smarting or burning sensation on being evacuated; also, 
when there is painful straining before, during, and after evacuation, fre- 
quently followed by protrusion of the lower intestine; severe, cutting 
pains; moreover, nausea and eructation, cold perspiration, trembling or 
shivering, great lassitude, and disposition to fainting; evacuations con- 
taining undigested substances. 

Dose: Of a solution of six globules to three tablespoonfuls of water; 
give a teaspoonf ul after every motion, until distinct amelioration or 
change. 
Nux-vomica. Scanty evacuations or motions, consisting of slime 
and blood, attended witli straining and great weakness; flatulency, and 
violent, cutting pains in the region of the navel ; diarrhoea, alternating 
with constipation. For some of the accompanying symptoms, the reader 
is referred to the indications mentioned respecting this remedy, in the arti- 
cle on "Indigestion." 

Dose: Six globules, in a teaspoonf ul of water, every two hours, until 

amelioration or change. 
Arsenicum. Autumnal diarrhoea, or looseness, arising from errors in 
diet, acids, fruits, cold drinks, ices, or from a chill, etc., the characteristic 
symptoms for its employment are : watery, slimy, greenish, or brownish, 
corrosive, burning evacuations, with violent colic, excessive thirst, ema- 
ciation and great weakness, and when the affection is more liable to come 
on at night, or after eating or drinking. This is, also, a most important 
medicine for the treatment of the bowel complaint of children, as hereaf- 
ter, separately, considered. 

Dose: Of a solution of six globules, to two tablespoonfuls of water, 
give a teaspoonf ul every half hour (in very acute cases); or every 
hour (when the symptoms are modified by intervals of respite, until 
amelioration or change. If in alternation with Veratrum, of a sim- 
ilar solution (separately.) of each medicine, give first two doses (as 
just stated,) of the one, then pause an hour, and continue with two 
doses of the other, similarly. If singly, however, and only partial 
relief ensue within half an hour, or an hour after the third dose, pro- 
ceed with the next medicine. 

Veratrum should be employed half an hour or an hour after the 
third dose of Arsenicum, when similar symptoms occur which have not 
yielded to the previous use of the latter. Veratrum is, moreover, especi- 
ally appropriate in cases in which the complaint is attributable to atmos- 
pheric causes. Veratrum and Arsenicum are important when excessive 
exhaustion accompanies the complaint. 

Dose: In all respects as directed for Arsenicum. 

DIARnilCEA. ASSOCIATED WITH CONSTITUTIONAL DEIHLITY. 

Sulphur is a most valuable remedy in diarrhoea, particularly occur- 
ring during the night, in persons of a scrofulous habit, or in very obstinate 
cases. In adults predisposed to piles, or in children, when the looseness 
of the bowels is attended with excoriation and with papular eruptions, it 
is particularly efficacious ; also, in cases where the slightest cold brings on 
a relapse or an attack ; or when milk disagrees and causes a looseness. 



284 DISEASES OF THE INTESTINES. 

Dose: Against the prevailing acute symptoms, of a solution of six 
globules to two tablespoonfuls of water, give a teaspoonful every 
six hours, until the frequency of the motions are diminished. Sub- 
sequently give six globules, in a wineglassful of water, every morn- 
ing (fasting) the first thing, for ten days, unless collateral symptoms 
meanwhile occur, requiring other treatment; after which, pause 
four days, resuming the course, if necessary, as before. 

Sepia is to be preferred in obstinate cases of diarrhoea, occurring 
amongst females ; especially, when associated with predisposition to hys- 
terical attacks, headache, whites, sudden sweats, or flushes of heat and 
frequent attacks of shivering or shuddering, chiefly during stools. 

Dose: In every respect as directed for Sulphur, continuing the course 
in like manner, until permanent amelioration or change. 

HOME TALK. Acids, or acidulous wines, beer, coffee, strong tea and 
fruits, whether raw or cooked, should be carefully avoided. Solid food is 
likewise forbidden, during the prevalence of an acute attack, as tending 
to keep up the intestinal irritation ; and gruel, fresh milk, (unless it 
should be known to disagree with the patient,) broths, and light mucilag- 
inous food should be substituted. 

The majority of vegetables are objectionable, potatoes in particular. 

In every severe case, indeed, (during the prevalence of the attack) 
little more than thin arrowroot or gruel should be taken. In milder 
forms of the complaint, well-boiled rice, moistened with good gravy, may 
be rather serviceable than otherwise. 

Beef tea (with or without addition of a teaspoonful of isinglass to the 
half-pint) may, in some cases, serve materially to assist the operation of 
the medicines. When the attack is subsiding, and for some time after- 
wards, young meat (such as veal or lamb) should be avoided; and sound, 
tender mutton, plainly roasted, will be found, generally speaking, most 
easy of digestion. Fish should be avoided. 

Above all, the patientshould guard against indulging a craving appe- 
tite, and eating too freely, or overloading the stomach. 

In protracted cases, attended with debility, but no symptoms of inflam- 
mation or ulceration, generous, easily digestible food, and sometimes a 
little wine, or wine and water, must not be withheld. In such cases, a 
basin (half a pint) of beef-tea, with the addition of a teaspoonful of isin- 
glass, and a few slips of toast taken daily, about three hours after break- 
fast, will usually prove a useful accessory. The use of a flannel bandage 
round the stomach, is often of service, especially for delicate children. In 
every case, the clothing should be warm ; exposure to moisture, and espe- 
cially to having the feet wet, should be avoided; fine woolen stockings or 
socks, and stout shoes, should be worn. 

Change of air will generally be of service to the convalescent. When 
diarrhoea prevails as an epidemic, as is not unfrequently the case towards 
the fall, all these precautions, which may or may not be essential under 
other circumstances, become indispensable. 

HOME REMEDIES. Take of Mayapple Root, pounded, one teaspoon- 
ful, White Oak Bark, pounded, or, if dry, powdered coarsely one tea- 
spoonful, boiling water a pint; steep near fire for an hour or two, and 
sweeten with white sugar. 

Dose: A spoonful after each motion of the bowels. 

A little burned brandy, added, helps this. This is very valuable. 



CHOLERA MORBUS. 285 

Take five or six clean corncobs, burn them on a clean fire, to a coal; 
drop the cob-coals in two pints of boiling water; as soon as cool take a 
tablespoon ful every three or four hours. This is specially valuable where 
there is much bloating, or the evacuations are very offensive, the eructa- 
tions tasting like what has been eaten. 



CHOLERA MORBUS. 

CnoLERA Morbus is a disease common in warm seasons, and especi- 
ally in warm climates. The principal features of the disease are vomiting, 
purging, and severe griping pains in the abdomen. 

Symptoms. The attack is occasionally preceded by chills, headache, 
giddiness, and a numb sensation in the limbs, but more generally the 
attack is sudden, commencing with nausea and distress at the stomach, 
succeeded by violent gripings in the bowels; these are followed by fre- 
quent vomitings of a thin, dirty-yellowish, whitish, greenish, or even 
colorless fluid, with discharges from the bowels of a similar character to 
that vomited up, and which occur as frequently as the vomiting. During 
the intervals between the vomiting and purging there is much nausea 
and uneasiness at the stomach ; but in some cases a sensation of relief is 
afforded by the discharges and the patient lies in bed, much fatigued, but 
apparently free from pain and distress. 

These attacks of vomiting and purging usually take place every ten 
or twenty minutes, being either simultaneous, or the vomiting immedi- 
ately followed by the discharge from the bowels, or else the reverse. 

Sometimes the pain is so severe as to cause the legs to be drawn up, or 
even to cry out. 

Generally, there is great thirst, but as soon as any liquid is swallowed 
it is ejected; the tongue is dry, the urine high-colored, deficient or sup- 
pressed, the pulse rapid, soon becoming small and feeble. If the disease 
is allowed to progress unchecked the pulse sinks, the extremities become 
cold, the countenance pale and indicative of much suffering, the breathing 
hurried, cramps in the limbs, hiccough, a cold, clammy sweat breaks out, 
great prostration, and death. The disease frequently proves fatal in twen- 
ty-four hours, and, when malignant, even in a few hours; sometimes it 
subsides spontaneously. 

Sometimes patients with cholera morbus complain of a great burn- 
ing sensation internally, and in the more malignant forms of the disease, 
it is not uncommon for the last discharges to resemble the " rice water" 
evacuations of Asiatic Cholera. 

Cholera Morbus may be known from Diarrhoea and Dysentery by the 
character of the discharges from the bowels, which, in this, are of a purely 
bilious nature, not mixed with blood or mucus, and with scarcely any fecal 
matter. 

Causes.— Cholera Morbus is owing to an irritation of the stomach and 
bowels and a greater or less derangement of the liver, and is ordinarily 
caused by improper substances taken into the stomach, as unripe fruit, 
acids, much fat food, certain kinds of fish, lobsters, unfermented cider, 
improper use of alcoholic drinks, or any article that will irritate the mucous 



283 DISEASES OF THE INTESTINES. 

membrane of the stomach and bowels, by undergoing an acid fermenta- 
tion. It is, also, produced by exposure to sudden changes, by sitting in a 
draught of cool air while in a state of perspiration ; by excessive heat ren- 
dering the bile more acid, or secreted in unnatural quantities, or by 
malarial influences. Persons of gross habits, or intemperate in eating and 
drinking, and those of sedentary habits, are the most subject to it. 

Prognosis.— When the symptoms gradually improve, vomiting ceas- 
ing, or becoming less frequent and distressing, with a gentle moisture 
upon the surface, succeeded by sleep, they are favorable. But frequent 
and severe vomiting, with great prostration of strength, swelling of the 
bowels, intermittent pulse, cold, clammy sweats, short, hurried breathing, 
constant hiccough, spasms of the extremities or convulsions are unfavor- 
able symptoms. 

ALLOPATHIC TREATMENT. Sporadic Cholera occurs independently 
of epidemic influences, and is commonly called Cholera Morbus. If the 
vomited matters have not contained undigested food, (the presence of 
which is probably causing the trouble,) a mild emetic should be given, if 
there is reason to suppose such irritating material still remains in the 
stomach. For this purpose, a teaspoonful of ground mustard in a glass of 
water is as appropriate as any other remedy, and has the advantage of 
being almost always on hand. Other mild emetics may be given. Almost 
always the contents of the stomach are expelled during the first acts of 
vomiting, and an emetic is almost always uncalled for, and, in that case 
will always do harm. 

The next indication is, to overcome the vomiting and purging. This is 
best effected by the hypodermic injection of one-eighth to one-fourth of a 
grain of Morphine, at the hands of your physician. This quickly effects 
the object. Other forms of Opium may be used by the mouth, if the phy- 
sician can not be procured. A third of a grain of Morphine, placed dry 
on the tongue, will generally prove efficient. Thirty drops of Laudanum 
is also an appropriate dose for the relief of the immediate symptoms. The 
dose ought to be repeated in an hour, if the vomiting and purging have not 
ceased. If the remedy is vomited as soon as taken, it should be immedi- 
ately repeated, in the absence of a physician, if administration of this by 
the mouth is not tolerated, a teaspoonful of Laudanum in a tablespoonful 
of thin starch or milk, should be given by injection into the bowels. 

It should be remembered, that this is a powerful remedy to handle, 
and if carried too far, there is danger of Opium poisoning. 

Another important point in the treatment of Cholera 3Iorbus is, to with- 
hold liquids as far as possible. The excessive thirst leads to an intense 
craving for drink. The presence of liquids in the stomach prolong the 
vomiting. The thirst may be relieved by letting small lumps of ice melt 
in the mouth, or ice water may be swallowed, but only a tablespoonful at 
a time. The immediate success of treatment depends largely on the strict 
compliance with this rule. 

The common practice is, to meet the prostration which follows the 
attack with small quantities of brandy or other spirits and water. They 
do not appear to be usually necessary. 

The appetite should be both carefully and moderately indulged after 
an attack. 



FEVERS.— GENERAL REMARKS. 2S7 

Many other methods of treatment are in vogue, but are not given 
here, because this one is habitually successful, and the best suited of any 
for employment by those deprived of the attendance of a physician. 

In epidemic cholera (Asiatic,) the use of Opium is well suited for use 
during the preliminary diarrhoea but is decidedly inappropriate when col- 
lapse has occurred. After this stage has passed, the best results have been 
produced by the use of Chloroform and Camphor, internally. 

During the cold stage, the hypodermic injection of Hydrate of Chloral 
is the best treatment discovered so far. 

HOMCEOPATHIC TREATMENT. Ipecacuanha corresponds to the 
less violent attacks, as long as the discharges have a bilious tinge, and the 
vomiting and retching are very severe. 

Dose: Six pills of the second or third decimal dilution, every fifteen 
to thirty minutes. 

Vcratrum-Album is particularly adapted to a case where the evac- 
uations are colorless; these cases are always the most difficult to manage. 
This characteristic of the evacuations may be expected with tolerable cer- 
tainty, if the disease sets in at once, with violent, copious and frequent 
vomiting, and the accompanying diarrhoea is equally violent. 

Dose: As for Ipecacuanha. 



FEVERS.— GEXERAL REM AUKS. 

In all forms of acute disease, fever is present; in fever, properly so- 
called, there is generally functional disturbance, accelerated action of the 
blood circulation with the participation of the nervous system, and a 
marked tendency to an increased development of heat. The symptoms 
common to most fevers are, at first, a feeling of coldness or shivering, 
then heat, accelerated pulse, thirst, restlessness, and languor. Fever, 
also, possesses the property of passing from one species (variety) into 
another. Thus inflammatory fever may pass into a low typhus, or, on the 
other hand, a simple fever, by injudicious treatment, may be changed 
into an inflammatory one; and that, again, assume the intermittent form; 
also, one attack may, if miserably mistreated, present all these different 
phases. 

Fevers terminating fortunately, and running a regular course, may 
be divided into five stages; the accession, (or first appearance,) increase, 
crisis, decrease, and convalescence. 

When the result is fatal, it may arise from a metastasis, (changing 
from one part to another more vital part,) the exhaustion of the vital 
energy of the patient, or the disorganization of some important part of 
the body. 

The belief in critical days is of very ancient origin, though there is 
some difference in the calculation of physicians upon this point. Some 
counting from the day the shiverings declare the onset, others from the 
first hot fit ; except in cases where a marked periodicity exists, as in ague, 
such distinctions are of little value, because the treatment is directed to 
forwarding the crisis, and thereby' materially shortens the duration of the 
disease, and changing its virulence, so the value of the counting for the 
critical day, is very materially lessened. The best course is to watch the 



2S8 DISEASES OF THE INTESTINES. 

case closely, take careful note of the symptoms, and select, with great care, 
the remedy pointed as the best to meet successfully that condition. By 
so doing, you will be most certain to have the pleasure of seeing your 
patient come safely through the attack, and arrive speedily at a state of 
perfect health. 

A Crisis may make itself known by diarrhoea, profuse perspiration 
hemorrhage, or increase or alteration of other secretions, or by the appear- 
ance of an eruption, after which, if the turn is favorable, the skin becomes 
moist and resumes its functions, and the pulse returns to its usual stan- 
dard . 

Fevers have been differently classified by different medical writers. 
The arrangement we shall adopt is as follows: simple irritative fever, 
inflammatory fever, typhus, putrid, gastric or bilious, intermittent, and 
eruptive fevers, such as scarlet fever, measles, etc. Although I have, for 
convenience in describing fevers and their remedies, so named them, I do 
hope no one will commit the error of treating the disease only by its 
name. Study carefully every case, and treat it according to its own indi- 
vidual peculiarities, as shown by its symptoms. 

Causes of Fever. It cannot be denied that there exists, in certain 
individuals, a peculiar predisposition t© acute diseases. The sanguine, 
nervous, and bilious temperaments (see "Temperaments,") possess 
this susceptibility in a more marked degree than the phlegmatic. The 
exciting causes are numerous; miasms, epidemic influences, contagion, 
powerful mental emotion, derangement of some important organ, exter- 
nal lesions, excess or errors in diet, heat or cold, eruptions which have 
gone in— in fact, anything that causes derangement of the equilibrium of 
the system, may produce fever. 



FEVER.— GENERAL TREATMENT AND DIET. 

The great essentials in the treatment of fever, are : 

Perfect rest— mental and bodily. 

Pure air and a cool apartment; the temperature of the sick room 
should be kept as near sixty degrees as possible. 

Feather beds should be avoided, and matresses substituted when prac- 
ticable ; let the bedclothes be light but sufficient. 

Nature herself, generally, prescribes the diet, taking away the appetite, 
while the thirst present is undoubtedly her loud and well considered call 
for water or fluid of some kind. Water is the best diluent ; no solid food, 
broth or even gruel is permissible, where the inflammation runs very 
high, and very great caution is to be observed in allowing gruel and weak 
broths during the decrease of the fever. An error here, often causes mis- 
chief which cannot be repaired ; it is always better to err a little on the 
side of abstinence, than on that of indulgence. 

Toast water, or barley water, or rice water, sweetened with a little 
sugar, and flavored with raspberry, strawberry, orange, or, above all, 
lemon, may be allowed frequently, and only a little at a time. 

Avoid, until recovery is complete, any article of diet which might, 
in the least degree, over-tax the weakened digestive organs. Fruits fully 
ripe in almost any form are not at all likely to do any injury. 



BILIOUS FEVER. 289 

GASTRIC OR BILIOUS FEVER. 

This is a form of fever in which, as its name implies, the digestive 
organs are chiefly affected. It somewhat resembles typhus, but it is dis- 
tinguished from the latter by the absence of nervous symptoms— although 
when it assumes a torpid character, these are occasionally developed — by 
the absence of the pressive aching pains in the back of the head ; and by 
the absence of disturbance or derangement in the senses of sight and 
hearing ; further, that the pain in the right side of the belly, which is so 
constant a symptom in typhus, is not a feature of this disease. 

Fevers of this description have no definite course or duration. They 
not un frequently fall short of the particular course to which the defini- 
tion is especially appropriate, as in such cases as result merely from indi- 
gestible substances, without actual increase in the discharge of (acrid) 
bile. In such cases, the successful effort of nature to expel the obnoxious 
substance (as by vomiting or purging, or both) is often sufficient to consti- 
tute a perfect resolution, and convalescence succeeds. In other cases 
nature is thus but partly relieved, the whole circulative system having 
become essentially involved, and the fever continues until some other 
crisis (as of sweat or urine) succeeds. Thus, gastric fever, if associated 
with mere foulness of the stomach, may run its course to perfect resolu- 
tion in a few days ; or, if the lining membranes of the stomach or bowels 
be seriously affected, or the action of the liver be much deranged, and 
there be bilious fever, properly so-called, the fever may continue for 
weeks (if not properly or successfully treated,) or may assume a highly 
inflammatory character, or degenerate into nervous or even putrid or 
into chronic or hectic fever. On the other hand, again, it may result in 
transitions of various characters — the superficial membranes, either of the 
throat or external surface (the skin) may become affected, and eruptions 
of various kinds, abscesses, boils, etc., may ensue. 

Complications, and their treatment. In the case of any such compli- 
cations occurring, the treatment must be conducted according to the spe- 
cial directions afforded in the separate article, respectively, devoted to 
the complicating disease. 

Predisposing causes. The predisposing causes may be identified in 
continued exposure to great heat— whereby, the rapid sympathy existing 
between the skin and the liver and stomach, has conveyed, to those 
organs, an undue degree of irritability ; exposure to excessive moisture 
of the atmosphere, particularly, extreme accumulation of condensed 
vapors (heavy dews) over a reeking, heated soil, which continues to emit 
exhalations; exposure to great (especially sudden) transitions of temper- 
ature, particularly from great heat to comparative coldness, or to the 
alternation of heat and cold; whence, it follows, that, under such circum- 
stances, this disease may assume an endemic or epidemic character. The 
more particular and predisposing causes are: weakness of the stomach, 
that is, a morbid sensibility of the lining membrane, and overdue irrita- 
bility of the liver ; habitual debauchery or excesses, sedentary habits, or 
anything, in fact, which may occasion derangement of the stomach, as 
considered in the article on " Indigestion.'' 

Exciting causes. The presence of obnoxious, indigestible, or irrita- 
ting matters in the stomach or bowels — which cannot be dislodged by the 
19 



290 DISEASES OF THE INTESTINES. 

ordinary action of those organs — either in the shape of excessive reception 
of food, whether or not in itself of an indigestible character, or simply 
the reception of indigestible substances in however small a quantity, or in 
the shape of altered or excessive internal secretions, such as bile. Other 
exciting causes are, taking cold, emotions, such as anger, grief, care, anxi- 
ety, etc , acute diseases; or, in fact, any cause of general irritation when 
acting upon persons already predisposed to this complaint, by such con- 
ditions as have been mentioned above. 

Symptoms— of which the following are the principal: sensation of 
fullness and weight in the region of the stomach, or flatulent distention, 
with inclination to vomit ; offensive, flatulent eructations, and, some- 
times, vomiting of food and tenacious phlegm mixed with bile; thickly 
furred, dirty-yellow tongue; belly soft; bowels costive; but in the 
advanced stage of the disease, the evacuations are often very offensive, 
and contain portions of undigested food; frontal headache; languor; 
sickly and distressed expression of countenance, with yellow discolora- 
tion of the white of the eyes ; more or less chilliness, succeeded by heat 
and dryness of skin ; pulse quick but soft, sometimes intermitting or irreg- 
ular, particularly the latter; urine thick, cloudy, and dark colored. 

When bilious symptoms are markedly predominant, all the symp- 
toms commonly appear in an aggravated form ; the heat of the skin is 
very considerable, and the restlessness and thirst are excessive (the 
patient expressing a constant desire for acid drinks.) The region of the 
stomach is much distended with flatulency, but in addition to this symp- 
tom, the following are more or less marked ; the tongue is covered, at first, 
with a pale yellow fur, which gradually assumes a deeper or brownish 
color; the taste and eructations are bitter, and the substance vomited con- 
sists of a greenish, bilious matter; the bowels are either confined or 
relaxed, the motions presenting, in the latter case, a yellow, green, or 
brown color; the face exhibits an earthly, somewhat jaundiced aspect; 
sometimes there is, also, a greater or less degree of sensibility, hardness, 
tension and burning in the region of the liver; the urine is dark-brown, 
bilious; the pulse full, accelerated, intermitting or double. 

ALLOPATHIC TREATMENT. Remittent fever (commonly called 
"bilious fever".) It is to be borne in mind that the exacerbations of 
fever, in this disease, are much longer than in intermittent fever or ague, 
and that the period of remission (diminishing) of the fever is of much 
shorter duration. It is not as convenient to get the physiological effect of 
anti-periodic remedies during the remission (while the fever is down,) as 
is the case in intermittent fevers. 

The one remedy which, par excellens, is a specific in this fever, is the 
Sulphate of Quinine, though the other preparations of Peruvian Bark 
hold a valuable place. 

As soon as it is discovered that the disease is remittent fever, by the 
occurrence of a distinct diminution of the heat (the degree of fever,) the 
patient should at once be given Quinine until its specific effect is pro- 
duced, viz.: a slight deafness, a slight ringing in the ears, or roaring in 
the head. This is best produced by giving large doses, not very fre- 
quently repeated. Ten grains of the Sulphate of Quinine, in solution, 
repeated every six hours, until the characteristic effects of the Quinine 



BILIOUS FEVER. 291 

are produced, is a good practice in this disease or in ague. If this dose 
is not sufficient to produce the effect or prevent the paroxysms of fever, 
the dose may be increased to fifteen or even twenty grains. An eminent 
authority advises the administration of twenty or thirty grains, at a 
single dose, once or twice a day, until the effects are produced. Other 
physicians give the remedy in doses of from three to six grains every 
two or three hours, which is by far the best practice. It requires about 
rive hours after its administration for the maximum effect of Quinine 
to be reached, so that it seems to me unnecessary to repeat the dose any 
oftener than that. 

For the solution of Quinine, the following is a suitable formula: Take 
of Sulphate of Quinine four scruples {eighty grains), water five ounces, 
Aromatic Sulphuric Acid a dram and a half. Mix. A fair-sized table- 
spoonful loill contain ten grains. 

The excessive bitter taste of the solution is very much obscured by 
chewing some Chocolate or Extract of Licorice, and taking the medicine 
while the mouth is still coated with the Chocolate or Licorice. 

The remedy may be taken in powder, easily, by enveloping it in a 
moistened medicine wafer, or enclosing it in jujuba-paste capsules. 

Quinine can be made into pills, for immediate use, by moistening the 
powder with Glycerole of Starch, or Aromatic Acid, rolling out the mass 
and dividing into pills. If the acid is used, the operator must be expedi- 
tious, as the mass soon hardens. 

Sugar, or Gelatine-coated pills of Quinine, may be used, and are an 
elegant form for the administraiion of Quinine, but slower in its action. 
They are liable to become hard with age, and so-unfit for use. Before buy- 
ing these ready-made pills, one of them should be cut open; if the pill 
under the coating is hard, they are unfit for use; if soft, they are good. 

This treatment is both curative and abortive. There is no complica- 
tion that can occur in this disease which will prevent the giving of Quinine. 
If the stomach can not be made to retain the remedy, it should be given 
by injection in the bowel. Once in twenty-four hours, is often enough to 
repeat the injection. The dose for this purpose is generally thirty to sixty 
grains. It may be mixed with Glycerine, Milk, or thin Starch. Thirty 
drops of Laudanum should be added to the mixture for the injection. If 
there is a disposition to expel the injection, firm pressure should be made 
on the anus (opening of the bowel) with a towel or napkin under the hand. 
A four or eight ounce hard-rubber syringe is preferable for the purpose of 
making the injection. 

Time need not be lost before the administration of Quinine for the 
action of cathartics, or any other preparatory treatment. Constipation 
should be relieved by the laxative effect of an Aloetic Pill, or one or two 
Compound Cathartic Pills, or by an injection of tepid water. 

This plan of treatment will, in a large proportion of cases, succeed in 
arresting the disease, but if the disease should continue, the treatment 
thereafter is essentially the same as in other continued fevers, which is 
more especially given in connection with typhoid fever. The anti-periodic 
remedies should be continued, but in more moderate doses. Five grains 
of Quinine two or three times a day, will, probably suffice, but if the fever 
should run high, the dose should be increased sufficiently to moderate the 
fever. 



292 DISEASES OF THE INTESTINES. 

When the fever continues high, after the full effects of Quinine are 
produced, Fowler's Solution (Solution of the Arsenite of Potash,) may be 
given in doses of one drop, three or four times a day. It may be given in 
water, and is useful if the delirium lessens, the skin becomes moist, and 
the tongue clean. When this disease is associated with Typhoid Fever 
(known as Typho-Malarial Fever,) Fowler's Solution seems particularly 
serviceable. 

Headache and delirium are due to the intensity of the fever, and much 
good may be done by applying cold to the head, by frequent bathing with 
cold water, or if the heat of the head is very intense, with a sack or bladder 
of pounded ice. 

Immediate relief from the intensity of the fever may be derived by 
sponging the surface of the whole body, with tepid or cold water, according 
as the fever is moderate or high. The degree of cold should be governed 
by its agreeableness to the patient. The spongings may be repeated as 
often as the patient desires. If the fever rises as high as one hundred and 
four degrees F , or higher, as shown by a fever thermometer in the armpit, 
the application of the cold wet sheet (cold wet pack,) will prove servicea- 
ble. For its application a sheet or linen is wrung out of cold water, and 
laid smoothly on a hard mattress ; the patient then lies, or is placed upon 
it, with his head upon a pillow. The sheet rs then drawn over the body, 
one side at a time, and tucked under the opposite side. Some blankets or 
comforters are then closely applied over the body. The patient may be 
placed in the wet pack several times a day, and allowed to remain in it 
from five or ten minutes to an hour, according to the state of the tempera- 
ture. The effect of cold water is only temporary, and the treatment with 
Quinine, or other preparations of bark, must not be delayed or neglected. 
Water should not be applied to the body, if the patient is sweating. 

If any remedies, besides Quinine and cold, are needed to reduce the 
fever, the Tincture of Aconite is best suited. Half a drop to a drop may 
be given from half an hour to an hour apart, until an impression is made 
on the fever movement, after which it may be given one or two hours 
apart, until the fever is reduced. Then its regular administration is to be 
discontinued, to be resumed again as before, when the fever rises. 

Nausea, (sickness at the stomach) and vomiting may sometimes be 
relieved by laying a cloth, previously dipped in ice water, and folded over 
the stomach or by a mustard plaster. Doses of one drop of Creosote, or 
Carbolic Acid in water, frequently give relief. Bismuth and Oxalate of 
Cerium are generally successful. Take of Subnitrate of Bismuth a dram, 
Oxalate of Cerium half a dram. Mix, and divide into six papers. 

Dose : One every hour or two. 

The powder can be taken dry on the tongue, and swallowed with a 
little water. Milk, with one-third part of lime water, can generally be 
taken by the stomach with benefit. Should the patient need nourishment 
and the stomach not tolerate food, nutritious injections should be given. 
Strong beef tea made with one pound of finely chopped lean Beef, to a pint 
of cold water, by heat (the temperature should be raised to 1 60°.) The 
temperature should be maintained at that for four hours, water being added 
from time to time to keep the quantity at one pint. One-fourth of this 
can be given by injection, or one-eighth by the mouth. Milk may also be 



BILIOUS FEVER. .'293 

give by injection. To the beef tea fifteen drops of dilute Hydrochloric 
Acid, and two teaspoonfuls of Glycerole of Pepsin, or two-thirds of a tea- 
spoonful of powder of Pepsin should be added. If milk is used the acid 
should be omitted. Twenty or thirty drops of Laudanum should be added 
to the injection, if the rectum is irritable, and the injection retained by 
firm pressure with the hand over a towel. Vigilance and restlessness will 
call for anodynes. For this purpose Tincture of Hyoscyamus in doses of 
one or two teaspoonfuls may suffice. If not, ten to twenty drops of Lau- 
danum may be added. A pill of one grain of Extract of Hyoscyamus and 
half a grain of Opium may be used. 

Protracted cases require the same treatment, with more attention 
given to feeding the patient. Fifteen drops of Dilute Hydrochloric Acid, 
in sweetened water, three or four times a day. It assists the digestion and 
relieves the dryness of the mouth and throat. During convalescence, tonic 
doses of Quinine, or Bark and Iron, should be taken. A dessertspoonful of 
the Elixir of Bark and Iron, is useful. Probably the Citrate of Iron and 
Quinine, or the Citrate of Iron and Cinchonidia in doses of two to five 
grains dissolved in Orange Flower Water, taken three times a day, answers 
the purpose the best. A tea (infusion) of Dogwood, Colombo, Gentian, 
Quassia, Boneset, and Wild Cherry, and Poplar, is useful, taken before 
meals. Two ounces of the dried drugs will make a pint of infusion (tea;) 
the dose is one or two tablespoonfuls. The Tincture of Iron, in doses of 
fifteen drops in sweetened water, may then be taken after meals. Should 
intermittent fever (ague) follow bilious fever, it should be treated as 
is directed for that disease. 

In Typho-Malarial fever the disease should be treated in the first place, 
as is directed in this article for remittent fever, aside from this the treat- 
ment will be as is directed for Typhoid fever. 

HOM(EOPATHIC TREATMENT. In simple cases, associated with 
uncomplicated derangement of the stomach, or simple foulness, especially, 
if the affection be casual, and can be traced directly to excess in eating or 
drinking, or to some particular indigestible substance, if all strikingly 
bilious symptoms be absent, such as those above enumerated, and if there 
be no bitterness of taste, or bitter eructations, the treatment should be 
regulated by the directions afforded in the article on " Indigestion." 

In the severer cases, characterized by predominant bilious symptoms, 
or if the disease assumes an inflammatory character, the ensuing indica- 
tions may advantageously be consulted. 

Aconitum is indicated, more especially, when everything received in 
the mouth, in the shape of food or drink, except water, has a bitter taste, 
or when there is continually a bitter taste in the mouth, the pulse being 
quick and frequent; when the tongue is covered with a yellow coating; 
when bitter eructations or violent urging to vomit, and retching occur, 
without discharge, or when there is vomiting of greenish, bitter, or slimy 
matters; also, by excessive nausea; suspended evacuations, or frequent, 
scanty, small motions, attended with much urging; swelling and tight- 
ness across the stomach, sensation of heaviness and fullness in the fore- 
head and temples ; and if fresh air appears to afford some relief. 

Dose: Of a solution of ten globules to two tablespoonfuls of water, 
give a teaspoonful every two hours, until amelioration or change. 



294 DISEASES OF THE INTESTINES. 

Belladonna is indicated when there is violent throbbing of the arter- 
ies of the temples, reeling giddiness, and intense and unbearable headache, 
chiefly seated in the forehead, as if the contents of the head would fall 
out at the forehead ; dryness of the mouth, and thirst; sometimes inces- 
sant nausea; tongue covered with a thick, whitish or yellowish coating; 
sour taste; repugnance to all kinds of food, and even to drink ; vomiting 
of food, or vomiting of sour, slimy or bitter matters ; suspension of evac- 
uations, or looseness of the bowels, with slimy evacuations; quick and 
full pulse; especially if the head symptoms be aggravated by moving the 
eyes, or by movement generally, or by shaking, or even by touch, and by 
the access of fresh air, or a draught, and if they be somewhat relieved 
when the head is supported or held backwards. 

Dose: In every respect as directed for Aeonitum. 

Ntix-vomica is indicated in bilious fever by the following symptoms 
amongst others: absence of thirst, or ardent thirst attended with heart- 
burn ; constant nausea ; bitter eructations ; foul, or bitter taste in the 
mouth, the tongue dry and white, or covered with yellow coating towards 
the root ; painful sensation of weight and tightness across the stomach, 
constipation, with repeated urging to evacuate, without discharge, or 
looseness of the bowels, with scanty, insufficient, watery or slimy evacua- 
tion ; spasm of the stomach; great inclination to vomit, sometimes even 
with empty retching, or vomiting of food ; full and frequent, or quick 
and intermittent pulse ; great prostration of strength in the first stage, 
and characterized by shivering, occurring with partial heat, or by heat 
following ; headache with heat of the head; dullness or confusion of the 
head, with reeling giddiness; buzzing, singing, or tingling in the ears; 
sallow appearance of the complexion, sensation of exhaustion and weari- 
ness; sometimes yellowish hue of the white of the eye, particularly of 
the lower part of the eyeball ; great sensibility of light, especially in the 
morning. 

Dose: Six pills dry, on the tongue, or in a teaspoonful of water, 
every two hours, until four doses have been given, and afterwards, 
if necessary, every six hours. 

ChamomMla is of eminent service after Nux-vomica, in very severe, 
cases, in which the last named remedy has failed to arrest the symptoms 
when the tongue is red and fissured, or when the tongue exibits yellow 
coating; or when further indicated by intense heat and redness of the face, 
(particularly at night,) restless and interrupted sleep, bruised pain in the 
head, with pressure, fullness, and heaviness; inflammatory redness and 
burning sensation in the eyes, bitter taste in the mouth ; every kind of food 
conveys a bitter taste; loss of appetite, nausea, or eructations ; vomiting of 
greenish, sour, or bitter matters; intense anxiety, and oppression of the 
cbest; looseness of the bowels, with sour-smelling evacuations, having the 
appearence of stirred eggs; or greenish evacuations, or, on the other hand, 
constipation, with suspended evacuations. 

Dose: As directed for Nux-vomica. 

Bryonia is particularly appropriate to the treatment of this disease 
in the hot season. The indications which identify it are as follows: — in- 
sipid, foul, or bitter taste, particularly on waking; continued thirst, tongue 
exhibiting a number of blisters, and covered with a white or yellow coat- 



BILIOUS FEVER. 295 

ing; desire for acids and stimulants, such as coffee, wine, etc., but repug- 
nance to solid or wholesome food; vomiting of bilious matters, particu- 
larly after drinking, or sometimes frequent, but ineffectual retching ; 
oppressive headache; constipation of hard difficult stools, as if burnt. 

Dose : As for Nux-vomica. 

Pulsatilla is, also, a most important remedy in this, as in every 
other disease in which the digestive organs are particularly implicated 
— the tongue being covered with whitish coating; after swallowing 
food or drink, there is bitter, foul taste in the mouth ; all food conveys a 
bitter taste, especially bread; regurgitation of food; extreme nausea, or 
inclination to vomit, in the evening; excessive accumulation of phlegm in 
the stomach and gullet; vomiting of food or of phlegm, or of bitter or 
sour matters, more severe at night; acidity of the stomach; flatulent dis- 
tention of the belly, with rumbling of wind in the bowels ; looseness of 
the bowels, with discharge of bilious or slimy matters in the evacuations, 
— or sluggish evacuations, and insufficient activity of the bowels -^split- 
ting headache, with tightness and compression of the forehead ; slowness 
and fullness of the pulse (in general ;) fits of shuddering and coldness in 
the evening, or towards evening. 

Dose : In every respect as stated for Nux-vomica. 

Mercuriiis may frequently be employed with great advantage after 
Belladonna, when indicated by the following symptoms and conditions: 
Dryness, and burning heat of the lips; drowsiness in the day time, but 
sleeplessness at night ; severe and painful sensitiveness of the belly and of 
the region of the stomach, to touch or to pressure, these symptoms being 
aggravated, or developed at night, the tongue covered with white or 
yellowish coating — or moist; foul, or even offensive and loathsome, or 
bitter taste in the mouth; nausea or inclination to vomit, or, at other 
times, actual vomiting of mingled phlegm and bilious matters ; the fever- 
symptoms are characterized by general coldness, shivering and shudder- 
ing all over the body, irregular, or quick and intermittent pulse ; heat of 
the head and face, with flushing, when all other parts of the body are 
affected with coldness, shivering, etc.; giddiness when the head is raised; 
intense headache, with desire to press the head between the hands; 
intense dejection, and listlessness. 

Dose: Of a solution of six globules, to two tablespoon fuls of water, 
give a teaspoonful every four hours until improvement or change. 

Ipecacuanha is indicated by inclination to vomit, with utter repug- 
nance to food; dryness of the mouth; the tongue either clean, or covered 
with a thick, yellowish coating; violent retching, without discharge, and 
attended with great straining, or, easy, copious vomiting of slimy matters 
or of food, with a violent gush; looseness of the bowels, with discharge of 
yellowish and very offensive, or even putrid evacuations; and accompa- 
nied with severe colicky pains; weight, and sensation of fullness, with 
very severe pains in the region of the stomach ; pale, yellowish hue of the 
skin; severe headache. 

Dose: Of a solution of ten pills to two tablespoonfuls of water, give 
(if violent vomiting occur,) one teaspoonful every hour, until the 
Symptoms yield. 

China is applicable to such cases as evince the following symptoms: 
Frequent eructions; vomiting or regurgitation of food; loss of appetite, 



296 DISEASES OF THE INTESTINES. 

and a sensation of thorough repugnance to all food, or as if one had eaten 
enough, or more than enough ; frequent emission of very offensive wind 
from the bowels; evacuations containing indigested food ; painful sensa- 
tion of tightness in the belly, and of weight in the region of the navel ; 
sensations of chilliness and shuddering after drinking; looseness of the 
bowels, with watery, slimy or yellowish evacuation ; heat, with full and 
quick pulse; headache (sometimes delirium,) burning sensation in thelips, 
red face, and dry mouth. 

Dose: Of a solution of ten pills, to two tablespoonfuls of water, give 
a teaspoonful every two hours, until amelioration or change. 

Arsenicum is an invaluable remedy in the majority of very severe 
and urgent cases, either when one or more of the preceding have failed 
to arrest the symptoms, or when the disease has run on to an advanced 
gtage before treatment has been resorted to. The chief indications for it 
are dryness of the tongue, accompanied with severe thirst, and with 
continual inclination to drink, with, however, inability to drink more 
than a small quantity at a time ; bitter, or very acrid, pungent eructa- 
tions ; saltish or bitter taste in the mouth ; nausea, vomiting of food or of 
greenish, brownish, or bilious matters ; extreme tenderness of the region 
of the stomach to contact ; burning and cutting, cramp-like, or spas- 
modic pains in the stomach and bowels, accompanied with chil- 
liness and anguish— or very painful sensation of weight and burn- 
ing at one spot in the stomach ; suspension of evacuations, excessive 
and continued relaxation of the bowels, attended with severe urging, and 
with brownish, yellowish, or greenish evacuations; scalding sensation in 
passing water; the evacuations (or vomiting,) are provoked by, or occur 
after every movement, or after drinking ; general heat of the body, usu- 
ally occurring at night, and accompanied with restlessness, anxiety, etc.; 
irregular, frequent, and quick pulse; extreme prostration of strength, and 
desire to assume, or to retain a recumbent posture. 

Dose : As for Nux-vomica. 



ENTERITIS-INFLAMZIATIOX OF THE BOWELS. 

The causes of enteritis are mostly the same as those of indigestion, 
dietetic transgressions ; the use of irritating, readily decomposed, sour 
substances; overloading the stomach; abuse of spirits; a cold. In addi- 
tion, we have poisonous substances ; mechanical irritation by fecal matter, 
the progression of which, in the bowels, is arrested, in consequence of 
which, the vessels become compressed, or, finally, though rarely, the in- 
flammation may be caused by worms. Besides these causes, enteritis 
occurs as a continuation of other inflammatory processes, gastritis, peri- 
tonitis, and as a form of reaction against ulcerations of the intestinal 
mucous membrane. 

Symptoms.— If at first the inflammation is not spread over a large 
surface, and confined to the lining membrane, the symptoms are not very 
grave. There are few local pains, little fever, loss of appetite, constipa- 
tion, feeling of fullness in the umbilical region; nausea occurs very sel- 
dom; there is never any vomiting. In this manner, the affection may 
exist a short time and disappear again almost imperceptibly, or it may 



INFLAMMATION OF THE BOWELS. 297 

increase and continue to spread ; very rarely the disorder breaks out at 
once in all its violence. The pains now become intense, burning 
or tearing, or cutting like colic, until they sometimes grow intolerable; 
they spread over the whole abdomen ; are generally most violent in the 
umbilical region, where the least pressure causes an intense aggravation 
of the pain, which is increased, even by the act of breathing; coughing 
causes extreme pain, which is likewise intensely aggravated every time 
the patient attempts to turn the upper part of his body, on which account 
he remains lying motionless on his back. At all times the pain has more 
or less prolonged aggravations like colic, evidently caused by the pro- 
gressive descension of the contents of the bowels. At the same time the 
abdomen is distended, but not to excess. Where the small intestine is 
alone affected, there is obstinate constipation ; where the large intestine 
is involved in the inflammation, we have sometimes, not always, diarrhoea, 
colored, frequently bloody stools, or alternate constipation and diarrhoea, 
or, finally obstinate constipation. In such cases, the colicky pains are 
more frequent and extensive, the distention of the abdomen more consid- 
erable. In violent attacks of this disease the constitutional symptoms 
are always very marked. A general chill only precedes a very sudden 
invasion of the disease. The patient feels the heat more preceptibly than 
others ; he is constantly complaining of an intolerable thirst ; the pulse is 
accelerated, even to one hundred and twenty beats, small and contracted, 
not often unequal and intermittent; the skin of the body is hot and dry; 
the extremities are frequently cool; the forehead is covered with a 
perspiration, as if from anguish; the appetite is entirely gone; the tongue 
has at times a light coating, at times it is clean and very soon becomes 
dry. If the affection increases in violence, the first symptom generally 
is nausea, which soon becomes associated with retching and vomiting. 
At first, bile and mucus are vomited up with the food ; but if the inflam- 
mation is extensive, even fecal matter may be thrown up ; the vomited 
matter very soon acquires a smell like that of feces. The signs of col- 
lapse now become more apparent; the face has a cadaverous appearance, 
expressive of deep suffering, with elongated features and sunken eyes. 
Under such circumstances, the patient often wanders, the skin becomes 
cool, and is covered with a cool perspiration. Convulsions and fainting 
tits occasionally complicate these symptoms, and death may ensue under 
such circumstances. A rapid and complete recovery only takes place 
exceptionally. 

The prognosis is always uncertain, because the disease is apt to pass 
into insiduous chronic complaints, even after the recovery seemed to be 
fairly under way; at all events, enteritis always constitutes one of the 
more important diseases. 

The diagnosis of enteritis, although somewhat difficult, yet, with 
proper care, can be made, in the majority of cases, with positive certainty. 
The disorder is most easily confounded with incarcerations, simple choler- 
ine, colic. The last two can become dangerous, if the trouble is esteemed 
too highly. Since it is not always possible to make a sure diagnosis until 
the disease has run along for a time, the employment of irritating remedies 
cannot be sufficiently guarded against in cases of colic and cholerine. 

ALLOPATHIC TREATMENT. Enteritis. The discrimination of 
acute enteritis (inflammation of the small intestines,) will be very unsat- 



298 DISEASES OF THE INTESTIKES. 

isfactory, if made by unprofessional hands. If the diagnosis is made out, 
the treatment will be, essentially, as follows: 

The patient should remain in bed. Hot fomentations should be per- 
sistently applied to the abdomen, and some form of Opium given to the 
extent of relieving the pain and checking the diarrhoea. Opium, in doses 
of a grain, should be given two to four hours, or longer, apart; but suffi- 
ciently often to procure relief from pain. Hyoscyamus or Belladonna may 
be advantageously given with the Opium, rendering the action of the Opium 
more pleasant. The dose of the Extract of Hyoscyamus is one grain ; 
of the Tincture, one or two teaspoonf uls. The dose of Extract of Bella- 
donna is a quarter of a grain, and a dose of the Tincture is ten drops. 

Laudanum, in doses of twenty drops; or Morphine, in doses of a quar- 
ter of a grain, may be used instead of Opium. 

It is as well to administer the Opium by injection into the rectum. 
For this purpose, a teaspoonful of Laudanum should be used, mixed with 
one or two tablespoonf uls of thin starch or milk. An eight-ounce hard- 
rubber syringe is a suitable instrument for this purpose. After drawing 
the mixture into the syringe, the nozzle should be elevated, and the air 
can be expelled by slowly pressing the piston. After the injection, firm 
pressure on the anus (opening of the bowel) with a towel under the hand, 
for a time, will enable the patient to retain the injection. Both these 
methods of giving the medicine may be alternated. 

It is not best to give cathartics, unless there is good reason to believe 
irritating substances are contained within the intestinal canal, and then 
it is better to resort to injections of warm water, if the bowels require 
moving. 

The diet should be of a character which will not require intestinal 
digestion, nor cause irritation by their presence in the intestine. Beef- 
tea, beef-juice, raw eggs, and milk, answer this purpose as well as any- 
thing of which we have command. Rice and barley-water, or arrow-root, 
boiled in water, may be drank. 

It is common to recommend Cod Liver Oil and Iron. They are well 
suited to these cases. I believe tablespoonful doses of pure Glycerine, 
having dissolved in it three to five grains of the Citrate of Iron, or the 
Citrate of Iron and Quinine, answer the purpose better. 

The patient will require systematic feeding, if the disease be pro- 
longed, to support the powers of life, as in fevers. Full directions for this 
will be given on the subject of typhoid fever. 

During convalescence, the usual diet should be returned to very cau- 
tiously. 

When the disease affects children, it is necessary to be very cautious 
in the use of Opium. The Camphorated Tincture of Opium should be 
used, with an equal quantity of Tincture of Hyoscyamus. The usual dose 
of each being fifteen or twenty drops for a child one year old. For a child 
of five years, three grains of Dover's Powder, equal to one-third of a grain 
of Opium, may be used. 

If the stools become charged with mucus, a teaspoonful or two of 
Castor Oil, with an equal quantity of Glycerine, flavored with one or 
two drops of Oil of Cinnamon, may be given. Rochelle Salts is, also, an 



INFLAMMATION OF THE BOWELS. 299 

appropriate laxative, in doses of half a teaspoonful (in lemon syrup). 
Laxatives should, however, be given with caution. 

The diarrhoea, which follows often upon the subsidence of the inflam- 
mation, may be checked by appropriate doses of Paregoric, Dover's Pow- 
der, or Opium, with ten grain doses of Sub-Nitrate of Bismuth, or Tinct- 
ure of Catechu, or Kino, in equal quantity with the Paregoric, in Chalk 
Mixture. 

Local, and other general treatment, will be the same as for adults. 

HOMCEOPATHIC TREATMENT. Aconite in the early stages, when 
the inflammation is just beginning, will cut the disease short. Dry, hot 
skin; full, frequent pulse ; mouth and tongue dry, with intense thirst. 
Abdomen swollen and tender to the touch ; cutting, burning and tearing 
pains in the region of the navel. Great fear and anxiety of mind with 
nervous excitability ; bright-red and hot urine, are the leading symptoms 
calling for this remedy. 

Dose: Eight pills every one to three hours, dissolved in a little water, 
or dry on the tongue. 

Mercurius. Abdomen swollen hard, and painful to contact. Cut- 
ting, stabbing pains in the bowels, accompanied with chilliness and shud- 
dering ; green or bloody mucous stools, with violent griping; profuse 
perspiration affording no relief; pale, wretched complexion ; foul smell 
from the mouth ; vomiting of bitter mucus ; restless sleep. 

Dose: A one-grain powder or six pills every two to four hours. 

Belladonna. Great heat and tenderness of the abdomen. Violent 
contraction or clutching pains in the bowels. Pains which appear sud- 
den ly and disappear just as suddenly after continuing for a longer or 
shorter period. Congestion of blood to the head, with throbbing of the 
arteries of the neck (carotids.) Face flushed, eyes red and sparkling. 
Great intolerance to noise and light. Starting and jumping during sleep. 
Sleepiness, but cannot sleep. Partial or general spasms. Almost constant 
groaning or moaning. 

Dose: As for Aconite. 

Arsenic tun. Even if the previous treatment fails, there is still hope 
that this remedy will succeed, if the following symptoms are present : — 
Very rapid and weak pulse. Sudden failure or sinking of strength. Cold, 
clammy sweat, and great restlessness. Intense thirst, drinking often but 
little at a time. Burning in the abdomen, worse after eating or drinking, 
usually followed by vomiting. Symptoms all worse after midnight. 

Dose : As for Mercurius. Arsenicum always gives the best satisfac- 
tion in potencies as high as thirty or upward. 

Bryonia and Cantharis are, also, good sometimes. See '• Repertory." 
Make hot applications to the abdomen. Bathe with tepid or cold water. 
Drink Elm Bark Water, etc. 



CATARRHAL DYSEXTERIA.—FLUX. 

Symptoms. The disease sets in without any definite precursory symp- 
toms, or suddenly with violent pinching, cutting pains, radiating from 
the umbilical region downwards, and which are speedily succeeded by a 
violent urging to stool, with discharge of fecal, soft or watery masses. 



300 DISEASES OF THE INTESTINES 

After the evacuation, the pains abate for a shorter or longer period, after 
which they return with renewed violence, and more particularly with 
increased urging, attended with tenesmus, (pain and difficulty with 
frequent desire) and severe pressing pain, during which a small quantity 
of white, and subsequently blood-stained, mucus is discharged, withoutany 
admixture of fecal matter in most cases. At the same time, the patients 
experience an acute burning pain in the anus, and with every new dis- 
charge the tenesmus increases. In slighter cases the disease sometimes 
runs its course without any fever ; the more acute cases may be attended 
with violent fever; the stomach is at times involved in the affection, at 
times not at all ; there is loss of appetite, retching, nausea, vomiting; the 
tongue is usually quite clean. The duration of the disease usually depends 
upon its extent, which is pretty accurately measured by the extent of the 
pain. The slighter cases sometimes do not last more than a day, the 
severe cases last weeks, and then are disposed to pass into the chronic 
form. In the case of children the non-admixture of fecal matter in the 
stools is an exception to the rule ; blood, pus, and scrapings of intestinal 
membrane, shreds of mucous membrane, and false membrane, are met 
with the more frequently, of mixed green color. The dysentef y of chil- 
dren assumes more easity a chronic form than in the case of adults, and 
almost always leaves a peculiar disposition to relapses. The so-called 
teething dysentery is just such a catarrhal affection, and arises less fre- 
quently in consequence of the process of dentition, than of other influ- 
ences acting upon the little patient, especially, an erroneous system of 
preparing and administering nourishment. In the case of children, even 
if there is no sign of fever, convulsive symptoms are apt to follow, 
imparting a higher degree of importance to the otherwise not very impor- 
tant disease. 

A fatal termination of catarrhal dysentery, in a person of an other- 
wise good constitution, is a rare occurrence. Even where the disease sets 
in as a complication of other diseases, the danger incident to its course is 
only of moderate importance. 

The treatment will be shown when we come to speak of dysentery 
proper. 



DYSE&TERIA EPIDEMICA, DYSENTERY PROPER, 

FLUX. 

However trifling catarrhal dysentery may seem, dysentery proper is 
an important and dangerous disease. 

History. Dysentery usually breaks out in an epidemic form; the 
few cases of sporadic dysentery that call for treatment, are either not 
dysentery, properly speaking, or else they are very rare occurrences. 

Dysentery is, more particularly, a disease of young persons and those 
of middle age, and very seldom attacks either the very young or very old. 
Epidemic dysentery almost always breaks out late in the summer, or in 
the beginning of fall, in very hot and dry seasons; it rarely lasts until 
winter is somewhat advanced ; it seems to occur more frequently among 
the lower than the higher classes ; its spread is promoted by living in 
crowded rooms; nothing shows this clearer than the devastations which 



FLUX. SOI 

dysentery causes in the ranks of armies. Neither city nor country peo- 
ple are spared ; it even seems as though the latter were more fearfully 
visited by this plague. 

If a disposition to dysentery prevails, errors in diet and catarrhal 
exposures excite the attack; the statement, however, that the use of fruit 
favors the breaking out of dysentery, is not yet proven. This assertion, 
at most, only applies to unripe fruit, or to such kinds as are apt to cause 
cholera morbus, diarrhoea, etc., such as the early cherries, plums, etc. 
There are, undoubtedly, individuals whose bowels are irritated by the 
use of any kind of fruit, and in whom it may cause an attack of dys- 
entery. 

These detached and well established historical data, cannot well be 
harmonized in one series, except by the supposition that there exists a 
peculiar virus, which has a special relation to the large intestine; for it is 
only in these parts that the phenomena of dysentery become localized. 
In this respect, dysentery is very near to Asiatic cholera, and, likewise, 
to other infectious epidemics. What the quality of the dysenteric virus 
is, has not yet been decided with any degree of certainty. That the virus 
is of a vegetable nature, might be accepted as true, where dysentery 
spreads over extensive districts ; but this theory does not apply where 
dysentery attacks whole armies. A discussion of this point is not as use- 
less as it might seem, since its proper solution is intimately connected 
with the preventive treatment of dysentery. This question may, per- 
haps be better elucidated by subsequent epidemics. It is certain that the 
virus is engendered in the patient, and is transmitted by him, like the 
poison of cholera. Contagion does not take place by contact, but the 
infection is propagated by water-closets, close stools, etc. This theory, 
which is now received as explanatory of the spread of cholera, explains 
the fact, why the disease decreases and disappears with the appearance 
of frost; the cold destroys the poison. This may be the reason, also, 
why dysentery sometimes continues as long as midwinter, provided the 
warm weather lasts, and there is no frost. The circumstance that during 
an epidemic all the inhabitants of one house, but not all the houses in the 
neighborhood, are attacked, and that epidemics spread more extensively, 
and more frequently in the country where the exhalations from excre- 
mentitious matter are more freely diffused through the air, speaks, like- 
wise, in favor of the theory, that infection is communicated in the man- 
ner above described. Among armies in the field, the epidemic is propa- 
gated in a like manner, whereas, the soldiers, lying in the barracks, are 
protected much more efficaciously, and the cases of dysentery occurring 
among them, are less numerous. Even if the views which we have here 
expressed, are not absolutely accepted as true, yet no reasonable physi- 
cian will neglect to arrest the spread of the disease, by effecting the remo- 
val of the various circumstances, which we have pointed out as exciting 
causes of the epidemic. Another important question regarding the his- 
tory of dysentery is, whether an alteration in the functions of the liver 
does not constitute the chief exciting cause of the disease. The origin of 
the epidemic, at a time when the action of the liver is known to be 
altered, and the affections of the liver which so often prevail, during and 
after epidemic dysentery, seem to confirm this opinion. Hence, individ- 



302 DISEASES OF THE INTESTINES. 

uals in whom unhealthy changes in the functions of the liver, have 
developed a disposition to be attacked with dysentery, are most likely to 
be assailed by this plague ; this circumstance again shows why middle- 
aged persons should be most liable. 

Where the ulcers are not too extensive, they heal without much cica- 
trization. If the loss of mucous lining is considerable contracting 
cicatrices are the result, so that the bowels look as if twisted around by 
cords, or presenting valve-shaped contractions. It is upon the duration 
of this process that the length of the period of convalescence depends. 

Symptoms. The breaking out of the disease is almost always pre- 
ceded by precursory symptoms. The patient feels languid, prostrate, and 
out of humor; the appetite is, more or less, wanting; there is oppression 
of the stomach, deranged digestion, and an increased accumulation of 
flatulence. These symptoms soon increase to nausea and desire to vomit, 
with coated tongue and foul taste ; sleep is disturbed ; there is drawing in 
the extremities, sensitiveness to external cold, shiverings, and an accel- 
erated pulse. These symptoms show that the disease has invaded the 
organism. Above all, it is the diarrhoea which denotes the local sphere 
of the disease. Even if all the other precursory symptoms are wanting, 
diarrhoea generally precedes the attack, in company with slight, colicky 
pains, and without any further characteristic peculiarities. As these 
pains increase, the diarrhoeic discharges occur more frequently, but are, 
at the same time more scanty, in the same proportion the tenesmus, 
which precedes every discharge, begins to distress the patient. At 
times, after a few fecal evacuations, and at others after a somewhat 
longer duration of the simple diarrhoea, fecal matter ceases to be dis- 
charged; this is the commencement of the real disease. The colicky 
pains, which are seldom wanting, increase in intensity, become more 
continuous, and are attended with a painful urging to stool; a sensa- 
tion as if the bowels would press out of the abdomen, or as though a 
heavy weight were suspended from the anus, or as if the sphincter ani 
(muscle that closes the anus, "puckering string") would tear. When 
these pains reach their hight, there occurs a scanty discharge, attended 
with an intense burning at the anus. At first a remission of the distress 
takes place after this discharge, but the more frequently it occurs, the 
more the tenesmus increases in violence, and the less it intermits after the 
evacuation has taken place. 

The evacuated substance, which, for some time, continues to show a 
little tinge, soon becomes a mere mucus, with a grayish admixture, or a 
more or less copious admixture of blood (red and white dysentery,) and of 
a peculiar insipid odor. In more violent cases, pure blood is evacuated. 
According as the disease is more or less intense the discharges occur every 
hour, sometimes every few minutes, so that the patient scarcely dares 
leave the chamber, however difficult it may be for him, owing to the con- 
tinued violent and colicky pains, to sit up. The pains now become more 
tearing, cutting, radiating from the umbilicus (navel) downwards. The 
constitutional equilibrium is not much disturbed at the outset. In mild 
cases, the fever is scarcely perceptible, but there are frequent chilly creep- 
ings. The pulse is but a little accelerated, and temperature of the skin 
is not much increased. In proportion as the discharges increase in fre- 



FLUX. 303 

quency, the pulse becomes correspondingly accelerated, hard and small, 
the skin hot and dry, the thirst distressing; the desire to vomit increases 
to real vomiting, although not regularly; the appetite is entirely gone. 
The patient soon loses his strength, and feels unable to sit up. The affec- 
tion may continue, at this stage, for a week, after which it may gradually 
terminate in recovery. If the local changes are more considerable, the 
disease increases in intensity. The pulse grows frequent, small, and 
feeble, the thirst becomes agonizing, the temperature unequal, the extrem- 
ities feel cool to the touch, the tongue can hardly be kept moist, the face 
has a cadaverous expression, and the prostration is complete. Usually the 
abdomen is much distended and sensitive. The discharges follow each 
other more rapidly, and the tenesmus continues uninterruptedly. The dis- 
charges, together with the blood, contain shreds of mucous membrane, and 
a number of membranous fragments. When the disease reaches this 
hight, delirium is not an unusual occurrence. If the disease approaches 
a fatal termination, the discharges either become fetid, or else they cease 
entirely, or take place involuntarily, as a sign that the bowel is paralyzed. 
It is always a bad symptom, if the discharges diminish in frequency without 
any corresponding improvement. Death supervenes amid symptoms of 
general prostration, meteorism (distention with gas), delirium, coma. The 
termination in recovery may be considered certain, if a general improve- 
ment is accompanied by a decreasing frequency of the stools, and the colic 
abates, although the tenesmus still continues. 

As sooo as the discharges contain feces, and the fecal odor is restored, 
recovery may be considered under full headway. The pulse generally 
continues somewhat more rapid, yet becomes fuller and stronger, and the 
symptoms of fever disappear. After a severe attack of dysentery, recov- 
ery scarcely ever takes place very rapidly ; which, as we said before, is 
owing to the slowness, with which the ulcerated surfaces heal; it may, 
also, be owing to the fact, that the condition of the digestive organs does 
not admit of a rapid reparation of the waste, by a copious supply of food. 

In armies, especially, the transition of acute into chronic dysentery is 
not a rare occurrence. The symptoms of chronic dysentery correspond 
with those of ulceration of the bowels, which, indeed, constitutes the basis 
of the chronic form. In such a case the fever disappears entirely, but the 
diarrhoea continues, consisting at one time of fecal masses, lined with pus 
and blood, and at other times of a sanguineo-purulent mucus, or changing 
about with obstinate constipation. At the same time, the appetite does 
not return, and the patients continue to lose flesh. Death is apt to termi- 
nate such sufferings, though, frequently, not until they have lasted a long 
time. 

The severest forms of dysentery, the septic, putrid or typhoid form, 
are of very rare occurrence in our latitude; they are more frequently met 
with in hot climates. Such forms arise either because the milder form 
assumes a malignant type, with all the signs of gangrenous destruction of 
the bowel, or else they break out at once, with an extraordinary degree of 
intensity, characterized by the signs of a most acute typhus, and rapidly 
terminating in death. 

Strictly speaking, there is no transition into other affections; the 
abscesses of the liver, which do not occur unfrequently, even among us, 



304 DISEASES OF THE INTESTINES. 

after a violent attack of dysentery, are most probably due to the absorp- 
tion of pus into the vessels ; or possibly to a disease of the liver, running 
its course simultaneously with dysentery. 

The Prognosis, in the dysenteries of our climate, is emphatically- 
favorable. 

ALLOPATHIC TREATMENT. Treatment of Acute Sporadic Dysen- 
tery or Flux (occurring independently of epidemic influences.) In this 
disease nature points unerringly toward a thorough emptying of the intes- 
tinal canal of its contents. This is shown by the copious diarrhoea which 
precedes the dysentery. 

The first object of treatment, therefore, is to effect this end as quickly 
and thoroughly as possible, assisting nature's efforts by an efficient cathar- 
tic. By far the most effective cathartic for this purpose is Sulphate of 
Magnesia (Epsom Salts). Take a sufficient quantity of Sulphate of 3Iag- 
nesia to saturate seven ounces of water ; add one dram of Aromatic 
Sulphuric Acid. The dose of this mixture is a tablespoonful every hour 
or two, until it operates freely; or the Epsom Salts may be given in doses 
of a heaping tablespoonful steeped with one-third of its bulk of roasted 
coffee and repeated in four hours, if a free watery stool has not been before 
produced. Rochelle Salts, in doses of a tablespoonful in solution with 
water and lemon juice, or, Citrate of Magnesia, may be employed, but the 
acid solution of Epsom Salts is to be preferred. Castor Oil is only of less 
value as a purge in this disease than the cathartics before mentioned. If 
used, it should be given in doses of a tablespoonful or more, mixed with an 
equal quantity of Glycerine, and flavored with a couple of drops of Oil of 
Cinnamon. This should, also, be repeated in four hours, if it has not oper- 
ated. After thorough purgation has been produced, the cathartic is to be 
discontinued. 

This effect is followed by a period of rest, and sometimes recovery im- 
mediately takes place. This rest of nature should be aided, and prolonged 
by a full dose of Opium. The Opium benefits, also, by its direct effect on 
the inflammation (called antiphlogistic) as well as aiding recovery by 
prolonging the quiet of the intestine. It is preferable to give the Opium 
by injection into the rectum. For this purpose a teaspoonful to a tea- 
spoonful and a half of Laudanum should be mixed with one or two table- 
spoonfuls of thin starch or milk, and injected into the rectum with a hard 
rubber syringe. If it is thrown off it should be immediately repeated and 
caused to be retained, by firm pressure upon the anus (opening of the 
bowel) with a towel under the hand, until the efforts to expel it cease. 
Generally speaking, once in twelve hours is often enough to repeat the 
injection of Laudanum, but it should be often enough to afford complete 
relief, and the dose increased until this effect is produced. Suppositories 
of Opium or Morphine can be purchased, which will answer the purpose. 
In some instances, neither the injections nor suppositories can be retained 
in the rectum. In such cases, it must be given by the mouth. Then the 
powder or pills of Laudanum or Morphine may be used. The usual dose is 
one grain of the powder, or one pill, or twenty-five drops of Laudanum, 
or a quarter of a grain of Morphine, but the dose must be increased until 
relief follows its administration, and repeated often enough to continue 
the relief. 



FLUX. SOo 

The patient should be quiet in bed, a large flax-seed poultice, containing 
two or three tablespoonfuls of mustard, placed over the stomach. About 
half an hour after the Opium or Laudanum injection is given, thirty grains 
of Ipecacuanha, wrapped in a medicine wafer, should be given, or it may- 
be given in milk. The Ipecacuanha causes the stools to become natural, 
the griping and straining cease, the hot, dry skin becomes moist, and the 
patient becomes refreshingly calm. In a simple acute case, this may com- 
plete the cure. The Ipecacuanha may be repeated in from six to eight 
hours if required, and will be taken, if a disgusting sickness at the stomach 
is not caused. With every dose the hot poultice or a mustard plaster 
should be placed over the stomach. If a dose is vomited, it should be 
immediately repeated. 

Some patients find it impossible to continue the use of the remedy. In 
such instances, its use must be dispensed with. The treatment, then, will 
rest upon free cathartics and Opium. 

Whenever stools, with mucus or slime and blood, begin to pass, the 
cathartic should be at once resorted to, as in the first place, to be followed 
as before, with the Opium and Ipecacuanha, if it is tolerated. It is well to 
state here, that the treatment of dysentery, with Ipecacuanha, has reduced 
the fatality in acute dysentery to one-third of the mortality, previous to 
its introduction, as shown by reports from the East Indies. 

Persons who cannot take Opium or Morphine, can usually take the 
Watery Solution, or the Alkaloid of Opium, called Codia, in doses of one 
grain. The benefit from Opium is so great, that it is best for patients to 
suffer some inconvenience from the Opium. Its unpleasant effects may, 
sometimes, be obviated by giving with it a full dose of Hyoscyamus or 
Belladonna; one or two grains of the Extract of Hyoscyamus, or one-fourth 
of a grain of Extract of Belladonna. 

Remedies which may, sometimes, be associated with the internal use 
of Opium, in this disease, are Bismuth, in doses of twenty to thirty grains 
(half a teaspoonful); Acetate of Lead, (Sugar of Lead,) in doses of three to 
five grains ; Sulphate of Copper in doses of a twelfth to a fourth of a grain ; 
Tannin in doses of ten to twenty grains, and the various vegetable astrin- 
gents, among which are Rhatany, Kino, Catechu, Logwood, White Oak 
Bark, Witch Hazel, White Pond Lilly Root, etc. Very seldom will it be 
necessary to resort to any of them, if the foregoing directions, regarding 
the use of Cathartics, Opium and Ipecacuanha, are strictly followed. 

When the disease is prolonged, and the stools become of a bloody, 
watery character, these astringents occupy quite an important place in the 
treatment. Ipecacuanha should be given, if tolerated, together with Opium, 
in some of its forms, to the extent of relieving pain, some of the foregoing 
astringents, which may be tried in succession, and tonics. Cathartics, as a 
rule, should not be given in such cases. 

Particular attention should be given to the diet, and nothing of a coarse 
character, which will make stools, should be allowed, but the food should 
be rich in nourishment. Milk, meat essences and broths, raw eggs beaten 
up with a little sugar and milk, or water, answers this purpose the best. 

Moderate quantities of arrow-root, sago, tapioca, and rice, may be 
given. The patient may drink, at will, of thin mucilage of Slippery Elm, 
or Gum Arabic, or Flaxseed Tea, Barle> or Rice Water. 

20 



f>06 DISEASES OF THE INTESTINES. 

One of the best forms of tonic for prostrated cases, and when recovery 
is slow, is Elixir or Syrup of Quinine, or Cinchonidia, Strychnine and Iron. 
The dose is, usually, a teaspoonful three times a day, though a dessert- 
spoonful may be given. Whatever the form of tonic given, the dose of 
Quinine is one or two grains, Iron one grain, and of Strychnine not to 
exceed a thirtieth of a grain. 

In severe epidemics of dysentery, the treatment does not, materially, 
differ from the above, except, perhaps, in the quantities of medicines 
required to control the disease. The principles of treatment are the same. 
Cathartics are to be given more cautiously, and are to be omitted altogether, 
if the discharges become watery instead of mucus, or if the patient be 
notably prostrated. 

The rules for giving Opium and Ipecacuanha are to be observed. Much 
larger doses of Opium may be required to procure relief from the pain and 
griping, and to arrest the frequency of the discharges from the bowels. It 
should be given frequently enough, and in increasing quantities, until that 
result is reached. After a dose of Ipecacuanha has been retained, as a rule, 
less Opium will be required. While the Ipecacuanha should be repeated as 
before directed, no intermission must be permitted in giving the Opium, 
and should always be carried to the extent of checking the watery, bloody 
discharges, in increased doses, till this effect is produced. 

In increasing the doses in this way, the patient must be carefully 
watched that Opium poisoning (narcotism,) is not produced. Contraction 
of the pupils ("sight of the eye,") decreasing frequency of breathing, and 
profound sleep, indicate this condition. If, however, the patient breathes 
twelve times in a minute, the danger from narcotism is not great. 

In cases of great danger from exhaustion and prostration, stimulants 
are to be given with the nourishment. For this purpose, I believe Brandy 
to be the best. It should be given to a point short of excitement of the 
circulation or nervous system. Its beneficial effect will be shown by a 
general calm, and the pulse will become softer, fuller, more regular, and 
slower, and the tongue moistens. The dose should be begun at a table- 
spoonful for an adult, repeated at intervals of four hours, preferably with 
food, and may, if necessary, be increased in frequency and quantity 
to meet the requirements of the case. It does harm, if the frequency of 
the pulse is increased and the tongue becomes dry. 

Symptoms of malarial trouble will call for Quinine, the same as is 
directed in (bilious) remittent fever. 

In all cases of dysentery, patients should refrain as much as possible 
from efforts to stool, for the sensation is delusory, depending on the 
inflamed state of the bowel. Cold to the anus, as ice wrapped in a cloth, 
is useful. The Opium injections relieve this painful sensation the best of 
anything. Five grains of Sugar of Lead may be added to the injection 
with benefit, though for this combination a half a grain of the Acetate of 
Morphine, dissolved in a teaspoonful of Glycerine is better than the Lau- 
danum. 

Tannin, in quantities of a scruple, may be used in this way, instead 
of Sugar of Lead. 

In cases which, after thorough trial, cannot take Opium in any form, 
I would recommend an injection of one of the astringents named, dis- 



FLUX. 307 

solved in a tablespoonful of Glycerine, with fifteen drops of the Fluid 
Extract of Belladonna or a teaspoonful of the Tincture. A teaspoonful 
or two of the Fluid Extract of Hyoscyamus, or two or three grains of the 
Solid Extract, may be rubbed up with Glycerine, and used instead of the 
Belladonna. 

In case none of these are procurable, a strong tea made with Stramo- 
nium, (Jimson Weed) may be used with benefit. 

During convalescence, the amount of doses and frequency of giving . 
them, should be gradually diminished. Tonics, as recommended in simple 
acute dysentery, are applicable here. 

So dangerous a disease as epidemic dysentery, requiring such positive 
treatment, ought to be under the direction of a competent physician. 

HOJKEOPATHIC TREATMENT. According to our remarks on the 
causes of dysentery, it is evident that there must be a preventive treat- 
ment of dysentery, and that it must result in great good. From what we 
have said on the subject, the single points of this prophylactic treatment 
can easily be inferred. In this place, we desire to call attention to the 
absolute necessity of keeping the evacuations of dysenteric patients sepa- 
rate. It is, moreover, of the utmost importance to treat every diarrhoea 
that may occur during epidemic dysentery, with great care, and to arrest 
it as soon as possible, since it is an established fact, that a diarrhoea pro- 
duces an increased sensitiveness to the dysenteric virus. 

Mercurins occupies the first rank among the remedies for dysentery, 
and among the mercurial preparations it is the Corrosive Sublimate (Merc. 
Corr.) This remedy corresponds to the symptoms of ordinary dysentery 
so perfectly, that it may safely be regarded as a specific remedy for the 
whole process. The leading symptoms of dysentery, the bloody mucous 
evacuations without any fecal matter, attended with the most violent 
tenesmus and cutting colic, is a characteristic and constant symptom of 
Merc. Corr. All physicians agree that the lower attenuations of this rem- 
edy are preferable, and that it should not be given higher than the sixth ; 
they likewise agree that the dose should be frequently repeated. The 
best plan is to give a dose of the remedy after every discharge; as the dis- 
charges diminish in frequency, the medicine will likewise have to be 
repeated less frequently. The effect of the remedy is perceived very soon, 
in most cases within thirty-six hours. Of course, we cannot expect to 
perceive a striking improvement in twenty-four hours; nor would it be 
advisable to select another medicine, if no improvement takes place in 
that space of time. For this and all other remedies in this disease, the 
Dose is six pills after every second motion of the bowels, as long as is 
required by the symptoms. 

The Merc. Corr. almost always deserves a preference in epidemic dys- 
entery; Mercurius sol. is preferable in the so-called white dysentery. In 
epidemic dysentery, the so-called white dysentery is of rare occurrence, 
and then only a very transitory condition. On the contrary, catarrhal 
dysentery, is, in every respect, adapted to Mercurius sol., and it is only in 
exceptional cases that this remedy will prove unavailing. As long as the 
evacuations contain feces, although in small quantity, it is well to give 
the solubilis the preference, no matter whether blood is discharged with 
the stools or not. On this account this remedy is especially appropriate 



308 DISEASES OF THE INTESTINES. 

in the dysentery of children, especially during the period of dentition. 
The triturations of solubilis are preferable, whereas, the Sublimate acts 
better in solution. The Mercurius vivus is preferred in this disease by 
many physicians. 

Next to Mercurius Belladonna is, without doubt, the most important 
remedy in dysentery, both the catarrhal and epidemic. As far as local 
symptoms are concerned, Belladonna is indicated by the violent urging to 
stool, with or without scanty discharge ; violent pains in the distended 
abdomen ; they are aggravated by pressure, or else evidently of an inflam- 
matory character ; liability of the rectum to protrude. Other prominent 
indications for Belladonna are : considerable urinary difficulties, even 
retention of urine; violent fever, also, with delirium, severe gastric 
derangement, nausea, vomiting. Belladonna is most frequently suitable 
for children ; less so for adults. 

The catarrhal form of dysentery being exceedingly varied, a number 
of other remedies might be recommended for this disease. Chamomilla, 
for instance, is a main remedy in the dysentery of teething children, if 
the local symptoms are accompanied by acute fever, restlessness, sleepless- 
ness, constant cries, vomiting of bile, nightly aggravation of the symp- 
toms, or the symptoms only show themselves during night-time. Ano- 
ther remedy is Ipecacuanha, when the tenesmus only sets in after the 
discharge, and there is frequent and distressing vomiting of bile, while 
the fever is not very considerable ; Dulcamara and Pulsatilla, when the 
discharges consist of mere mucus; they mostly take place at night. Baryta, 
for the dysentery of children, when it threatens to become chronic, 
provided there are no striking symptoms of ulceration of the intestines. 
Calcarea Carbonica is adapted to the same form of dysentery as Baryta, 
likewise applicable to ulceration of the bowel. Here it is even a chief 
remedy for children. A Dose of any of the preceding remedies should be 
given after each evacuation, provided they do not occur more frequently 
than every hour. 

We have already stated, that the above-mentioned remedies are suffi- 
cient in epidemic dysentery, unless it should pursue an entirely excep- 
tional, abnormal course, or be complicated with various accessory symp- 
toms. This statement, likewise, only applies to cases that have been 
treated homoeopathically, from the commencement. But we are also 
called upon to treat dysentery in its more advanced stages, or after the 
system has been saturated with powerful medicines. For such abnormal 
forms of dysentery, the above-mentioned remedies are not sufficient, and 
one or more of the following list will have to be selected. 

Arsenicuwi-album is never indicated at the commencement of dys- 
entery, only when evident signs of putrid decomposition become apparent, 
together with paralysis of the bowels and anus, in a slight degree. The 
evacuations have no longer a peculiarly insipid smell, but are fetid, of a 
blackish-brown color, mixed with numerous shreds of mucous membrane. 
The pains are uniformly severe, the fever is intense, attended with signs 
of rapid prostration and great thirst. 

Rhus-toxicodendron, Hartmann says : " It is particularly applica- 
ble in protracted cases, where the violence of the symptoms has been 
diminished by the previous treatment, but where all the symptoms that 
characterized the attack from the commencement, are still present ; it is 



COLIC. 30 ) 

prominently indicated by excessive prostration, the blood is greatly defi- 
cient in plasticity, the organic activity threatens to become extinct; 
typhoid symptoms supervene." In other words, Rhus is suitable in 
typhoid dysentery. A noteworthy symptom is the circumstance that the 
evacuations appear at night; there are, also, involuntary discharges. 

HOME REMEDIES. Of all treatments within the easy reach of all, 
there is nothing equals the complete and thorough washing out of the 
bowels, by large and frequent injections, of tepid or cool water. Many a 
case which appeared entirely hopeless, has been permanently cured by this 
simple means ; but be sure the washing out is thorough and frequent. 



COLIC— ENTERALGIA. 

A disease which appears under a great variety of aspects, and which is 
associated with various derangements, either casual, or permanent and 
organic. It should, therefore, especially be considered, with due regard to 
the general review of disorders affecting the stomach and intestines, as 
afforded in the article on " Indigestion." 

Colic may be spasmodic, particularly, as associated with hysterical 
complaints ; or may be associated with local determination (congestion) of 
blood, as occurring in conjunction with menstruation or piles; or, again, it 
may be developed as a transition of disease from other organs: as, for 
instance, when some previous disease has been suddenly suppressed; or, 
again, it may be associated with worms, or, may appear as a manifestation 
of flatulency; or, again, purely from foulness or surfeit of the stomach, or 
result from indigestible food ; in other instances, again, colic is associated 
with gravel, or other organic derangements of the kidneys, etc.; or it may 
become developed in consequence of the suppression of chronic eruption 
on the skin, or again, from excessive or acrid discharge of bile from the 
liver into the stomach and intestines. 

Symptoms. Griping, tearing, gnawing, or shooting pain in the 
bowels, chiefly confined to the region of the navel, generally attended with 
a painful distention of the belly, with spasmodic contraction, and some- 
times accompanied with vomiting and costiveness, or looseness of the 
bowels. One of the characteristic distinctions between this disorder and 
inflammation of the bowels, consists in the degree of alleviation to which 
the pain is subject upon pressure. The long continuance and intense 
severity of colic may, however, result in inflammation, for which reason it 
is ever advisable to arrest its progress in any severe case. 

Causes. The general exciting causes of this complaint are acid fruits, 
and indigestible substances, cold from wet feet, drinking cold beverages 
when heated, constipation, worms, etc. It is frequently, also, a concomit- 
ant symptom of some other derangement, but occurs equally often as a 
primary disease. 

This disease is so well understood, that we are justified in proceeding 
at once to the treatment, giving in its course various symptoms, as devel- 
oped by different causes. 

ALLOPATHIC TREATMENT. Colic. In the treatment of colic, the 
first indication is to relieve pain, whatever may be the cause. This is 
done best by an injection of a teaspoonf ul of Laudanum with fifteen drops 



310 DISEASES OF THE INTESTINES. 

of Tincture of Belladonna. If there is flatulence, a couple of ounces of 
Mixture of Asafcetida may be used as a vehicle for the Laudanum. The 
injection should be made with a hard-rubber syringe. 

If no flatulence exists, the injection of Laudanum, with or without 
the Tincture of Belladonna, may be given with a couple of tablespoonf uls 
of Starch Water. The Asafoetida Mixture (or Milk) is made by rubbing 
two drams of the gum in a pint of water. 

A couple of teaspoonfuls or a tablespoonful, of the Mixture (Milk) of 
Asafcetida given by injection, is an efficient remedy for the flatulent colic 
of infants. Three to five drops of Laudanum may be added, if the first 
injection does not relieve. 

A cathartic ought not to be given in colic, until after the pain is 
relieved, and then, if no inconvenience is experienced, twenty-four hours 
or a couple of days may pass before one is given. In the mean time, the 
bowels will generally move spontaneously. If they do not move, a large 
injection of warm water may be given. If this proves ineffectual, three 
Compound Cathartic Pills should be taken. 

If cathartics are given before relief from pain, the spasm of the intes- 
tine interferes with its action, and it aggravates the malady. 

Much relief is obtained by hot applications over the abdomen. In mild 
cases, some hot aromatic tea, as Ginger, Anise, Cloves, or Mint, may give 
relief. In severe cases, recourse should be had at once to the injection 
of Laudanum, or to a dose of twenty-five drops, and a teaspoonful of 
Spirits of Camphor, by the mouth. 

Morphine, in doses of a quarter of a grain, or an Opium and Camphor 
Pill may be given. If complete relief is not obtained in an hour, the dose 
should be repeated, either by injection or by the mouth. 

Hysterical colic is almost always relieved by an injection of a pint of 
the Mixture of Asafcetida; but if this does not succeed, the same remedy 
may be given by the mouth, in doses of a tablespoonf ul— Opium or Lauda- 
num may be added, in extreme cases, as directed above. 

The carminative teas, before mentioned, and hot applications, are 
useful. The treatment is given, in considering the disease (hysteria,) to 
which the reader is referred, if anything additional is needed. 

In rheumatic colic, immediate relief from pain is to be procured as 
before directed for "colic." The rheumatic trouble may, generally, be 
overcome by the continued use of Salycilic Acid, in doses of ten to 
twenty grains, four times a day, given in capsules or medicine wafers. 
For further consideration of the rheumatic condition, the reader is 
referred to the treatment of Rheumatism. 

The treatment of neuralgic colic is identical with that of neuralgia, 
to which, and to the treatment of neuralgia, the reader is referred. 

In Printers' and Painters' Colio (Saturnine or Lead Colic) the treat- 
ment consists, in the first place, in the relief of the extreme pain. This 
is accomplished precisely as is directed for simple colic. The use of 
opiates must be persisted in until relief is obtained. The obstinacy of 
the colic will require their continued administration at varying inter- 
vals of from one to six hours, for a much longer period than is required 
in simple colic. 

Together with the use of Opium, a liniment of one part each ofChtoro- 



COLIC. 311 

form, Tincture of Aconite and Laudanum, and three parts of Soap Lini- 
ment, may be freely applied over the abdomen. Hot bathing is, also 
useful. 

As a means of relieving the pain of lead colic, used continuously with 
the use of Opium and hot bathing, Alum may be given by the mouth, in 
doses of fifteen grains every two hours. A good formula is this: Take of 
Alum two drams, Aromatic Sidphurvc Acid one dram, Syrup _of Lemon one 
ounce, Water three ounces. Mix. 

Dose: A tablespoon ful every two hours. 

A teaspoonful and a half of Alum may be added to a pint of boiling 
milk, separate the acrid acid from the whey (Alum whey.) The patient 
may take a wineglassful every hour or two. 

After the pain is relieved, the elimination of the lead from the system 
may be greatly hastened by free purgation with the saline cathartics. 
The best one for this purpose is the Sulphate of Magnesia (Epsom Salts.) 
Take an ounce of Epsom Salts, Aromatic Sulphuric Acid a dram, Water 
four ounces. Mix. 

Dose: One-fourth part every three hours, until free purgation takes 
place. 

After first giving relief with Opium, the bowels should be briskly 
moved every day during the treatment, by the use of Epsom Salts. 

The Iodide of Potassium is one of the best remedies to facilitate the 
elimination of lead from the system. Take of a saturated solution of 
Iodide of Potassium fifteen drops three times a day, and gradually increase 
the dose until the characteristic effects of Iodine are produced, viz : 
until the symptoms of an accute catarrh, with the presence of Iodine in 
the secretion from the nose. 

A drink of one dram (teaspoonful) of Aromatic Acid to the pint of 
water, sweetened as desired, is protective against lead poisoning. Thor- 
ough cleanliness, washing out the mouth and nose (with a douch) warm 
bathing each evening, and the occasional use of Epsom Salts as a purga- 
tive, should be practiced. 

In Colic from Copper, the relief of pain as directed for lead colic, with 
the use of Sulphate of Magnesia (Epsom Salts) for a purgation, are the 
principal points in treatment. Iodide of Potassium, given as directed for 
lead colic, assists in throwing the poison off from the system. The same 
precautions as to cleanliness are required as against lead. Milk is said 
to be a preventive. 

HOMEOPATHIC TREATMENT. JSTux Vomica is a valuable rem- 
edy in colic, either associated with flatulency or piles, or in colic arising 
from a chill, and is, particularly, indicated when there is a sensation of 
fullness and tightness at the upper part of the waist; deep-seated or cut- 
ting pains in the belly, with acute and hard, pressive, and forcing -down 
sensations, compelling the sufferer to bend double; confused headache, 
with occasional loss of conciousness ; flatulence, aggravation of the pains 
on the slightest motion, generally disappearing when at rest; constipa- 
tion, coldness and numbness in the hands and feet during the parox- 
ysm ; at the monthly period in females, when we find weight, or vio- 
lent, deep-seated, aching pain in the belly, dragging pains extending to 



312 DISEASES OF THE INTESTINES. 

the thigh ; aching and creeping sensation in the same part when sitting; 
painful pressure towards the terminal bowel. 

Dose : Of a solution of six globules to six tablespoonfuls of water, give 
a teaspoonful every half hour (in very acute cases,) or every hour, 
when the pain is not continuous or insupportable, until distinct 
amelioration or change. 

Pulsatilla is more useful in the affection occurring in females, 
either during the menstrual discharge or at other times, when coming on 
periodically in the evening during cold, damp weather ; also, when there 
are present a disagreeable tightness and distention of the belly and the 
upper part of the waist, pulsation in the pit of the stomach, aggravation 
of the suffering when at rest, or in the evening, attended with shivering, 
which increases with the pains, and is mitigated by motion, when it has 
arisen from overloading the stomach, or from rich, greasy food, with 
inclination to vomit, flatulence, looseness of the bowels, paleness of the 
face, livid circle round the eyes, and headache ; also, hsemorrhoidal 
colic, with fullness of the veins of the hands and forehead, restlessness, 
anxiety, and sleeplessness. 

Dose: A solution of six globules, or, otherwise, in all respects, as 
directed for Nux-vomica. 

Chamomilla is chiefly useful for bilious colic (with looseness of the 
bowels and bilious vomiting ;) or for colic in females during the menstrual 
discharge. The following are the principal indications ; sensation as if 
the intestines were gathered into a ball, and as if the belly were empty, 
with tearing and drawing pains, attended with excessive anxiety and 
restlessness; distention under the lower ribs, and in the pit of the 
stomach; incarcerated flatulency, sometimes nausea, bitter vomiting, fol- 
lowed by desire to relieve the bowels, and bilious diarrhoea; livid circle 
round the eyes, alternate paleness and redness of the face ; the pains come 
on particularly at night, at times early in the morning, or after a meal . 
This remedy is particularly adapted for children of irritable tempera- 
ments, and is extremely serviceable in all cases in which a fit of passion 
has been the exciting cause, of the sufferings. It is, also, useful when 
colic has arisen from cold in the feet, or checked perspiration. 

Dose : As for Nux. 

Colocynth, In the majority of violent and obstinate cases, Ave find 
this a most valuable remedy ; it is indicated when the pains are exces- 
sively violent, and of a constrictive or spasmodic character, or resemble 
stabbing and cutting, as if from knives; sometimes there is a sensation of 
clawing and pinching, and tenderness of the belly, with a pain, as from a 
blow, or distention ; at other times, a sense of emptiness is experienced, 
with cramps and shivering, or tearing pains in the legs ; during the con- 
tinuance of the attack, we find excessive restlessness, agitation, and toss- 
ing about, from the violence of the pain; when the pains come on, they 
continue without any apparent intermission; after their disappearance, a 
sensation of bruising remains, and the sufferer feels as if the intestines 
were held together by thin threads, likely to break from the slightest 
motion. This remedy, like Chamomilla, is, particularly, efficacious in the 
so-called bilious colic, being indicated by the loose discharge from the 
bowels, and bilious vomiting attending it ; and, also, in cases where pas- 
sion has been the exciting cause. Colocynth is, more particularly, useful 
in the case of adults. 

Dose : As for Nux, 



COLIC. 313 

Belladonna is useful against flatulent colic, when there is protru- 
sion of the transverse section of the great intestine, which becomes dis- 
tended, like a pad, above the navel, attended with colic-like pain, doubling 
up of the body, which is relieved by pressure on the part; also, severe 
bearing down of the whole intestines; also, in menstrual colic, with spas- 
modic constriction in the belly, and a burning pain lower down, or in the 
small of the back; pain in the lower part of the bowels, as if a number of 
nails were holding the intestines. The symptoms are, also, attended with 
a liquid or matter-like discharge from the bowels, and swelling of the 
veins of the head; and the pains are sometimes so violent as almost to 
deprive the patient of reason. 

Dose: Of a solution of six globules to two tablespoonf uls of water, 
give a teaspoonful every half hour (in very acute cases,) or every 
hour (when the sufferings are not continuous or intolerable,) until 
distinct amelioration or change. 

Cocculus is indicated {especially, in menstrual or flatulent colic) when 
there are severe constrictive or spasmodic pains, and distention of the 
entire stomach, with nausea and fullness of the lower part of the belly, 
great flatulence, and difficulty of breathing; also, when there is a sensa- 
tion of emptiness, and tearing and burning pains in the intestines, some- 
times with squeezing, tearing and pulling pains, excessive anguish and 
nervous excitement; constipation. 

Dose : As for Bell. 

Arsenicum is often appropriate in cases of colic (bilious,) arising 
from disordered stomach, with nausea, vomiting, great relaxation of the 
bowels, with green or yellow evacuations, violent gripings, headache, pale- 
ness of the face, and blue marks around the eyes. Again, in cases of bil- 
ious colic, which is prone to be preceded, followed or alternated with sick 
headache, Arsenicum is of great service. 

Dose : As for Nux-vomica. 

Coffea is valuable when we have to prescribe for colic with excessive 
pains, attended with great agitation, anxiety, and tossing about, grinding of 
the teeth, convulsions, suffocative attacks, oppressive despair, acidity of the 
stomach and coldness of the body and extremities. It is, also, useful in some 
kinds of menstrual colic, denoted by a sensation, as if the belly were being 
rent asunder ; or by fullness and pressure in the stomach, and violent spasms 
which extend to the chest. It is, also, indicated by cutting pains in the 
intestines, us if divided by a knife, and, also, by the pains present being so 
violent as almost to drive the patient to distraction, causing him to bend 
double, and draw up his limbs. 

Dose : As for Bell. 

Ir/natia is a most valuable remedy for colic, particularly as affecting 
female patients of delicate constitution, and is indicated by the following 
symptoms, amongst others: Fullness, tightness, and pressive sensation 
across the region which extends along the lower ribs; accumulation of 
wind in the bowels, which is expelled with much difficulty, a relief, how- 
ever, being obtained upon the expulsion of wind; stitching pains in the 
region of the spleen, etc.; more especially, however, if the colic occurs, or 
is worse at night. 

Dose : Of a solution of eight globules to three tablespoonfuls of water, 
give a teaspoonful every hour, Cor in very mild cases, every three 
hours,) until distinct amelioration or change. 



SI 4 DISEASES OF THE INTESTINES. 

Iris-versicolor {Blue Flag*) Involuntary escape of fluid of an 
offensive, putrid and coppery odor. In cholera morbus, it arrests the vio- 
lent pain. 

Mercurius is a medicine of great value, in cases of colic, character- 
ized by the following assemblage of symptoms: Nausea, with profuse 
flow of saliva ; voracious appetite, with repugnance to sweet things ; fre- 
quent and troublesome hiccough ; constant and painful urging to evacu- 
ate ; severe, pinching, drawing, nipping pains, with tightness and hard- 
ness of the belly, particularly, about the navel; or tensive, stinging, cut- 
ting, or burning pains ; aggravation of these sufferings at night, and, 
more particularly, in the latter part of the night; extreme tenderness of 
the belly upon contact or pressure (the clothes or bed-clothes appear to 
cause pain ;) sometimes looseness of the bowels with slimy evacuations ; 
considerable prostration of strength, and chill (or even shuddering,) 
accompanied with flushing of the cheeks. Mercurius is, also, a most 
important medicine in cases of colic, associated with worms. 

Dose: Of a solution of six globules to three tablespoonfuls of water, 
give a teaspoonful every half hour, until amelioration or change. 

Secale-comutum is indicated for male patients affected with colic, 
attended with pain in the small of the back, eructations and vomiting, or 
dragging, tearing pain in the thighs; or, amongst female patients, for 
colic, occurring at the menstrual periods, when tearing pains in the bow- 
els, paleness of the face, small, weak pulse, coldness of the extremities, 
and cold sweats, are predominant symptoms ; or when constipation, with 
cramp-like pains in the bowels, and burning pains on the right side of 
the belly prevail. 

Dose : Of a solution of eight globules to three tablespoonfuls of water, 
give a teaspoonful every hour until the suffering abates, and then 
every three hours until distinct amelioration or change. 

Carbo-veg* occurs, in many cases of somewhat serious aspect, as a 
medicine of great importance, and is particularly indicated by the follow- 
ing symptoms : Violent pains in the bowels, provoked even by the light- 
est and most wholesome meal; sensation of heat in the head and in the 
bowels ; determination of blood to the head, attended with heavy, aching 
pains; fullness and tightness of the belly, so severe as to convey the sen- 
sation that it would burst, and accompanied with flatulent risings, or 
accumulation of wind with difficulty and oppression of breathing, nipping 
pains and rumbling, and sluggish action of the bowels. Carbo-veg. may 
often be administered with striking success in cases of colic associated 
with piles or with flatulency. 

Dose: As for Bell. 

PREDISPOSITION TO COLIC. 

Sulphur is amongst the most valuable remedies in the generality 
of cases, in which a constitutional predisposition to affections of this 
nature is evinced by the failure of other medicines to afford permanent 
relief. Therefore, in particular, if Nux-vomica, or Carbo-veg., or if both 
have been employed as above directed, in cases of colic associated with 
piles, but have failed in obviating the repeated recurrence of the attacks, 
the persevering administration of Sulphur becomes necessary. The same 
may, also, be said of bilious colic, in which Chamomilla or Colocynth, or 
both have been employed with similar results. The same remark is 



COLIC. 315 

equally applicable to cases of flatulent colic, in which Nux-vomica, Carbo- 
veg., Chamomilla or Cocculus, or two or more of these medicines, have 
been previously employed in like manner. 

Done : During the continuance of an acute attack, of a solution of six 
globules to two tablespooon fuls of water, give a teaspoonful every 
hour until relief is obtained. Subsequently, however, give six glo- 
bules in a wineglassful of water every morning, the first thing (fast- 
ing,) for ten days, (unless collateral symptoms should appear in the 
meanwhile)— after which pause four days, and resume the course as 
before (if necessary,) and so on until the symptoms are permanently 
subdued or undergo a distinct change. 

WORM COLIC. 

As this is, in point of fact, a mere symptom dependent upon the pres- 
ence of worms in the intestinal canal, or upon the cases which promote 
the generation of these parasites, the subject will be more accurately con- 
sidered in the article devoted especially to that subject, to which, there- 
fore, the reader is referred. 

Home Measures in Casual Attacks. In cases of colic, arising 
from indigestible food, a cup of black coffee, without milk or sugar, will 
frequently afford relief, by causing the stomach to free itself from the 
cause of annoyance ; that is, in patients who have not used that article as 
an ordinary beverage. 

Diet and Regimen. In this, as in all other complaints arising out 
of derangements affecting the functions or organs of digestion, the diet 
and general habits, or the particular precautions in individual cases, 
should be regulated in conformity with the directions afforded under the 
head of "Indigestion." If particular food or drink, such as raw fruit, 
milk, or cold things, be apt to provoke an attack of colic, the particular 
food or drink in question, in every particular case, should be carefully 
avoided. 

Aconitum, Belladonna. One or both of these medicines may be 
advantageously administered, singly, in alternation, or in succession, and, 
in addition to such as have been mentioned with detailed indications (such 
as Opium, Nux-v., etc.,) when the constipation is associated with predom- 
inant fullness of the vessels of the head. 

Dose: Of either medicine, as selected, give three globules in a tea- 
spoonful of water, every six hours, until the predominant head 
symptoms are modified, and then every twelve hours, until positive 
amelioration or change. 

HOME MEASURES. In all cases of an inveterate or chronic nature, 
recourse may, occasionally, be had to an enema, or lavement of tepid or cold 
water, as a temporary mode of relief, until the medicine has effected the 
desired result. The drinking of a tumblerful, or more, of cold water, thrice 
a day, when fasting— dashing cold water against the belly, and then apply- 
ing brisk friction, by means of a coarse towel— combined with early rising, 
and daily exercise, (not violent or beyond the strength of the patient, so as 
to cause suffering,) will be found useful auxiliaries in promoting a regular 
action of the bowels. 

Electro-magnetism is another, and most useful, auxiliary, either in 
cases arising from culpable neglect, or indolence, or from inability, or 
impracticability, to relieve nature whilst traveling. In chronic cases, aris- 



31© DISEASES OF THE INTESTINES 

ing from inertness of the bowels, or a sort of intestinal paralytic debility, 
the application of electro-magnetism is often superior to any other aux- 
iliary. 

Diet. The diet ought to be regulated according to the state of the 
primary digestive organs, and highly seasoned food, or that which con- 
tains much fibrous or ligneous matter, such as radishes, cabbages, tur- 
nips, green fruits, etc., should be avoided. 



HMMOHMHOIBS— PILES. 

Symptoms. Enlargement of the veins, or effusion of blood in the 
cellular tissue of the terminal bowel, either within or without the fun- 
dament (internal or external piles ;) or protrusion and distention of one 
or more of the inner foldings of the same intestine, with or without 
bleeding (open or blind piles,) preceded or accompanied by pains in the 
back, the base of the spinal column, and belly ; sensation of itching, prick- 
ling, tickling, burning, or pressing at the terminal bowel, sometimes 
extending to the adjacent parts, with, in general, constipation, and not 
unfrequently derangements of the urinary organs. 

Predisposing Causes. The predisposing causes of the disease arer 
1. A constitutional taint. 2. Local debilitation of the vessels by con- 
tinued excesses, by abuse of warm drinks, purgings, or injections, etc. 

Exciting Causes. Among the exciting causes are, habitual costive- 
ness, severe exertion on horse-back, use of drastic medicines; of warm 
stimulating diet, or of vinous, alcoholic, and fermented drinks, tea or 
coffee, the excessive use of seasoned food and spices, the suppression of 
long-continued discharges, sedentary habits, sitting on a cold seat or on 
damp ground, the pressure of the gravid womb, tight-lacing, or any other 
cause of local pressure, morbid accumulation of blood in the liver, men- 
tal emotions, etc. 

The painful practice among surgeons of removing the hemorrhoidal 
excrescences by means of the knife or ligature, is much to be deprecated ; 
for, independently of the danger not unfrequently attending the opera- 
tion, it may occasion serious consequences by a sudden transfer of the 
congestion to some of the noble organs ; in a great number of cases, more- 
over, it wholly fails, and the disease returns, sometimes even in an aggra- 
vated form. 

ALLOPATHIC TREATMENT. Treatment of Haemorrhoids (Piles) 
will consist, in the first place, in the avoidance of those causes, which pre- 
dispose to congestion of the veins of the rectum (lower bowels). Active 
out door life must take the place of sedentary occupation. Constipation 
must be completely remedied by the means directed for that disease. 
Attention to diet and the regular habit of emptying the bowels being all- 
important. Cathartics nor injections will not answer this purpose, 
though, as directed for constipation, a free cathartic will be necessary, 
when the bowels have been for a long time inactive, and the bowels filled 
with fecal accumulations. When this conditon of the bowels is attended 
with recurring attacks of bleeding the cathartic is especially useful. 

Straining at stool must be avoided, neither must the patient remain 
long sitting at stool. The inflammation which causes futile efforts at 



PILES. 317 

straining, must be restrained by anodyne remedies. These efforts 
increase the congestion and contribute towards the formation of tumors. 
Diarrhoea must be treated as directed in that disease. The lax condition 
of the tissues in diarrhoea, aids in the development of piles. 

Immediately after the evacuation of the bowels has occurred, the anus 
(opening of the bowels) and the protruding piles should be bathed with 
cold water. The parts should be carefully dried and annointed with an 
ointment made by the following formula : Take of Tannin a dram, (.sixty 
grains,) Pulverized Opium a scruple, (twenty grains,) and Stramonium Oint- 
ment an ounce. Mix. Five grains of Morphine may be used instead of 
the Opium. In the absence of this ointment, before the piles are returned, 
they should be washed and dried as before, and lubricated with Cold Cream, 
Sweet (Olive) Oil, or Glycerine, before they are returned. 

When the piles are protruding, they can be more readily pressed back 
when the patient is in a stooping position, with the hips raised, or sup- 
ported on his knees, while the chest and head rest on the bed. If the piles 
become swollen and inflamed and cannot be returned, the patient should 
remain in bed and cold applications, as cold water, or a cloth wet in a 
solution of Sugar of Lead thirty grains, Acetate of Morphine ten grains, 
in a pint of soft water, or poultices, may be used. 

The above ointment may be made more curative by thoroughly mixing 
with it half a dram of Iodine. At night, the ointment should be applied 
again, and if the piles have not protruded, it should be introduced into the 
rectum with a suppository tube. 

Much suffering may be avoided, by establishing the habit of having 
the regular movement of the bowels occur just before bedtime, after which, 
if the piles are returned, as before directed, the sphincter muscle recovers 
its tone during the night, and the tumor of piles does not escape during 
the next day. By removing this much irritation, so much has been done 
toward a cure. 

The stools may be rendered soft and unirritating by taking one or two 
teaspoonfuls a day of the following mixture in water : Take of Magnesia, 
Sulphate of Magnesia, Precipitated Sulphur, and Sugar of Lead each an 
ounce, and Pulverized Anise Seed half an ounce. Mix well. 

The use of Ergot and Nux-vomica will often overcome the laxity of 
the tissues about the rectum, which predispose to piles, as: Take of 
Ergotine (Squibb' 's Extract) a dram, Extract of Nux-vomica fifteen grains; 
make into thirty pills and give one night and morning ; or, take of Fluid 
Extract of Ergot one and a half ounces, Tincture of Nux-vomica half an 
mnce. Mix. 

Dose: Take a teaspoonful morning and evening. 

It is claimed a cure can be effected by the faithful application of a 
totion of Iodine, Tannin and Stramonium, every night, to the part. Take 
of Iodine thirty grains, Iodide of Potassium six grains, water, eight drops 
is sufficient, Glycerine an ounce. Mix, and add to the mixture, two drams 
of Tannin, and afterward mix with it, in a mortar, two drams of Extract 
of Stramonium, moistened with sufficient water. Label Pile Lotion. 
This solution, to be beneficial, should be applied every night. 

A suppository of tallow may be formed, (with the fingers) dipped in this 
mixture, and inserted into the rectum at night, and allowed to remain 



318 DISEASES OF THE INTESTINES. 

until morning. If a greater anodyne effect is desired, five grains of Mor- 
phine may be added to the solution. 

The further treatment, if required, belongs to the practical surgeon. 
The most approved and most efficient treatment for the cure of piles, is the 
old, and well-tested operation of tying them off. The cure, by this means, 
is the most invariably complete of any method known. The plan is to 
thoroughly empty the bowel with Epsom Salts or Castor Oil, the evening 
before the operation. In the morning, the patient should, a couple of 
hours before the operation, take a large injection of a quart or more of 
warm water, and then take a half a grain of Opium. Then the anaesthetic 
can be given, the tumors exposed with a Thebault's anal speculum, and the 
tumors brought within reach with a Vulsellum. A large needle with a 
stout silk thread is passed through the base of the tumor, the needle re- 
moved and the thread tied tight on each side of the tumor, but not tight 
enough to sever the tumor. Two tumors, operated on in this way on each 
side of the gut, is sufficient to cause the cure of the others, if any exist. 
The patient will remain in bed, the pain relieved by Opium, in doses of a 
grain. The bowels should not be moved until the fourth day, when Castor 
Oil may be given, followed by an injection of warm water. After the op- 
eration, the urine (water) will generally require removing with a catheter. 
If the operation is to be done without an anaesthetic the cathartic should 
be given only about five hours before the expected operation, and, after 
they move, the warm water injection is given, and the patient brings down 
the tumors by straining over a vessel of warm water. When the tumors 
are down, they are tied as before directed. 

Small folds of membrane may protrude from the anus ; when inflamed, 
they are troublesome and frequently bleed. They should be removed with 
the scissors, if not inflamed, and if bleeding follow, Sub-sulphate of Iron 
ought to be immediately applied to stop it. 

Other plans of treatment are by excision, the hot iron, Nitric Acid, 
the galvanic cautery or the ecraseur ; but the plan of tying them off is to 
be preferred. The object is to obliterate the tumors. 

The plan of causing the obliteration of the tumors by injecting Carbolic 
Acid into each tumor, with a hypodermic syringe has come quite generally 
into vogue. The writer furnished the following description of this treat- 
ment for the Burlington Haiok-eye: Carbolic Acid, either concentrated or 
diluted with one to three parts of Glycerine or Olive Oil, is used. Four to six 
drops may be injected into each tumor. Only one tumor should be treated at a 
time, and from five to ten days should elapse between each operation. A 
coagulation is immediately formed in the tumor, which results in its ob- 
literation. Carbolic Acid, applied to the tissues, is an anaesthetic, so this 
operation is not painful, but the inflammation which sometimes results 
causes so much suffering, as to call for anodynes. For this purpose, 
Opium and Belladonna maybe given by injection into the rectum— a tea- 
spoonful of Laudanum and ten to fifteen drops of the Fluid Extract of 
Belladonna, in a little Glycerine, will be quite effectual in controlling the 
inflammation and pain. The injection may be repeated in twelve hours, 
if necessary. Further means for relieving pain should be by Opium 
given by the mouth. For this plan of treatment, the same preparation is 
required as for the operation by the ligature (tieing off), and the after-treat- 
ment will be the same. 



PILES. 310 

To prevent the return of piles, after a cure, attention to the general 
habit is necessary. The regular evacuation of the bowels, and keeping 
the fecal discharges in a soft state, by diet and laxatives, as is directed for 
constipation. 

HOM(EOPATHIC TREATMENT. Nux-vomica is a most valuable 
remedy, in this affection, and is very efficacious against both descriptions 
of piles, but especially against bleeding piles, particularly for individuals 
who lead a sedentary life, or who indulge in the use of coffee or stimulat- 
ing liquids, and also for females during pregnancy — when the haemorrhoids 
are attended with shooting, burning, or itching pains, colic, shooting and 
jerking pain, or pain as if from a bruise in the loins, rendering it difficult 
to rise or walk in an erect position ; and when they are accompanied by 
constipation, and sometimes painful and difficult passing of water, and the 
other symptoms described, as indicating this medicine, under the head of 
"Indigestion." 

Dose: Eight pills in a teaspoonful of water, night and morning, until 
amelioration or change. 

Sulphur may follow the administration of Nux-wmica; and an al- 
ternation of these remedies, at intervals of a week or ten days, frequently 
effects a cure in cases of long-standing. 

Dose: If to follow Nzix-vomica, to complete the cure, give six globules 
in a wine-glassful of water, every morning, the first thing (fasting) 
for ten days. 

Pulsatilla.— Discharge of blood and mucus during stool, and at 
other times, with painful smarting and sensation of excoriation in the 
piles, pains in the back, pallid countenance and disposition to fainting; 
difficulty in passing water. 

Dose: Of a solution of eight globules to six teaspoonfuls of water (to 
which add ten drops of alcohol), give a teaspoonful, morning and 
evening, until the whole is consumed. If further treatment then 
be requisite, pause four days, and recontinue the course in like 
manner. 

Ignatia is indicated by itching and creeping, and also, sensation of 
constriction and excoriation in the posterior passage, and prickings ex- 
tending deep into the lower intestine; discharge of blood or of bloody 
mucus, rumbling noise in the belly, and protrusion of the lower intestine, 
accompanied with acute pain. 

Dose: Three globules in a teaspoonful of water, every twelve hours, 
until amelioration or change. 

Antimonium-crudum. — Discharge of mucus and of blood at every 
stool, follovjed by severe colic and pains in the piles, with throbbing, itching 
and burning at the fundament, and discharge of glutinous, acrid moisture, 
particularly at night; frequent determination of blood to the head, with 
bleeding at the nose; stiffness in the back, shooting pains in the loins, 
burning and rheumatic pains in the limbs, flatulency and constipation. 

Dose: Of a solution of six globules to two tablespoonfuls of water, 
give a teaspoonful every six hours, until four doses have been given, 
and then every twelve hours, until positive change. 

HOME REMEDIES. Buckeyes. Take four or five ripe ones just 
after they come from the tree, remove the outer brownish shell from 
them; slice them up fine; put them in a tin cup with enough melted lard 
to cover them; let them simmer or steep near a fire for an hour or two. 
Then strain and press out the lard, and when cold, it (the lard) is fit for 



320 DISEASES OF THE INTESTINES. 

use. A little of this ointment must be applied to the tumors and within 
the bowel twice a day. 

Mullen, Take of the leaves a large handful, put in a quart of cold 
soft water, and place over the fire; let it simmer until reduced to a pint; 
then take out all the leaves, pressing them as dry as possible. Now put 
all the remaining liquor back over the fire and let it remain until reduced 
to one-fourth pint or less ; put in three tablespoonfuls of good, clean lard, 
and a lump of beeswax as large as a hulled black walnut; let it simmer 
until all the water has passed ofT in steam, then take off the fire and stir 
until almost cold, when you will have a nice smooth salve. 

To use. Apply a little of the salve to all the affected parts two or 
three times a day, rubbing it in well with the finger, reaching well up the 
bowel. This is reliable and gives permanent relief. 

The Surgical Operation for the Kadical Cure of Piles,* 
which has, of very late years, been introduced among physicians, and 
also used to a great extent by specialists who have uniformly charged from 
fifty to five hundred dollars, and even more for the operation, is only this 
simple thing: Take of Carbolic Acid fifteen grains, of pure Glycerine sev- 
enty-five grains. Mix. 

Dose: Of this inject with a hypodermic syringe one to three drops 
(owing to the size of the tumor) into each tumor. 

This causes the formation of pus or matter, and the absolute destruc- 
tion of the piles, but the pain after the operation is very great and, also, 
needless. One hour before the operation an injection of one dram of the 
Tincture of Nux-vomica, one dram Tincture of Stramonium and one 
dram Laudanum to a quart of water should be used. After the operation, 
a salve made by adding one dram Arnica Flowers, one dram Stramonium 
(Jimson Weed) leaves dry, one dram Tincture of Aconite, to a quart of 
water 1 , let it simmer slowly until it is reduced to one half pint, then add 
half a pound of good lard and an ounce of beeswax. Let this evaporate 
on the back of the stove, or near the fire, until all the water is gone, 
which will be when there is no more steam from it. It will burn very easy. 
Then pour off and press out all you can from the leaves, etc., and use to 
rub well on all the affected parts, two or three times a day, being careful 
to reach as far up the bowel as you can. With these precautions you will 
make a sure, safe, and almost painless cure. 

It will be best to go to some good, careful doctor, who knows his busi- 
ness, to get the hypodermic injections made. The rest you can do just as 
wello 

WOBMS.-HELMINTHIASIS. INVEBMINATIOK. 

The number of worms that are found, more or less frequently in the 
human bowels, is very large. Here we will name and speak of three 

*lt is a matter of surprise how many people suffer with piles. Naturally enough the number seeking 
relief is quite large, and it affords a tempting field for "specialists. 1 ' Wo do not know of any plausible 
objection to a physician making the treatment of any disease a specialty, but, of course, there are reasons, 
not only plausible, but just, why he should not play upon the credulity of patients to extort unreason- 
able fees for his services. In a communication from a well-known physician of Burlington, in 
regular standing, the attention of the public is called to the practice that sometimes obtains of charg- 
ing an extortionate price for the cure of a disease any family physician, of ordinary skill and experience, 
can treat by the method indicated, and for which he would make no more than the customary profes- 
sional charges. 



WORMS. 321 

varieties as being the ones likely to produce any of the symptoms of dis- 
ease. 

First: Pin worms or thread worms. 

Second : Long round worms or Lumbricoid. 

Third : Tape worm or Tarn la . 

First: The pin worm is the smallest of the three ; it is one-third to 
one-half an inch long, and as thick as common size thread. It has a very 
small swelling, which it uses for, and out of courtesy, we call it its head. 
Usually it is found only in the very last part of the intestine and some- 
times in the vagina, into which it crawls from the anus. At times, only 
a few are seen together ; sometimes, however, they occur crowded together 
in large masses, most generally among children. 

The symptoms occasioned by this worm, vary a great deal. One of 
the most common, is a violent, distressing itching of the anus, especially, 
in the evening and at night, and disturbing sleep a great deal. Some 
children are driven almost frantic by this itching, and are tormented by 
an almost unaccountable nervousness in consequence of it. Among 
adults, this itching is scarcely ever so painful and severe. The irritation 
caused by the worms, sometimes occasions a catarrhal affection of the 
mucous membrane of the rectum, or a spasmodic contraction of the 
sphincter, with a constant urging to stool, which is not less distressing 
than the itching. If a large number of them penetrate into the vagina, 
they cause severe itching, whites, and the constant rubbing is apt to give 
rise to self-abuse. Beside these less important results, w r e sometimes meet, 
without any otherwise assignable cause, with more important disturb- 
ances, principally of the central nervous system, sometimes resulting in 
indefinite spasmodic movements, and at other times in eclampsia, epi- 
lepsy, chorea, etc. We cannot prove that these affections are caused by 
worms, but this seems the more probable, as a removal of the worms is 
sometimes succeeded by an entire disappearance of the nervous disease. 

ALLOPATHIC TREATMENT. Pin Wobms. For practical purposes, it 
is sufficient to divide the treatment for worms into that for seat worms 
ascarides,) also called " pin worms " and thread worms. Round worms 
lumbrici,) and tape worms (teniae). 

Seat worms inhabit the low r er bow T el (rectum) and large intestine. In 
females, they sometimes invade the vagina. They deposit their eggs in 
the folds of the anus and vagina. Remedies, to be effective, must be 
applied to these parts. One of the best and simplest is a large injection of 
a solution of common salt, repeated every third or fourth day, until three 
or four injections are given. Some of the same solution should be applied 
to the folds of the anus, and, with female children, to the folds of the 
external genitals. 

In cases of females, an injection may be required into the vagina. 
One injection will kill all the worms that it touches, but the eggs hatch 
in three or four days, so that the injection needs repeating. 

Tea (infusion) of Quassia is, also, effective as an injection. The strength 
of this tea is tw r o ounces of Quassia chips to a quart of water. 

A weak decoction (tea) of Aloes may, also, be used for the same pur- 
pose. 

21 



322 DISEASES OF THE INTESTINES. 

In case the last two remedies are used, a solution of Carbolic Acid 
should be applied with a sponge to the folds of the anus and external 
genitals of female children. 

Should the worms continue to appear, it indicates that they lodge 
high up in the intestine, and a few doses of Santonine, of two to five 
grains to an adult, and half a grain to a grain to a child, should be given 
two or three times a day, for two or three days, followed by a purge of 
twenty grains of Calomel, for an adult, or five to ten grains for a child, or 
of Castor Oil. 

The Santonine may be given, powdered with a little sugar. After the 
purge, the injections will complete the cure. 

HOMCEOPATHIC TREATMENT. Of all three kinds of worms, the 
expulsion of the pin worm is by all odds, the most difficult. Internal rem- 
edies can do very little good, as these little pests have their home in the 
very lowest part of the bowels, where medicine, taken by the mouth, can- 
not reach them to do any good. But a solution of salt in water, about two 
teaspoonfuls to the pint, will reach them, if used as an injection, and 
repeated a few times. Or a decoction (tea) of common Garlic (Allium 
Sativum) used in full injections for a month; at intervals of three or four 
days, will make them seek a more pleasant place. 

A few doses of Cina, or Sulph. will remove any unpleasant constitu- 
tional symptoms remaining after the removal of the worms. 

Dose: Of either, six pills dissolved in a teaspoonful of water, every 
morning before eating. 

Long worm (lumbricoides). The intestinal long worm is the most com- 
mon of all. It is, from six to twelve inches long, has a cylindrical body 
of the size of a goose-quill, tapering at both ends. Its common abode is 
the small intestine ; exceptionally, the worm wanders into the stomach. 
Very seldom, only one worm is present in the intestine, generally, there 
are several together, sometimes as many as twenty or thirty, and even 
many more. 

The symptoms caused by the presence of these worms, vary greatly. 
In the majority of cases, there are no very prominent symptoms present; 
it is only by accident, that the presence of worms is generally discovered; 
the only symptom, is perhaps, an increased longing for bread and pota- 
toes; and perhaps, a less fresh and healthy complexion, More deep-seated 
and more general derangements, may be caused by a number of worms 
together, or by the agglomeration of the worms into large balls, or by 
their entrance into some other organ; or else, the bowels may be exceed- 
ingly irritable, in consequence of which a small number of worms may 
cause intestinal catarrh or enteritis, together with their consequences. 
Among these latter, we number the nervous phenomena, caused by 
worms, which have already been mentioned in the paragraph on pin- 
worms. 

The ailments caused by lumbrici, often resemble greatly other more 
or less important processes, such as gastric fevers, typhus, dysentery, and 
likewise, the above mentioned nervous derangements; it is of no small 
importance to ascertain their origin, at an early period. These nervous 
derangements, manifest themselves by various phenomena, of more or 
less constant occurrence. The appetite becomes fitful, or the patient has 



worms. 323 

a more or less exclusive, or, at any rate, decided hankering for farinaceous 
food,- the nose and anus, itch violently; the pupils are considerably 
dilated, the eyes are surrounded with dark margins; the patients are of a 
changeable and irritable mood; bowels act irregularly, at times consti- 
pated, at other times, alternately constipated and loose, with frequent 
changes of this character. It sometimes happens, that their irritation 
occasions a real gastric fever, which does not always disappear immedi- 
ately after the removal of the worms; large balls of these worms may 
even cause the same functional or structural changes, as hard masses of 
fecal matter. Properly speaking, it is only in children, that lumbrici cause 
nervous derangements, and it is well, when these derangements manifest 
themselves, that you should direct your attention to the presence of 
worms. 

ALLOPATHIC TREATMENT. Rouxd Worms. In giving medicines 
for worms, the bowels should be as empty as they conveniently can, so that 
the remedy may act on the worms as energetically as possible. For this 
reason, it is best to give remedies for worms in the morning, before break- 
fast, and if cases are rebellious, the patient should abstain from eating 
till noon, or through the day. 

Medicines ought not to be given to children, for worms, merely on sus- 
picion, but only when there is positive evidence of their presence. 

For round worms, one of the most efficient remedies is the Fluid 
Extract of Pink Root and Senna. The dose for an adult, is a tablespoon- 
ful, and half a teaspoonful to a teaspoonful for children, every four hours 
until it purges. This will probably end the round worm. 

"Wormseed Oil, in doses of five to fifteen drops on sugar, three times a 
day for two or three days, followed by a purge of Castor Oil. is successful 
treatment. It may, also, be given with the Fluid Extract of Pink Root 
and Senna. 

Santonine is an efficient remedy against the round worm. It is 
tasteless, and may be given with sugar, or sprinkled on bread and but- 
ter. The dose is from half a grain to five grains, according to the age of 
the patient. It should be given three times a day, for a couple of days 
followed by a purge of Calomel or Castor Oil. After the purge, it should 
be given for a couple of days, to destroy any worm which may recently 
hatch. 

Another effectual plan is, to take a purge in the morning, fasting during 
the day, and take at night five grains of Santonine with twenty grains of 
Calomel, for an adult, or one or two grains of Santonine and five grains of 
Colomel for a child. The next morning a purge of Senna should be taken. 
An infusion (tea) of Senna for this purpose may be made by steeping an 
ounce of Senna leaves in a pint of water. One-fourth of this is a dose for 
an adult, and one or two tablespoonfuls for a child. It can be flavored 
and sweetened to suit the taste. 

The common remedy, Turpentine, ought not to be given, unless neces- 
sity compels it. It is not reliable against worms, unless given in doses of 
a tablespoonful, and then unpleasant effects may follow. If used, it should 
be given with twice the amount of Castor Oil. 

HOMOEOPATHIC TREATMENT. The long worm is most surely 
removed by Cina (worm seed,) and the form in which it is best, is the San- 
tonine (an alkaloid of worm seed, as Quinine is of Peruvian Bark.) This 



324 DISEASES OF THE INTESTINES. 

can be given in doses of one or two grains, twice each evening for two 
days; then omit for one week, and repeat until twelve doses are taken. 
This remedy can usually be obtained in the shape of candy, called San- 
tonine Lozenges, containing one grain each, and are to be given as 
directed above. 

After the child has taken this remedy, the clothing or bedding which 
comes in contact with the urine, is almost always stained yellow or straw 
color, which is no cause for any alarm. It is best to keep the child from 
eating farinaceous food the day previous to taking the medicine. 

For conditions or symptoms remaining after the worms are removed, 
see Cina, Nux-vomica, Spigelia, Mercurius, Pulsatilla, at the close of this 
chapter. 

The tcenia or tape worm is from three feet to twenty or more yards 
long, is smooth the best part of its length, and about a quarter to a half 
of an inch wide; towards the extremity representing the head, its shape 
is more rounded and thin, and the head itself is thin as a thread. The 
color is of a faintish white, with a yellowish tint. The worm consists of 
the very small head, which is sucked fast in the intestinal mucous mem- 
brane, and to which a neck of the thinness of a thread, and half an inch 
in length, is attached, from which neck, the single links of the worm 
afterwards proceed. At first, these links are narrow, but rather short 
than broad, so that the worm exhibits a series of closely-crowded trans- 
verse lines ; the further removed from the head, the more the length of 
these links increase in proportion to their breadth, until the last links 
acquire a length of half an inch to one inch and more. 

The worm grows in length from head outward, until the last full- 
grown links become, sooner or later, detached, and are expelled with the 
stool. The taenia has its principal abode in the small intestines, and is 
only exceptionally met with in the large. Generally, there is only one 
taenia found in the same individual, although we are acquainted with 
one case where twenty-one worms were discharged by the same person. 
Such cases are, of course, very rare. 

As in the case of other worms, so are the disturbances caused by the 
taenia exceedingly various, both in kind and degree of intensity. It may 
be safely asserted, that in the majority of cases, the taenia causes very lit- 
tle trouble, and that the patients do not become aware of its existence, 
until a few links have been expelled with the stools, when a variety of 
ailments and distresses are forthwith traced to the taenia, which, in real- 
ity, are the work of the imagination, rather than of the taenia. The 
mildest disturbances which the taenia occasions, are winding, twisting, 
colicky pains around the navel, not very intense, setting in paroxysm- 
ally, more particularly after eating certain kinds of food, and in the 
morning, when the stomach is yet empty. Generally, these pains are 
associated with a little nausea, or even with a sensation of canine hunger, 
but these symptoms are so trifling, that they are only complained of when 
the patient has become perfectly certain that a taenia is growing in his 
bowels. Under circumstances which it is difficult to analyze, more 
intense disturbances may show themselves, a disconnected enumeration 
of which we here subjoin : violent colicky pains in the bowels, or a creep- 
ing or crawling sensation, as from a worm around the umbilicus, with 



WORMS. S25 

increased secretion of saliva, nausea, even vomiting, especially after eat- 
ing fermented food, herring, sharp condiments, sour fruit. Increased 
appetite, canine hunger, in spite of which the patient emaciates ; itching 
of the nose and anus; sickly complexion ; low spirits and irritable mood; 
irregular stool, alternately normal and diarrhoea; headache, disturbed 
sleep, vivid dreams; palpitation of the heart; changes in the sound of 
the voice. Finally, the above-mentioned more striking affections of the 
general nervous system, which can be traced with more certainty to the 
presence of taenia. 

The presence of taenia can only be diagnosed, with perfect certainty, 
if the patient has actually passed links of the worm. Many lay-persons 
are too anxious to attribute their ailments, gastric derangements, such as 
heartburn, water-brash, etc., to the presence of taenia; especially, if they 
experience a sensation as if a worm were crawling about in the stomach, 
or up the oesophagus ; if, in such a case, no links are passed within a few 
weeks, it is pretty certain that there is no taenia. Most links are passed 
spontaneously at the time of the new moon. 

ALLOPATHIC TREATMENT. Tape Worms. In the treatment of tape 
worm the patientshould fast for a day, taking a little milk or beef teaonly. 
In the evening a purge should be taken of a tablespoonful of Castor Oil, 
a tablespoonful of Epsom Salts, or three drops of Croton Oil. After this 
purge operates, the worm is exposed to the full effect of the medicine 
which should then be taken. 

One of the most efficient remedies we have against tape worm, is 
Pumpkin Seed. Two ounces of fresh seeds are to be pounded in a mortar 
with half a pint of water, until the husks are separated, and the meats 
thoroughly incorporated with the water. The mixture is strained and 
taken, the fastings in the meantime continuing. The dose may be 
repeated in three hours, and in three hours more a purge of two teaspoon- 
fuls of Castor Oil should be taken. If the worm is not removed, head 
and all, the treatment is to be repeated the next day. 

The pressed Oil of Pumpkin Seed may be given instead of the above 
emulsion in doses of a tablespoonful two or three times, and followed by 
the Castor Oil purge, as before directed. 

After the preparatory treatment of fasting and a purge, a dram tea- 
spoonful of the Oleo-Ptesin of Male Fern (Felix Mas,) give a fourth part 
thirty minutes apart, on two successive days, followed by a purge of 
Castor Oil (two teaspoon fu Is); or three drops of Croton Oil is an effectual 
remedy against tape or round worms in persons of any age. It can be 
given in syrup or mucilage. 

Should necessity compel the use of turpentine, one or two table- 
spoonfuls, with an equal quantity of Castor Oil, should be given after the 
preparatory treatment. 

As a preventive of intestinal worms of all kinds, only filtered water 
should be drunk. Meat should be thoroughly cooked, but it is not neces- 
sary to cook it until dry. Fruit and vegetables should be made clean 
before eating. Tonics following the treatment are useful. 

HOME TREATMENT. Tape worm is easily expelled by the use of 
either of the following: 

Take Kousso three to four drams, place in a common goblet or tum- 
bler, and pour cold water upon it until the glass is well filled, being care- 



826 DISEASES OF THE INTESTINES. 

ful that none of the powder is left floating on the surface; let it stand 
over night, and in the morning, after taking nothing more than a small 
cup of black coffee, drink the medicine in two portions, half an hour 
apart. 

If there is a disposition to vomit, a little lemon juice may be swal- 
lowed. In from two to five hours after taking the medicine, the worm is 
expelled. No need of a cathartic. 

Pumpkin seeds two ounces, peel off the outer covering, bruise well, 
mix in a little water, and use as directed above for Kousso, except if the 
worm does not come away in six hours, use a cathartic or an injection of 
Oil. 



COSTIVENESS- CONSTIPATION— OBSTIPATION. 

This complaint is generally sympathetic with some other derangement 
of the organism, and consequently, in our treatment of different diseases, 
we have had frequent occasion to allude to it. One of the leading causes 
of aggravation and excessive obstinacy in the constipation, is the practice 
of flying to laxative medicines on the slight appearance of costiveness, 
under the absurd idea, that keeping the bowels open is a species of panacea 
against disease of every description. Many mothers are so possessed with 
this idea, that they continually administer physic to their children, with- 
out the slightest apparent call for it, and thus lay the foundation of 
dyspepsia and other visceral derangements in after life. Many a slight 
case of costiveness, which, if left to nature, would have disappeared of 
itself, leaving no ill consequences, has, by an ill-judged administration of 
aperients, been converted into obstinate and habitual constipation, embit- 
tering existence, and predisposing the constitution to a variety of diseases 
in after life. To prevent misconception upon this point, it should be 
clearly understood, that we by no means undervalue a regular state of the 
bowels, but, that when costiveness shows itself, we happily possess reme- 
dies calculated to restore the general balance of the system ; and in obstinate 
cases, do not content ourselves with simply alleviating the symptoms, but 
mainly direct our attention to the permanent removal of the affection. 

Many of the principal causes of this disorder, besides that mentioned, 
are the same as those particularized under Indigestion or Dyspepsia. 

ALLOPATHIC TREATMENT. Constipation is to be treated, always, 
with reference to the producing cause. In temporary constipation, as 
that of pregnancy, and in recovery from acute disease, is to be met, chiefly 
by attention to the diet ; but, if this fail, recourse should be had to laxa- 
tives, or, possibly, in the first place, to an active purge. If there is com- 
plete obstruction, the disease is too serious to be tampered with by any but 
the most skillful man. 

In habitual constipation, there should be a regular effort at stool, at 
a regular time, whether the desire exists or not. The preferable time for 
this is soon after breakfast. As a preventive of constipation, the natural 
desire to go to stool should never be voluntarily restrained. 

The constipation should be remedied, as far as possible, without medi- 
cines, but by laxative food. Vegetable diet tends toward a looseness of 
the bowels, and animal food, by being almost wholly absorbed, to consti- 



COSTIVEXESS. 327 

pation. The articles of diet to be preferred for this end are, cracked 
wheat, graham flour, indian meal or hominy, and oat meal, prepared 
according to the art of the kitchen, eaten with cream and sugar, or with 
butter and molasses. 

Almost all kinds of fruit, taken quite freely, are advantageous in 
overcoming constipation. Molasses and brown sugar aid to make the 
bowels more lax. Milk is constipating, but only, I believe, because it is 
almost wholly absorbed. 

None of these articles of diet are to be used, if they disorder digestion 
or occasion other disturbance. Sometimes more harm is done by burden- 
ing the stomach and bowels with articles difficulty of digestion, or loading 
the intestines with unbolted flour, than could be done by the constipa- 
tion. 

In the use of medicines, the patient should not, as a rule, be physiced, 
but the least active medicines which will accomplish the result, are to be 
used. If, however, constipation has for a long time been present, and 
the bowels filled with fecal accumulations, a cathartic, which will thor- 
oughly empty them, is a necessity. For this purpose, a tablespoonful of 
Epsom Salts is a most efficient remedy. If boiled with a teaspoonful and 
a half of roasted coffee, for a couple of minutes in an earthen vessel, and 
after it is allowed to draw for a few minutes and strained, the taste will be 
covered. 

A tablespoonful of Castor Oil, mixed with an equal quantity of Gly- 
cerine, flavored with a couple of drops of Oil of Cinnamon or Wintergreen 
is appropriate under the same conditions. From three to five Compound 
Cathartic Pills, are also suitable for an immediate cathartic. 

Cathartics must not be frequently repeated, as this secondary effect is 
to render the bowels torpid; therefore, the smallest dose and the mildest 
means which will accomplish the result, should be resorted to, and prefer- 
ably those which have the peculiarity of not causing constipation after 
their action. One of the best of this class is Aloes. As a cathartic, the 
dose is from two to ten grains, but a fraction of a grain, with tonics, suffi- 
ces, generally. The remedy is well suited to all causes of debility in this 
disease, and to cases of hypochondria as with constipation. 

With sedentary persons, who cannot change their occupation to an 
active life, and woaien who suffer from a torpor of the intestines, and con- 
sequent constipation, the following pill will be found, in most cases, to 
overcome the trouble: 

Take of Extract of Nux-vomica, Extract of Belladonna, each ten grains; 
Powdered Aloes fifteen grains, Extract of Dandelion thirty grains. Mix 
well, and divide into thirty pills. Take one pill at night. 

If the bowels do not move next morning, another pill should be taken, 
but, usually, one a day will be sufficient. If this proves too active, the 
Aloes should be omitted from the formula. The directions for taking will 
be the same. 

After the bowels have been moving regular for a long time, the pill 
should be omitted, and oniy taken again if the regular opening of the 
bowel does not continue. 

For those who cannot take a pill, the same remedy may be given in 
fluid. 



328 DISEASES OF THE INTESTIKES. 

Take of Tincture of Nux-vomica, and Tincture of Belladonna, each two 
and a half drams, and of Tincture of Aloes and Fluid Extract of Dandelion 
each five and a half drams. Mix. 

Dose : A teaspoonf ul, under the same conditions. 

The Dandelion is not necessary to the efficiency of the prescription. 

The Belladonna and Nux-vomica restore the tone and healthy action of 
the intestines, and seem, in my judgment, essential, particularly the latter, 
for the cure of many cases of constipation. There are many pills in the 
market for the relief of constipation, which have merit, as the Eccoprotic 
Pill of Wm. Warner & Co., and the Aperient Pills of other leading phar- 
maceutists. Before purchasing any of them, it should be ascertained that 
they contain Extracts of Nux-vomica and Belladonna, or Hyoscyamus. 

Palmer's Anti-constipation are a good remedy. 

Dose : One pill once or twice a day. 

From ten to twenty drops of the Tincture of Colchicum after each 
meal will often overcome constipation. Podophyllum is an appropriate 
laxative for constipation ; a quarter of a grain is an appropriate dose. It 
is often used with benefit with Belladonna and Nux-vomica, as may, also, 
be the Compound Extract of Colocynth, the dose of which for this purpose 
being two grains. One or two Compound Cathartic Pills, at night, relieve 
constipation, but do not produce a cure, as a rule, without the use of Nux- 
vomica or Strychnine. 

Senna is not inappropriate as a laxative. The Confection of Senna 
may be eaten, one or two teaspoonf uls at a time, or a tea of ten ounces of 
Senna leaves to a pint of water may be made, and one to four ounces taken 
at a time. 

Co-existing dyspepsia will require treatment as directed in that disease. 
A general debility will require tonics of Quinine and Iron. 

The Citrate of Iron and Quinine two drams and a half dissolved in four 
ounces of Syrup of Orange Flowers, is one of the best tonics. 

Dose: A teaspoonf ul three times a day. 

The Syrup of Elixir of Iron, Quinine and Strychnine, in doses of a tea- 
spoonful, three times a day, are appropriate. Many other tonics might be 
given, and are particularly suitable to cases afflicted with constipation. 

If a person is of a full habit, a teaspoonf ul of Epsom Salts daily, is an 
effectual remedy for his habitual constipation. 

The regular use of an injection of cold water, is a simple and often 
effectual temporary measure for relieving constipation. A piece of hard 
soap, about the size and shape of a pigeon's egg, will sometimes excite a 
movement of the bowels. These are only temporarily useful. An effectual 
cure almost always depends upon the will, establishing the habit of a regu- 
lar motion, with the tone restored to the intestine, by the use of Nux- 
vomica and Belladonna. If these are given for a time with Aloes or 
Podophyllum, the cathartic should then be omitted, and the Belladonna 
and Nux-vomica given alone. 

If the plan before suggested, of having a regular time for stool, and 
allowing nothing to interfere with it, were rigidly carried out, and taught 
by parents to their children, constipation would be a disease as seldom met 
with, as it is frequent now. 

HOMCEOPATHIC TREATMENT. In trivial cases it will be found suf- 
ficient to pay proper attention to diet, to avoid too dry or indigestible food, 



COSTIVENESS. 329 

to masticate properly, to partake of meat only once a clay, and to take 
sufficient exercise in the open air. Should this course not have the desired 
effect, we must choose one or more of the following remedies: 

Opium is chiefly to be selected in recent cases, when constipation is 
not habitual; but is, also, like Nux-v., and other remedies, serviceable in 
cases of a more chronic character, occurring in vigorous, plethoric, well- 
nourished subjects, and arising from inactivity in the intestinal canal, or 
from sedentary habits. In old people, it is generally more useful than 
Bryonia and Lachesis, when diarrhoea alternates with the constipation, 
although these, and other remedies, such as Antim., Phosjjh., and Rata, 
must be borne in mind, and, administered when called for by the nature of 
the symptoms. The more immediate indications for Opium are: want of 
power to relieve the bowels, with a feeling of constriction in ano; pulsa- 
tion and sense of weight in the abdomen, dull, heavy pain in the stomach, 
parched mouth, and want of appetite, determination of blood to the head, 
with redness of the face, and headache. 

Dose : Six pills every twelve hours. 

Nux-vomica. This remedy is particularly useful when constipa- 
tion results from too heavy a meal, indigestible food, and stimulating 
liquids; or when the confined state of the bowels has resulted from pro- 
longed diarrhoea, or frequent purgings. In the latter instances, Opium 
may often be advantageously alternated with Nux-v. In obstinate cases, 
arising from long-continued indulgence in vinous, fermented, or spirit- 
uous drinks, or coffee, or from sedentary habits or excessive study. Nux-v 
is one of the most effectual medicaments. It is peculiarly adapted to per- 
sons of irascible and lively temper, with determination of blood to the head, 
and headache, unfitness for exercise, disturbed sleep, and a feeling of gen- 
eral oppression, or heaviness ; frequent and ineffectual efforts to relieve 
the bowels, attended with sensation of stricture, and sometimes frequent, 
painful and difficult emission of urine. It is, further, as remarked under 
the head of Indigestion (which see, for other indications for this rem- 
edy) particularly indicated for individuals subject to piles. 

Dose: Six pills, taken in a teaspoonful of water every night, until 
amelioration or change. 

Pulsatilla. Has nearly the same indications as Nux-vomica, with 
the characteristic distinction of temperament before noted under the 
head of Indigestion, (which see). In recent cases, it is particularly indi- 
cated when the obstruction has arisen from indigestion brought about by 
rich or greasy food, and when it is accompanied with moroseness and 
shivering. 

Dose; Six pills, as directed for Nux-vomica. 

Alumina is useful against constipation, from inactivity of the 
bowels; motions hard, dry, broken, evacuated with considerable exer- 
tion and forcing, and sometimes streaked with blood ; constipation 
from traveling. 

Dose: Six pills in a teaspoonful of water every evening, or every 
night at bedtime, until amelioration or change. 

Bryonia is especially useful in constipation occurring in warm 
weather, and in persons of dark complexion, and of irritable or obstinate 
disposition, with a tendency to be easily chilled, and subject to 
rheumatism; it is further indicated, when constipation arises from dis- 



330 DISEASES OF THE INTESTINES 

ordered stomach, and is attended with determination of blood to the head, 

and headache. 

Dose: Six pills in a teaspoonful of water, repeated in twenty-four- 
hours, even if partial relief ensue. In chronic cases, six pills may 
in like manner, be taken daily for ten days, or until positive ameli- 
oration or change. 

JPlatina is a useful remedy, when constipation has been brought 
about by traveling, when Opium has failed; or especially when the act 
of expulsion is attended with straining, and when a feeling of weakness 
is experienced in the bowels after a stool, sometimes accompanied by 
shuddering. 

Dose : Eight pills in a teaspoonful of water, night and morning, until 
amelioration or change. 

Sulphur is one of the best remedies in the relief of habitual consti- 
pation, particularly, when haemorrhoids are present, or a disposition to 
them exists; costiveness; with hard, bullet-shaped stools; or frequent 
inclination to go to stool, but without the desired result. 

Dose: For adults, six pills, for young persons, four pills every morn- 
ing the first thing (fasting,) until amelioration or change; or for ten 
days, then pausing four days ;— after which, if requisite, the same 
course may be resumed, and so on. 

Sepia may frequently be taken with advantage, in chronic consti- 
pation, after Nux-v. and Sulphur ; and is, moreover, particularly well 
adapted for females, in whom there is an irregularity, or obstruction of 
the menstrual discharge ; it is also indicated by constipation in individuals 
subject to rheumatism, as well as by hard, conglomerate, bullet-shaped 
motions, and stoppage of the bowels. 

Dose: When the disorder is not of very old standing, give six pills in 
a teaspoonful of water, every twelve hours, until amelioration or 
change. In very inveterate cases, six globules, as directed for Sul- 
phur. 

Lycopodium. Chronic constipation with ebullition and determina- 
tion of blood to the head ; colic, flatulence, sense of weight in the lower part 
of the bowels. 

Dose: For adults, four globules, or, for young persons, three globules 
in a teaspoonful of water, every twelve hours, until amelioration or 
change. 

CONSTIPATION ALTERNATING WITH LOOSENESS. 

Mhus-tooc. f Antimon-crud., Huta, Phosphorus. One or more 
of these four medicines may be advantageously administered singly, in 
alternation, or in succession, in addition to such of those already men- 
tioned, as correspond with the features of the case, when the costiveness 
or constipation occurs in alternation with looseness. 

Dose: Of the remedy selected, give four globules in a teaspoonful of 
water, every twelve hours, until amelioration or change, or for ten 
days, if requisite; then pausing four days, and resuming the course, 
if yet required. 

JEsculus-hippocastanum (Horse-Chestnut). Dull headache. Dis- 
tress in the stomach. Desire for stool and pains in the abdomen. Con- 
gestion of the liver, which pains by walking; it acts when Nux-v. and Sul- 
phur fail to cure. 

Dose: As directed for Baryta-c. (See next page.) 



COSTIVENESS. 331 

Collinsonia-canadensis (Stone Root). Headache. Constipation 
with flatulence. Sluggish stool with distention of the abdomen. Intense 
heat and itching of the anus. 

Dose: As directed for Baryta-c. 

Hydrastis-canadensis (Golden Seal). In chronic and obstinate con- 
stipation. 

Dose: As directed for Baryta-c. 

Fhytolacca-decandra (Poke- Weed). Long-standing constipation. 
Pains in the abdomen, when moving. 

Dose : As directed for Baryta-c. 

Podophi/llum-peltatum (Mandrake). Pain in the forehead. Acute 
and chronic constipation of long standing. 

Dose: A small powder of the first trituration when rising and when 
going to bed, will make a permanent cure in ten days. 

CONSTIPATION OF AGED PERSONS. 

Baryta-c, will often be found of great service in cases of this kind, 
in addition to, before, or after, such of those medicines, named in the 
foregoing part of this article, as correspond most closely with the case in 
question. The particular indications may be gathered from the article 
upon the characteristic action of the medicines. 

Dose: Four pills in a teaspoonful of water the first thing in the morn- 
ing, (fasting) until amelioration or change, pausing, however, for 
four days, after a course of ten days, if the administration should 
require to be continued so long. 

CONSTIPATION OCCASIONED BY PURGING. 

China is particularly appropriate to the treatment of constipation, 
which occurs as the result of previous and violent purging, continued 
looseness, and the like. 

Dose: Four pills in a teaspoonful of water every twelve hours, until 
distinct amelioration or change. 



PBOLAFSUS ANI— FALLING DOWN OF THE LOWER 
FABT OF THE INTESTINES. 

A protusion of a portion of the rectum, or of its internal coat from the 
anus, is denominated a prolapsus or procidentia ani. In some cases, a con- 
siderable portion of the rectum comes out to the extent of three or four 
inches, in others only a little, it presents a circular dark red, pad-like 
lump, from the size of a small hulled black walnut to that of a goose-egg. 

Causes. Anything which tends to weaken the muscles which sup- 
port the intestiue. Among these are the frequent use of cathartics (phy- 
sic,) especially, those containing Aloes, Epsom Salts, etc. The presence of 
pin worms, (ascarides) in the lower portion of the intestinal canal, habitual 
costiveness, piles, straining at stool during diarrhoea, or dysentery (flux,) or 
when straining to pass water. This is much more frequent among child- 
ren than grown people. In some cases, the intestine remains out a 
considerable time without any ill consequences, but more commonly it 
swells and inflames very speedily. 

TREATMENT. When this accident occurs, some person of strong and 
steady nerve, should at once attempt to replace the protruding parts, by 



332 DISEASES OF THE INTESTINES. 

first oiling the parts well with fresh lard, Sweet Oil, Tallow, fresh butter 
not salted, or sweet cream; then second, make steady, not very hard, pres- 
sure in the center of the protruding parts, with the well oiled thumb or 
thumb and forefinger ; occasionally, if necessary, making light pressure on 
the outside of the tumor with the thumb and finger of the other hand, near 
the anus ; when it will slowly, or in some cases, quickly return to its proper 
place. If, after carefully and perseveringly trying for a reasonable time, 
ten or fifteen minutes, (which will appear to be a long time,) the parts do 
not return, send at once for a good and careful physician. 

This trouble having once occurred, is liable to occur again. The best 
means of preventing this, is a quiet position and careful attention to the 
diet, which should consist of the plainest aliment; rye mush and sugar is 
very good food in such cases. The Homospathic remedies, which will 
usually permanently relieve the tendency to return, and, also, help in the 
moment of the accident, are in the order of their names, Nux-vomica, 
Ignatia, Mercurius, Sulphur, Podo. 

Hydropathic in connection with careful diet, take a cold sitz bath 
every evening. This bath is, also, generally used by the homoeopath. 

ECLECTIC. Gently push the protruding part back into the body and 
inject into the bowels the following: Take of Crowfoot or Alum Eoot, 
White Oak bark, each in coarse powder, a tablespoonf ul ; make half a pint 
of strong decoction (tea.) to which add half a tablespoonf ul of powdered 
Alum. Tnis should be injected cold two or three times a day ; when very 
severe, a bandage will have to be worn to keep the bowel from falling. 

Internally let the child drink freely of tea, or equal parts of Golden Seal 
and Solomon's Seal. 

The child should be taught not to strain during stool, and its diet must 
be similar to that recommended for costiveness. If while the bowel be 
firmly held in place by a tight bandage, the child be made to lift several 
times every day, a weight proportioned to its strength, it will aid materi- 
ally in overcoming the difficulty. 



PERITONITIS- INFLAMMATION OF THE PERITONEUM. 

Causes. In the main, the origin of the disease is traceable to the 
following causes: 

After all injuries which bring the peritoneal cavity in contact with 
atmospheric air, peritonitis may be expected in the majority of cases. 
Although the inflammation very often remains confined to the injured 
locality, yet it will almost certainly spread over a larger portion of the 
peritoneum, if blood, pus, or a quantity of atmotpheric air enters the peri- 
toneal cavity. This point deserves the utmost consideration in operations 
upon the abdominal cavity. The danger of inflammation is likewise 
greater, if the abdomen is very much distended before the operation, and 
collapses after it; hence, peritonitis is very apt to occur after tapping for 
dropsy, and after operations during confinement. 

An intense cold will sometimes cause peritonitis among persons, who 
are otherwise perfectly healthy. Among women, a cold may be a mat- 
ter of great importance. There is no question, that confinement and 
the menses are very apt to cause peritonitis: especially, if a cold super- 



PEKITONITIS. 333 

venes at such times. This observation is so common, even among lay- 
people, that women have become accustomed to be very careful at such 
times. The disappearance of the menses, or of lochia, at the commence- 
ment of the inliamniation, has given rise to the theory, that it is this 
suppression which causes the inflammation ; it seems to us more simple, 
and more natural, to reverse this relation of cause and effect. During 
confinement, the collapse of the distended abdomen exerts a powerful 
influence; hence, peritonitis is more apt to occur in the case of women, 
who have borne several children, than among primiparte. 

By far the most violent forms of peritonitis, and which run the most 
rapid course, occur, if an organ becomes perforated, and its contents, or 
even the smallest portion thereof, escape into the peritoneal cavity. This 
occurs most frequently in the case of perforating ulcer, ulcerations of the 
intestines, and gangrenous destruction, consequent upon stricture of the 
intestine. 

Symptoms and Course. These, of course, not only differ in degree, 
according as the inflammation is confined to small portions of the perito- 
neum, or, as diffuse peritonitis invades the whole of the peritoneal 
expanse ; even the diffuse form differs, according as it develops itself sud- 
denly, or by degrees. 

Acute, diffuse peritonitis, either if caused by perforation, or when 
setting in as an idiopathic affection, almost always commences with a 
severe chill, attended with pain in the abdomen. This pain, which is the 
most characteristic symptom of the disease, is most intense from the very 
moment it is first felt. The pain is, as though a pointed knife were 
plunged through the abdomen, from above downwards, without the patient 
being always able to indicate the precise starting point of it. Immediately 
after, a feeling of illness overtakes the patient, he feels unable to remain 
up, and he is satisfied that a severe sickness is upon him. If peritonitis 
sets in, in consequence of the gradual spread of some other affection of the 
bowels, its own development is gradual ; the existing local pains increase 
in intensity, and gradually spread over the whole abdomen, at times 
rapidly and at others more slowly. In violent cases, the invasion of the 
pain is not at once followed by violent fever; on the contrary, the patients 
die in a state bordering on syncope, with cold extremities, and it is only 
the extremely hurried pulse that indicates the approach of a violent fever, 
which is scarcely ever more than twent3 r -four hours in coming. From its 
first beginning, the pain never abates one moment, except, that it some- 
times seems more like a colicky pain ; as the pain spreads the abdominal 
walls become so sensitive, that the patients cannot bear the least pressure, 
so that it is even a relief to them, if the blankets or sheets do not toucli 
the abdomen. The least motion increases the intensity of the pains to 
such an extent, that the patients have to lie on their backs motionless, and 
dare not draw a deep breath, because the pain is aggravated by the pres- 
sure of the descending diaphragm; they even have to speak in a low 
whisper. The pains are at times tearing, at others stinging, lancinating, 
but most of the time fiercely burning, and with a soreness as from an open 
wound. Sometimes the disease sets in with violent vomiting, and diar- 
rhoea, almost like cholerine; in such a case, the act of vomiting causes 
intense suffering. The general symptoms betray, at first sight, the exist- 
ence of an intense disorder. At the first onset of the disease the face 



334 DISEASES OF THE INTESTINES. 

looks pale, with a peculiar expression of distress and anxiety, and with 
pendulous features ; afterwards the face looks flushed, or else the paleness 
remains throughout the whole disease, in spite of the fever. The eyes are 
dull and unsteady. The breathing is hurried, is carried on with the ribs 
only, the speech is short, a mere whisper. The tongue is usually quite 
clean ; there is a craving for cold water, yet only a small quantity can be 
drank at one time. Retching and vomiting, unless present at the first, are 
very apt to supervene ; otherwise these phenomena and the diarrhoea dis- 
appear as the disease increases in intensity; as a general rule, the 
peritonitis is attended with complete retention of stool the first eight days 
of its existence. The urine is always less ; voiding it is often painful, 
or there is constant urging, yet no urine is voided. The pulse is hurried, 
from one hundred and twenty to one hundred and sixty beats, and soon 
becomes small, hard and tense. The skin is dry and constricted, although 
profuse and exhausting sweats sometimes break out ; the temperature 
varies from a burning heat to a disagreeable coolness. An examination of 
the abdomen is difficult, on account of the pain, which is aggravated by the 
least attempt at percussion. Soon after the pains are felt, the abdomen 
becomes more and more distended, so that the distended bowels can be 
felt through the abdominal walls. The sleep is very much disturbed; if 
the patients sink momentarily into a sort of slumber, they at once become 
delirious. All such patients habitually lie on their backs, with the lower 
extremities slightly drawn up toward the abdomen. 

In the further course of the disease, the symptoms generally undergo 
the following changes : The distention of the abdomen increases more and 
more, although its painf ulness to contact generally decreases in proportion 
as the exudation becomes more copious; it even happens, that the sensi- 
tiveness disappears entirely. This, however, is a bad symptom, if, at the 
same time, the whole condition of the patient seems to change for the 
worse. The difficulty of breathing corresponds to the degree of meteoristic 
distention. The anguish increases, the lips become bluish. The pulse is 
a little slower than at the commencement of the fever, but its quality 
remains the same; it does not indicate any remission of the fever, whose 
intensity continues unabated. If the disease terminates fatally, the 
general sensorium is overwhelmingly brought under its influence, the 
patients grow apathetic, do not feel any pain; the pulse becomes imper- 
ceptible, the face has a sunken, cadaverous appearance. Death may take 
place in thirty-six hours, and seems to be principally caused by paralysis 
of the bowels; the disease, however, seldom terminates in such a short 
period of time; it generally continues until the seventh day. 

ALLOPATHIC TREATMENT. The one remedy, without which acute 
peritonitis cannot be treated satisfactorily, is Opium, and it is invaluable. 
It should be given in doses of one grain, from two to four hours apart, 
until the pain is completely relieved, after which the dose should be 
repeated sufficiently often to maintain freedom from pain. This treat- 
ment, alone, will often save the patient's life. Right hot poultices, applied 
over the abdomen, will benefit, if their weight does not cause distress; or 
the ointment of Extract of Belladonna and Extract of Opium may be 
smeared upon the skin of the abdomen and hot fomentations. The appli- 
cations should be kept hot. 



PERITONITIS. 335 

Cathartics should, in no wise, be given, but if there are feces in the 
large intestine, an injection may be cautiously given. 

Nourishment should consist of milk, cream, raw eggs and beef essence. 
Upon the first indication of exhaustion, stimulants should be given in 
doses of a tablespoonf ul of brandy at intervals, varying from two to four 
hours apart. 

HOMOEOPATHIC TREATMENT. Aconitum. For many forms of 
peritonitis, Aconite is undoubtedly the most suitable and surest remedy. 
It is the specific remedy, if the inflammation either spreads further from 
a circumscribed spot, or increases where it sets in with more local symp- 
toms, without the accompaniment of the general disturbances, which 
are sometimes truly fearful, except, perhaps, the presence of an intense 
fever. It is in this manner, that inflammations, with an excess of plastic, 
exudation, generally announce themselves. Observation has shown, that 
in inflammation Aconite is only useful until the exudation is completed 
At this stage the pulse, in inflammations, for which Aconite is indicated, 
becomes somewhat slower and stronger, and the pain abates in a marked 
manner, which is seldom the case before the fifth day of the disease. All 
physicians agree, that one of the lower attenuations should be given in 
repeated doses. 

Dose: Six pills in a little water every hour or two, until the fever is 
somewhat under control. It is frequently well to alternate with 
Belladonna. 

Belladonna is suitable only at the commencement of peritonitis. It 
competes with Aconite, if the local symptoms are accompanied by severe 
congestions of the head and chest, with anguish, dyspnoea, restlessness, 
dark-red and bloated face ; and continual and distressing vomiting of bile, 
which changes about with retching. The exudation is profuse, and the 
intestines are distended at an early stage of the disease, so that the single 
convolutions can be distinctly felt through the abdominal integuments. 

Intestinal catarrh, which may be present during the first days of the 
disease, is an additional recommendation for this drug, so is the development 
of this inflammation from enteritis. Belladonna is likewise an excellent 
remedy for the vomiting, which is apt to set in, in the subsequent stages 
of the disease; in this respect it is only surpassed by Arsenic in a few 
cases. The abatement of meteorism designates exactly the period when 
Belladonna is indicated. 

Dose : Six pills as directed for Aconitum. If in alternation with Aeon- 
ite, give a dose of one, and in one or two hours a dose of the other, 
and so on. 

Veratrum album is related to Belladonna in some respects. If the 
disease sets in in the form of chlorine; more particularly, if the vomiting 
is copious and frequent, at the same time the patients look pale and 
sunken, and feel cool to the hand ; the pulse is small at the onset, and the 
anguish, restlessness and thirst are exceedingly distressing, Veratrum is 
the appropriate remedy. As a general rule, the disease assumes this form 
in the first three days; afterwards other remedies have to be employed. 

Dose: As for Aconite. 

Mercurius is less adapted to peritonitis than to enteritis. The ten- 
dency to suppuration is the best indication for this remedy. Hence, it is 
in the second and third week, that Mercurius must be given ; and the 



336 DISEASES OF THE INTESTINES. 

more special indications are the above-mentioned phenomena, character- 
izing the process of purulent metamorphosis. It is the frequently exacer- 
bating fever, with creeping chills, and copious perspiration after the heat, 
which points to Mercury. In partial peritonitis, on the contrary, as soon 
as the inflammation is localized, Mercurius may be given at the onset. It 
is likewise appropriate, if the purulent exudation seeks to penetrate to the 
outside and form an abscess. 

These four remedies are the only ones that need be given in the first 
stage of the disease. In the further course of the disease we may have to 
administer : 

Bryonia alba. It comes into play at the most decisive period in the 
development of the disease, namely : when we desire to remove the effused 
fluid as soon as possible It is almost certain, that under the influence of 
Bryonia the exuded fluid will be reabsorbed without causing any further 
derangements ; hence, that no suppuration will take place. But the medi- 
cine should be used consistently; we cannot expect to obtain results in a 
day, that can only be obtained in from ten days to a fortnight. As a gen- 
eral rule, Bryonia is not indicated, if a copious diarrhoea is present; this, 
however, is a rare occurrence in the second stage, and, if it does occur, it 
is a bad omen. 

Dose: Six pills in a little water every two to three hours. 

Sulphur is a second remedy we make use of in order to promote, or 
indeed, to excite the absorption of the exuded fluid. In cases where Bry- 
onia leaves us in the lurch, or effects the absorption of the exudation only 
to a certain point, Sulphur is entirely appropriate. It acts even when the 
remaining portion of the exuded fluid had been left for months without 
any alteration. 

Arsenicum album is very closely related to Veratrum album symp- 
tomatically; in a present case, it is difficult to decide between the two 
remedies, especially at the commencement of the attack. In the further 
course of the disease, it is particularly the continued, violent, colicky 
pains, that point to Arsenicum; which is, likewise, sometimes indicated 
by the gradual development of the inflammation out of gastritis, the per- 
forating ulcer, or ulceration of the bowels. We must not allow ourselves, 
by the peculiarities of the picture of the disease, more particularly by the 
extraordinary restlessness and anxiety, to be too readily induced to use 
Arsenic, as is so easily the case at the commencement of the disease. If 
Arsenic acts as a homoeopathic specific, the reaction must not be pros- 
trated, on the contrary it must be vehement; hence the fever must be 
violent and continued. 

Dose: Three pills every three to four hours. 

It remains for us to mention several drugs, to which attention must 
be directed under certain circumstances. Opium, in small doses is some- 
times useful against the paralytic weakness of the intestinal canal, which 
often remains after the disappearance of the exudation ; the intestine is 
unusually distended, and the constipation is complete. Nux-vomica is 
still more preferable, under such circumstances, only the meteorism must 
not be too great. In general, it is an excellent remedy in equalizing the 
remaining trifling irregularities in the digestive functions, especially, the 
torpor of the bowels. The medicines we have indicated are most probably 
sufficient in every case of peritonitis without any unusual complications. 



PERITONITIS. 337 

HOME REMEDIES. Although we have every reason to depend upon 
the efficacy of our means of treatment, yet the disease is so dangerous, its 
first invasion fills the patient with so much anxiety, and it is so exces- 
sively painful, that we are anxious to find out and apply such remedial 
agents, as will afford a momentary relief from the pains; and will, per- 
haps, exert a curative influence upon the morbid process generally. The 
chief palliatives are injections and fomentations. It is impossible to 
decide before hand, whether cold, or warm, moist, or dry applications 
deserve a preference. At first, when the pains are very violent, the patient 
usually prefers cold applications, ice-cloths, or even a bladder filled with 
ice. There are, however, exceptions to this rule, more particularly the cir- 
cumstance that patients cannot bear the least weight on their bowels, on 
account of the extraordinary sensitiveness of these parts. Warm and 
moist fomentations are generally best applied on the fifth day, in some 
cases, the patients prefer them at the very beginning of the disease; they 
are more especially useful, if the patients perspire very copiously. They 
should never be applied too hot, for too high a temperature is prejudicial. 
What had best be applied in a given case, will have to be decided by an 
actual trial, but such an experiment should be instituted with great care, 
lest obstinacy in waiting for a result, should prove injurious. As a gen- 
eral rule, the fomentations that do not afford relief to the patient within a 
few hours, or are otherwise than pleasant to his feelings, are not adapted 
to his condition. As regards the wet sheet, it is one of the best means of 
reducing the inflammation. At first, these wet clothes should be applied 
to the abdomen alone. In view of the great sensitiveness of the abdom- 
inal walls, it is doubtful whether such an application can be frequently 
repeated. Simple injections of water, whether cold or tepid, are exceed- 
ingly beneficial. If used at the commencement of the disease, they will 
prove sufficient to remove the paralysis of the intestinal canal. During 
convalescence, injections of water often render excellent service. 

In scarcely any other disease, the diet deserves more careful attention 
than in peritonitis. There is no necessity of enjoying special rest, since 
the pain, which the patient suffers, renders movement almost impossible. 
The room should be kept at a uniform temperature of about fifty degrees, 
F., the air should be kept fresh, and the patient should only be lightly cov- 
ered. Feather beds should never be used as a covering. Very frequently, 
all kinds of covering should be kept from the abdomen by some suitable 
contrivance, such as barrel-hoops. At the commencement of the disease, 
the patients are tormented by an agonizing thirst, which can only be 
quenched by fresh water. Small lumps of ice in the mouth, likewise, ren- 
der good service, and are partieularly suitable, if there is much retching 
and vomiting. Afterwards, if the appetite commences to return, such food 
should be used as will leave the smallest amount of fecal matter to be car- 
ried off by the bowels. Give beef broth early, and often enough to pre- 
vent exhaustion. 

22 



FART SIXTH. 

DISEASES OF THE LIVER AND SPLEEN. 



CHAPTER XIV, 



DISEASES OF THE LIVER. 



INFLAMMATION OF THE LIVEK. 

This disease is divided into the acute and chronic ; the latter gen 
erally goes by the name of Liver complaint, although, a careful con 
sideration of the symptoms, will frequently discover that the real dis- 
ease is in the stomach and intestines; however, in many cases, the liver 
itself becomes much affected from this cause, and, in itself, deserves 
considerable attention. 

When the disease has been for a long time unchecked, and the inflam- 
mation becomes deeply seated in the substance of the liver, an abcess 
frequently forms, bursting either externally or internally ; in the latter 
case often proving critical, inducing hectic fever. 



ACUTE INFLAMMATION OF THE LIVER. 

This disease is much more common in tropical climates than with us. 
There, a high mode of living, exposure to heavy dews, or damps in the 
evening, and the powerful rays of the sun by day, are amongst its princi- 
pal exciting causes ; but it may, also, arise from violent mental emotions, 
the use of stimulating, or alcoholic drinks, suddenly suppressed evacu- 
ations, strong emetics, or purgatives, the abuse of mercury, gall-stones, 
external injuries, or injury of the brain. 

Symptoms. These differ according to the seat of the inflammation . 
When it occurs on the outer surface, or convex side, the symptoms 
closely resemble those of pleurisy; there is, generally, a violent pain 
under the false ribs on the right side, sometimes resembling stitches, at 
others burning — shooting to the breast-bone, the right shoulder-blade, 
and point of the shoulder, and even affecting the right foot, — sensation 
of numbness, or tingling in the arm of the same side, the pain increased 
by inspiration ; a short, dry cough, and the symptoms of inflammatory 
fever ; bowels irregular, generally constipated, and stools, in the majority 
of cases, of an unnatural color. 

338 



INFLAMMATION OF THE LIVEK. 339 

In this form, the patient can only lie on the left side. 

When the seat of inflammation is on tlie inner, or concave side of the 
liver, the pain is much less, and the patient complains rather of a sensa- 
tion of pressure, than actual pain, 'but the whole biliary system is much 
affected. The eyes and countenance become yellow, and sometimes com- 
plete jaundice declares itself; the urine is orange-colored, the evacuations 
mostly hard, and generally, of a whitish or gray color. We also find 
bitter taste in the mouth, vomiting, and considerable distress. The 
patient can only lie on the right side. Inflammatory fever is present in 
this form, likewise. In both forms, on examination, the region of the 
lower ribs, on the right side, will usually be found hot, tumefied and 
painful on pressure. 

Inflammation of the liver, unless properly treated, is apt to assume 
the chronic form ; it may, also, end in suppuration externally, or inter- 
nally by a communication, either with the lungs or intestinal canal, or 
by an abscess in the substance of the organ itself, or may terminate in 
indurations, or other alterations of structure, in gangrene, or in the form- 
ation of adhesions. 

The disease may terminate by resolution, critical transitions to other 
organs, piles, diarrhoea, bleeding at the nose, or eruptions in the skin 
generally, erysipelas. 

ALLOPATHIC TREATMENT. The treatment of congestion of the 
liver, will consist, as far as possible, in the removal of the causes of the 
disease. In some instances, there are sedentary life, and too generous 
living. Great benefit will be derived in some of these cases, from horse- 
back riding, hunting, walking, etc., while saline laxatives, as Seidlitz Pow- 
ders, directly diminish the congestion. The use of beer, and spirits 
should be discontinued, and the diet made more simple and plain. If 
the congestion is of long continuance, benefit will result from the use of 
Dilute Xitro-Muriatic Acid. It may be given in doses of ten or fifteen 
drops. It should be given before meals, largely diluted in sweetened 
water, or preferably in a couple of ounces of some bitter infusion, as 
infusion of Columbo (one ounce simmered in a pint of water). Bathing 
the right side with a solution of Nitro-Muriatic Acid — three ounces to a 
gallon of water, is of advantage. Drinking the water from some of the 
sulphur springs, is sometimes useful. If the patient is debilitated, the 
use of Xitro-Muriatic Acid should be associated with the use of Citrate of 
Iron and Quinine, a dram and a half dissolved in four ounces of Lemon 
Syrup, or of Syrup of Orange Flowers, of which, a teaspoonful may be 
taken after each meal. 

If the congestion of the liver depend on disease of the lungs or 
heart, treatment, will of course, have reference to those affections, and 
remedies addressed directly to the congestion of the liver, will be only 
palliative. 

In inflammation of the liver, there is great danger to life. The intense 
pain should be relieved by the use of Opium, in doses of a grain, at such 
intervals as may be necessary to relieve the pain— one or two hours, or 
longer, apart. The pain must be relieved. Laudnum may be given by 
injection, in doses of a teaspoonful in a tablespoonful of thin Starch, and 
repeated once a day. The anodyne effects of this may be increased, if 



340 DISEASES OF THE LIVER. 

necessary, by giving Opium in doses of a grain, or Morphine in doses of 
a quarter of a grain, by the mouth. 

A liniment of equal parts of Laudanum, Tincture of Aconite, Chloroform, 
and Soap Liniment, may be continuously applied to the right side, over 
the liver, by means of a flannel, saturated in the liniment, and covered 
with oiled silk. 

The bowels may need acting on mildly, preferably by an injection of 
warm water. 

In this disease there is especial danger from suppuration. 

Tonics and nutritious food are early called for. The best tonic remedy 
is Quinine and Nitro Muriatic Acid. Two or three grains of Quinine, 
every four hours, will be appropriate. The Nitro-Muriatic Acid should be 
given in doses often to twenty drops, largely diluted in sweetened water, 
at about such intervals as food is given, as an aid to digestion. 

Such food as milk, eggs beaten up with sugar and water, or milk, given 
raw, strong beef tea, and animal essences, are appropriate. 

Should the inflammation, whether embracing the whole organ or 
limited to a portion, result in abscess, which can be distinguished through 
the abdominal wall by feeling with the hand (palpation,) it is proper to 
open it. If the surface of the liver is adherent to the inner surface of the 
wall of the abdomen, the opening may be made directly into the abscess. 
But if the adhesion has not plainly taken place, an incision should be 
made down to the peritoneum (lining membrane of the cavity of the 
abdomen) and the wound filled with Lint or Oakum. In three days the 
membrane will be adhered so the opening can be made with safety, 
which may be done either with the knife or trocar. 

Generous diet, with the Quinine, will probably enable the patient to 
survive. 

Should the abscess open into the intestine or bronchial tubes, it may 
be necessary to give anodynes (as Opium) in small doses to relieve the irri- 
tation of those parts. 

H0M(E0PATHIC TREATMENT. Aconitum, Belladonna, Mercur- 
ius, Lachesis, Aconite is especially indicated in the commencement of 
the attack, and may always precede the other remedies, when there is vio- 
lent inflammatory fever, attended with insupportable shooting pains in 
the region of the liver, with tossing, restlessness, and great anxiety and 
anguish. 

Dose: Of a solution of eight globules to two tablespoonfuls of water, 
give a teaspoouful every three hours, until improvement or change. 

Belladonna may be advantageously administered, after Aconite 
has subdued the preceding symptoms, or from the commencement, when 
the following indications present themselves; oppressive pains in the 
region of the liver, which extend to the chest and shoulders, distention of 
the pit of the stomach, sometimes extending across the region of the 
stomach, producing a sensation of tension, with difficult and anxious res- 
piration ; determination of blood to the head, with cloudiness and 
giddiness, sometimes causing faintness ; great thirst, tossing about at 
night, and sleeplessness. Belladonna may be advantageously alternated 
with ISTux-vomica in such cases as coincide with the joint indications 
afforded for both of these medicines, especially, if the patient has been 



ACUTE INFLAMMATION OF TIIE LIVER 341 

addicted to excessive use of fermented liquors. Belladonna is, moreover, 
especially appropriate when the temperament of the patient exhibits a 
combination of the sanguine and lymphatic. 

Dose: If singly, dissolve eight globules in two tablespoonfuls of 
water, and give a teaspoonful of the solution every two hours, until 
amelioration or change. If no positive and permanent improve- 
ment should ensue within four hours after the third dose, pause two 
hours more, and proceed with the next medicine. If in alternation 
with Nux-v., the like solution of each administered in rotation, by 
teaspoonfuls, at intervals of two hours. 
Mcrcurius will, in the majority of cases, prove effectual when Bella- 
donna has failed to produce a favorable impression on the disease, and 
should accordingly be administered six hours after the third dose of the 
foregoing remedy in such instances. The particular indications for Mer- 
curfcis are as follow : 

Considerable fullness or tumefaction in the region of the liver, with 
pricking, burning, or oppressive pains, not allowing the patient to lie long 
on the right side, and sometimes augmented by movement of the body or 
part affected; pain in the shoulders; bitter taste in the mouth, want of 
appetite, thirst, and continual shivering, sometimes followed by sweat- 
ing, but without relief, with pale yellow color of the skin and eyes ; also, 
in more advanced stages of the complaint, when there is induration of 
the liver. This medicine may, moreover, like Belladonna, be adminis- 
tered in alternation with Nux-vomica, under similar conditions. If the 
patient is of a lymphatic temperament, or is distinguished by softness of 
the muscular system, there will be additional reason for selecting Mer- 
curius. 

Dose: A solution of eight pills, in all respects, singly, or in alterna- 
tion, as directed for Belladonna. 
Bryonia, Cliamomilla, Bryonia, when the pains in the region of 
the liver are mostly shooting, or consist of an obtuse pressure, with tension 
and burning, increased by touch, coughing or respiration, and, especially, 
during inspiration, or much exacerbated by movement ; also, when the 
symptoms are attended with violent spasmodic oppression of the chest ; 
rapid and anxious respiration; bitter taste in the mouth, tongue coated 
yellow, and constipation. Bryonia, like Chamomilla, is particularly useful 
in cases which have been excited by mental emotions, such as a violent 
paroxysm of anger, and is well adapted to persons of nervous or bilious 
temperament, and of choleric disposition. 

Dose : Of a solution of eight pills to two tablespoonsful of water, give 
a teaspoonful every three hours, until distinct amelioration or 
change. In eases in which the pain is very severe, the doses should 
be repeated every two, three and four hours, progressively, accord- 
ing as an improvement ensues, and, subsequently, every six hours. 
Cliamomilla is more particularly required in the milder forms of 
the complaint, or, more correctly speaking, in simple irritation of the 
liver, when there are pressive pains, pressure in the stomach, oppression 
of the chest, and a sensation of tightness under the ribs; yellow color of 
the skin, pains not aggravated by motion, etc.; tongue foul and yellow, 
bitter taste in the mouth; paroxysms of great anxiety. Chamomilla is, 
also, almost a specific, when the above symptoms have been brought on 
by a fit of passion. 

Dose: In all respects as directed for Bryonia. 



342 DISEASES OF THE LIVER. 

Nux-vomica is particularly indicated when the pains are shooting 
and pulsative, and attended with excessive tenderness in the region of 
the liver, to the touch, pressure in the region of the stomach and under 
the ribs, with shortness of breath and constipation ; also, when enlarge- 
ment and induration occur; and, in the chronic form, when there are 
marked symptoms of derangement of the stomach. This medicine is, 
especially, appropriate for the treatment of patients of a sanguine or bil- 
ious temperament or choleric disposition. 

Dose : In acute attacks, four globules in a teaspoonf ul of water every 
two hours, until a degree of effect is apparent, and then every six 
hours, until positive improvement results. In chronic cases, six 
globules in a tablespoonful of water, every night at bed-time, for a 
week, after which, a pause of four days should ensue, the adminis- 
tration being similarly resumed, if necessary, and so on. 
Pulsatilla. Sensation of tension in the region of the liver, and pres- 
sure or dull pain in the region of the stomach; oppression at the chest, 
bitter taste, yellow tongue, nausea; loose, greenish, and slimy stools; 
excessive anxiety, especially, towards evening or during the night. (Tem- 
perament lymphatic; disposition mild). 

Dose : Of a solution of six globules to two tablespoonf uls of water* 

give a teaspoonf ul every six hours, until amelioration or change. 
Sulphur is valuable to follow any one of the preceding medicines, 
which, although apparently indicated, does not speedily produce a decided 
action; or when the disease continues, although in a diminished degree; 
it is particularly efficacious, after Nux-vomica, to combat the bad conse- 
quences of the disease. In many instances, in which the distinct analogy 
between the symptoms of the disease, and those which characterize one or 
more of the otfier medicines enumerated herein, has led to the administra- 
tion of such other medicine or medicines, and when such treatment has 
failed to be followed by adequate benefit, the intermediate administration 
of a single dose of Sulphur, from time to time, has served to awaken the 
susceptibility of the system to the action of such other medicine (when 
evidently appropriate,) and the repetition of its administration after such 
dose of Sulphur has been followed by admirable results. 

Dose: To assist the action of the other medicines, give four globules 
in a teaspoonful of water, following up the treatment with the rem- 
edy judged most appropriate to the case, after an interval of twelve 
hours. 



SUPPURATIVE INFLAMMATION OR ABSCESS OF THE 

LIVER. * 

Sulphur, Silicea, Kali-c, Lycopodium. These four medicines 
may be numbered amongst those which have proved most useful in cases 
of suppuration of the liver. The selection from amongst them, must, of 
course, depend upon the particular features of each individual case, and 
must be regulated by instituting a comparison between the symptoms of 
the disease, and those which are recorded as characteristic of each of these 
medicines in the article on that subject. 

Dose : As for Nnx. 

* See Treatment of Inflammation of the Liver. 



CHRONIC INFLAMMATION OF THE LIVER.— JAUNDICE. 343 

Diet. The regulations for diet which are prescribed for the treat- 
ment of Fevers in general, and such other regulations as are detailed in 
the article on " Indigestion," are equally applicable to cases of Inflam- 
mation of the Liver. 



CHRONIC INFLAMMATION OF THE LIVER, OR 
CIRRHOSIS. 

In this form of the disease, we find many of the foregoing symptoms, 
but in a modified degree; and in addition, a continued pain or uneasiness 
in the right side seldom leaves the patient, who gradually falls off in flesh 
and loses strength ; and there is, not unf requently, present an occasional 
cough with expectoration ; sometimes, considerable perceptible enlarge- 
ment of the liver, either continual or returning periodically, with a num- 
ber of dyspeptic symptoms; high-colored or red urine, yellow tinge of the 
skin and eyes, occasional febrile symptoms; the pulse, except during these 
attacks, generally quick but regular. 

ALLOPATHIC TREATMENT. Chronic Inflammation (Cirrhosis) of 
the Liver is, generally, caused by the use of alcoholic drinks. The patient, 
generally, pays no attention to this trouble, until it causes dropsy of the 
abdomen. It is then safely regarded as incurable. 

In the early stages of the disease, by the abandoning of the use of 
spirituous liquors, and by the use of Arsenious Acid, and the Iodides, as 
in the following formula, a recovery can doubtless be made. Take of the 
Iodide of Ammonium a dram, Fowlefs Solution, half a dram, Tincture of 
Columbo, an ounce, Water, four ounces. Mix. 

Dose : A teaspoonf ul three times a day, before meals. 

The use of Dilute Nitro-Muriatic Acid in doses of ten or fifteen drops 
in sweetened water, three or four times a day is beneficial. 

In the later stages, the treatment is the same as for Dropsy of the 
Peritoneum (Ascites) 

HOMCEOPATUIC TREATMENT. With proper modifications, as to the 
frequency of doses, the regulations prescribed in the foregoing article (pp. 
340 to 342) are equally applicable to this variety of the disease. The med- 
icines enumerated should, accordingly, be selected in conformity with the 
indication therein set forth. The following, however, are especially appro- 
priate, in the majority of cases of Chronic Inflammation of the Liver, and 
the undermentioned rule for the dose is generally, reliable, as regards 
other medicines. 

Nux-vomica, Bryonia, Sulphur, Sepia. There are compara- 
tively few cases (if any) of Chronic Inflammation of the Liver, in which 
one or more of these medicines, either singly, successively, or alternately, 
will not be required; for indications see pages 340 to 342. 

Dose: Of the medicine selected, give four globules in a teaspoonful of 
water, morning and evening, for a week (or until an earlier subsi- 
dence or change in the symptoms); after which, pause four days, 
resuming the course, as before, if necessary, and so on. 



JAUNDICE. 

Symptoms. Yellow color, varying in shade from a pale saffron to a 
dark-brown yellow, appearing first in the eyes, then extending over the 



344 DISEASES OF THE LIVER. 

surface of the whole body; hard, whitish evacuations; orange-colored 
urine; symptoms of deranged digestion, and sometimes, tensive pain 01 
pressure in the region of the liver. 

In severe cases, even, the perspiration will impart a yellow hue to the 
patient's linen. 

Exciting Causes. The disease frequently declares itself without 
being plainly referable to any exciting cause ; the principal causes, how- 
ever, are affections of the liver, indigestion, poisonous substances, taking 
cold, powerful mental emotions, emetics^ drastic purgatives, # or internal 
obstructions, such as gall-stones, or even worms obstructing the biliary duct. 

Predisposing Causes. Amongst the predisposing causes may be 
enumerated, a too sedentary or irregular mode of life, indulgence in spirit- 
uous liquors, and the frequent use of aperients. 

It may be, also, remarked, that this disease frequently assumes the 
intermittent type. 

Jaundice is not, of itself, to be considered as a dangerous disorder, but 
rather as an indication of some internal derangement, which, if neglected, 
may entail serious consequences ; for example, dropsy,, hectic fever, or gen- 
eral wasting away. 

ALLOPATHIC TREATMENT. Jaundice is a symptom which accom- 
panies (other) diseases of the liver, and, in such instances, its treatment is 
that of those affections. 

Generally, there is a catarrhal inflammation of the upper part of the 
intestine (duodenum) requiring that the food should be light and unirri- 
tating to this part of the digestive tube. Milk, eggs, animal broths, broiled 
beef steak, oysters, fresh fish, are suitable. Bread, arrow -root, rice, pota- 
toes, beans, pies, etc., may, by calling upon the functions of that part of 
the intestine, continue the disease, and should not be used. 

Laxatives may be called for, but must be mild. Injections are to be 
preferred, if there is constipation. A Seidlitz Powder may be taken. 

In this, as in other affections of the liver, the Nitro-Muriatic Acid is 
useful, in doses of ten drops in sweetened water, three times a day. 

Manganese has appeared useful, in catarrhal jaundice. Take of dried 
Sulphate of Manganese forty grains, Purified Ox Gall sixty grains, Resin 
of Podophyllum two and a half grains. Mix well, make a mass and 
divide into twenty pills. 

Dose : One three times a day. 

In Malarial Jaundice, after from ten to twenty grains of Quinine has 
been given, Manganese is, also, useful. Take of Dried Sulphate of Man- 
ganese forty grains, Chenoidine sixty grains. Mix and make into twenty 
pills. 

Dose: One three times a day. 

A small blister over the stomach has appeared useful. 

Pain should be relieved with half grain doses of Opium, or ten drops 
of Laudanum, or a grain of the Extract, or one or two teaspoonfuls of the 
Tincture of Hyoscyamus. 

When jaundice has continued for weeks or months, there probably is 
an irremediable obstruction to the flow of bile. If it cannot be removed, 
remedies are directed to aid in the elimination of bile by the kidneys, and 
skin and to support the powers of life. 



JAUNDICE. 345 

To increase the flow from the kidneys, the diuretic pill composed of 
one grain each of Extracts of Squill and Digitalis and Calomel, may be 
given, one pill every three hours, until it acts freely on the kidneys. Or 
the Fluid Extract of Broom may be given in doses of half a teaspoonf ul. 
Watermelon or Pumpkin Seed tea may be useful. 

The skin may be sufficiently acted on by hot bathing. If not, by the 
hot wet pack. 

Bile may be supplied to the aid of digestion by giving one or two cap- 
sules filled with ox-gall after each meal. 

It should be remembered, that the yellowness will exist in the skin for 
some time after the bile duct is open, so that the bile flows naturally into 
the intestine. 

HOMEOPATHIC TREATMENT. Mercurius, China. These are two 
of the best remedies in the treatment of the disorder. 

Mercurius may be denominated a specific remedy for jaundice in a 
great number of cases, when, indeed, the patient has not been subjected to 
drenching courses of Mercury or Calomel. 

Dose: Six globules in a teaspoonf ul of water, every six hours, until 
four doses have been given, and then every twelve hours, until per- 
manent and positive amelioration or change. 
China is, however, to be preferred to Mercurius, in cases in which 
Mercury has been too copiously administered. China is, also, particularly 
appropriate when the attack has come on after violent corporeal exertion, 
or when it can be distinctly traced to indigestible substances ; also, when 
the disease assumes an intermittent character. In a great number of cases, 
indeed, in which jaundice recurs periodically, or in which patients, already 
predisposed to its attacks, have been unavoidably or inadvertently exposed 
to some directly exciting cause, (such as over-exertion, cold, etc.,; China will 
operate as a preventive resource, and will commonly ward off the develop- 
ment of an incipient attack. 

Dose: For the treatment of jaundice, in an advanced stage, give four 
globules in a tablespoonful of water, three times at intervals of four 
hours, and at intervals of eight hours, until amelioration or change. 
As a preventive resource, give six globules in a wineglassful of 
water, night and morning, for three days, then pause two days, sus- 
pending treatment, or resuming the course, similarly, according to 
the state of the patient. 

Xux-vomica is preferable in the generality of cases, even in such as 
have been directly occasioned by violent emotion, when the bowels are 
confined, or alternately confined and relaxed. Ntix-vomica is, also, espe- 
cially, appropriate when sedentary habits, or study, or indulgence in 
spirituous liquors, appear to have been the predisposing, or, partly, the 
exciting causes of the attack. 

Dose: Three globules in a teaspoonf ul of water, every four to eight 
hours. 

Digitalis, A most important remedy in many cases of this disease; 
the following are the principal indications for its employment: nausea, 
retching, or vomiting and purging of greenish fluid; or sluggish state of 
the bowels, with white, gray, or clay-colored evacuations; tongue clean, or 
coated white; pressure at the pit of the stomach, and region of the liver ; 
alternate heats and chills. 



346 DISEASES OF THE LIVER. 

Dose : Of a solution of six globules to three tablespoonfuls of water, 
give a teaspoonful every two hours, until the violence of the symp- 
toms become modified ; and then every four hours, until positive 
amelioration or change. 

INFLAMMATORY JAUNDICE. 

Cases in which jaundice is associated with symptoms of inflammation 
and pain on pressure in the region of the liver, are so closely analogous to 
inflammation of the liver, that the reader is referred, on this subject, to 
the foregoing articles, treating especially of that disease. 



GALL STONE.-CHOLELITHIASIS, BILIARI CALCULI. 

The tendency inherent in the bile to form firm concretions, is 
quite considerable ; hence biliari calculi are a common occurrence. 
The causes of such concretions are very obscure; they occur in indi- 
viduals of the most varied constitutions, and pursuing the most 
diversified occupations, diet, and habits of life. Their formation 
seems to be most promoted by a copious supply of animal food, and by the 
use of lime-water. As a rule, such calculi are not met with until after 
the thirtieth year, but occasionally before; they occur more frequently 
among females, and their formation is promoted by every circumstance 
that causes an arrest of the flow of bile. 

Biliari calculi are chiefly found in the gall-bladder; here they are 
met with in large numbers, seldom as solitary concretions. In the latter 
case their form is oval or rounded ; where several concretions are present, 
they assume an angular form with more or less curved surfaces, in conse- 
quence of the sides being rubbed off, and of the pressure and counter- 
pressure they exert upon each other. 

They mostly consist of a nucleus, round which a lighter-colored layer 
of lime has been deposited, which is again surrounded by an envelope 
composed principally of cholestrine and bile-pigment. Their color is at 
times light, at others white, yellow, dark-brown, dark-gray or black. 
They are not very firm ; in their recent state they are friable and can 
easily be crushed. 

Bilious concretions maybe present without any danger to the individual 
affected with them; they may be expelled without any pain ; on the other 
hand they may acquire importance from the pains which they cause and 
from the lesions to which they give rise. In this respect, the size of the 
concretions is of much less importance than their shape and the internal 
condition of the gall-bladder ; biliari calculi (gall stones) of the largest 
size sometimes cause the least distress. 

Symptoms. Hence the symptoms caused by these concretions vary a 
great deal according to their shape and intensity of pain. In slight cases, 
a short-lasting spasmodic pain, corresponding to the region of the gall- 
bladder, accompanies the expulsion of the calculi into the bowels. In 
other cases the pain is continuous but not violent, sometimes it is parox- 
ysmal. It is only in the smallest number of cases that the calculi cause 
regular attacks of colic. This colic commonly sets in all at once, the 
patient feeling otherwise perfectly well ; it is attended with a more or less 
violent pain in the region of the gall-bladder. Generally, this pain 



GALL STONE. 317 

increases very rapidly in intensity; it is an intolerably burning, boring 
pain, and, while increasing in intensity, radiates over the chest and abdo- 
men to varying distances. At the same time the region of the liver 
becomes exceedingly painful to pressure, it is apt to bloat, and, in 
consequence of the contraction of the abdominal muscles, the abdo- 
men becomes hard as a board. The pain is generally so distres- 
sing and acute, and the patients find it so difficult to breathe, that 
they toss about in the greatest agony. The general constitutional condi- 
tion is, likewise, affected by the pain according to the sensitiveness of the 
patient and the duration of the pain. Although there is no fever, yet the 
pulse soon becomes small, filiform, almost unaccountable, disappears even 
entirely, although the heart is in tumultuous motion; the skin becomes 
correspondingly cool, and is covered with a cold perspiration, the com- 
plexion is cadaverous. The pain is most commonly associated with 
distressing vomiting and retching which terminates in a painful hiccup- 
ing. The nervous system participates in the violent racking of the 
frame ; the patient is attacked by violent chills or local cramps, or else by 
violent convulsions at times tonic, at others clonic, which are apt to ter- 
minate in syncope. Such paroxysms sometimes last a few hours, at others 
a day and longer. The pains usually all cease as soon as the calculus 
enters the intestine ; sometimes they disappear gradually or have complete 
remissions, according to the condition of the excretory ducts of the gall- 
bladder, or to the peculiar shape of the calculus, which at times adheres 
and at others moves on again. After the pain ceases, all the incidental 
ailments generally disappear very rapidly, and nothing remains but 
languor and weariness. About this time, icterus (jaundice) makes its 
appearance in different degrees of intensity. The appearance of icterus 
depends upon the length of time that the excretory ducts of the bile 
remain obstructed. If the obstruction only continues a short time, the 
icterus may not break out at all : on the contrary, if the obstruction lasts 
long, the jaundice may already set in during the pains. As regards fre- 
quency, the attacks vary, but the same individual is scarcely ever attacked 
once only ; because, as we stated before, solitary concretions cause pain 
only exceptionally, whereas a multitude of smaller concretions that have 
become sharply angular by rubbing against each other, penetrate more 
easily into the excretory duct, and cause a more acute irritation. 

Prognosis. The terminations of colic from the presence of biliari 
calculi, or rather the consequences of gall stone, vary a great deal. Death 
scarcely ever takes place in consequence of an attack of such colic. If 
the calculus remains incarcerated for a long time, and fills, at the same 
time, the whole space of the excretory duct, we obtain a picture of a fully- 
developed jaundice, with the various symptoms previously described. If 
the incarceration is not removed, suppurative hepatitis, inflammation of 
the gall-bladder, and its excretory ducts, may be the consequence. In 
the last mentioned case, the patients succumb to peritonitis arising from 
perforation of the gall-bladder, or, if the gall-bladder should have become 
adherent to the surrounding parts, the patients fall away, gradually, 
until death ends their sufferings. 

The diagnosis of biliari calculi is, generally, very easy and sure. The 
seat of the pain, the sudden beginning and the equally sudden cessation 
of the pain, and, above all, the discharge of bilious concretions with the 



348 DISEASES OF THE LIVER. 

feces, establish the diagnosis. If the concretions are soft, they may not 
appear in the feces, for the former may break up and scatter during their 
passage through the intestines. If the colic is not violent, it is difficult 
to recognize its true character, especially, if the symptoms of the stomach 
are not very prominent, and the attack runs a slow course. The swell- 
ing and painfulness of the region of the liver may remind one of hepa- 
titis, or else the symptoms may be those of acute hyperemia of the liver. 
The spasmodic symptoms do not, generally, follow immediately after the 
commencement of an attack, so that it is scarcely possible to confound it 
with eclampsia, epilepsy, etc. 

The treatment involves an abbreviation and mitigation of the attacks 
of colic, and prevention of all further mischief from it; at the same time 
we must try to prevent the return or reproduction of new concretions by 
proper treatment. 

ALLOPATHIC TREATMENT. In the treatment of the passage of gall 
stones, is in the first place, to relieve the pain, and for this purpose, the 
best remedies are Opium and Belladonna. If a physician is at hand, he 
will give a hypodermic injection of a quarter of a grain of Morphine with 
a sixtieth of a grain of Atropine. The effects of the anodyne should be 
maintained, until the pain, caused by the passage of the stone, ceases. An 
injection into the bowel of a teaspoonful of Laudanum, with half a tea- 
spoonful of Tincture of Belladonna, in a couple of tablespoonfuls of thin 
starch, maybe made, or the same remedies given by the mouth in half the 
quantities. The pain may be intense enough to induce the physician to 
resort to the inhalation of Chloroform or Ether. 

Belladonna Ointment may be applied over the seat of pain, and cov- 
ered with a hot flaxseed meal poultice. 

A hot bath is sometimes successful in mitigating pain. No rule can 
be given for giving Opium in this disease, but when larger doses have 
been given for a few days, Opium poisoning may occur unexpectedly. 

Expulsion of the calculus (stone) may be aided by cathartics. For this 
purpose salines are to be preferred, as Epsom Salts and Seidlitz Powders. 

No remedies are known which can be given in sufficient quantity to 
dissolve the stones. 

As a preventive measure, the Phosphate of Soda should be given in 
doses of from twenty to thirty grains, two or three times a day. The rem- 
edy should be persevered in for months. It has the property of rendering 
the bile more liquid, and so prevents the formation of new gall stones. 

A change from a sedentary life is desirable. A simple, wholesome 
diet, and attention to the general health are called for. 



CARCINOMA HEFATIS, CANCER OF THE LIVER. 

The disposition to cancerous growths in the liver is one of the most 
common accompaniments of what is generally designated as the carcino- 
matous diathesis. Cancer of the liver constitutes one of the most fre- 
quent forms of the carcinomatous disease. 

The symptoms caused by carcinoma of the liver, differ in intensity 
according to the size and locality of the degeneration, so that the disease 



INFLAMMATION OF THE SPLEEN. 349 

sometimes remains without any symptoms. Usually the disease com- 
mences with the vague symptoms of hyperemia or of fatty liver, with 
pressure and a feeling of fullness in the right side; the pain, as a rule, 
exceeds that of any other affection of the liver, and, on that account, is an 
important diagnostic sign. If the carcinoma is deep-seated, the pain may 
be entirely absent. An important item in the diagnosis of the carcinoma 
of the liver is the rapid enlargement of this organ, even to an enormous 
size, and the consequent bulging of the margin of the ribs. 

The constitutional symptoms vary a great deal. Sometimes the stom- 
ach and intestinal canal are much disturbed by the affection of the liver, 
and sometimes they remain perfectly free from all traces of trouble. 

As a rule, Carcinoma of the liver is an incurable affection, which must 
prove fatal sooner or later. The duration varies from a few months to a 
number of years, and depends upon the rapidity with which the cancer 
grows. Carcinomata that break out after operations, are generally more 
speedily fatal, than such as are restricted to the liver. 

A treatment pursued with a view of curing the disease, has very 
small chances of success. Reported cures should be received with a 
great deal of distrust. 



CHAPTER XV. 



INFLAMMATION OF THE SPLEEN. 

.Symptoms. Sharp, pressing, or shooting pains in the region of the 
spleen, beneath the lower ribs on the left side, with, in most cases, a high 
degree of fever, with general derangement; and sometimes enlargement 
and tumefaction ; when very severe, vomiting of blood. 

From our very imperfect knowledge, however, of the physiology of 
this organ and its relation to the others, this disease, except when it pre- 
sents itself in the tangible form above mentioned, is extremely difficult 
to discover. Its best characteristics are tenderness or sensibility on pres- 
sure in the region about the spleen, with general debility ; paleness of the 
complexion, bloodless appearance of the conjunctiva (the superficial 
membrane lining the eyelids, and extending over the fore part of the 
eyeballs,) languid circulation, and tendency of the extremities to become 
cold. 

It is a rare disease in this country, but sometimes declares itself in hot 
seasons, when it is not un frequently mistaken for other affections. It 
may, however, arise in individuals of delicate constitutions, or in children, 
when exposed to the influence of marshy miasms, particularly when, to 
that cause, has been added insufficient clothing, want of exercise or proper 
nutriment, and long-continued mental disquietude. 

ALLOPATHIC TREATMENT. Acute inflammation of the spleen is to 
be treated on the same general principles as inflammation of the liver. 
The same anodynes will be required, and they are to be administered in 
the same way. The constant application of cold by means of a bladder of 



250 DISEASES OF THE LIVER. 

pounded ice over the region of the spleen, is particularly appropriate. 
Benefit will, also, result from the use of Ergot in large doses. A teaspoon- 
ful of the Fluid Extract of Ergot may be given three or four times a day. 

By far the most common affection of the spleen, is a chronic inflamma- 
tion, known as enlargement of the spleen, which occurs in malarial dis- 
tricts, or where intermittent fever prevails. It is also known as ague cake. 
This affection, occurring periodically, requires the use of Quinine in full 
doses — five or ten grains, given six hours apart, until a slight ringing of 
the ears is produced. For continued use for enlarged spleen, it should be 
continued with Sulphate of Iron. Take of Sulphate of Quinine sixty 
grains, Dried Sulphate of Iron, ninety grains. Make into thirty pills, 
according to the art of the apothecary. 

Dose: One pill, three, four or five times a day. 

Bromide of Potassium, given in doses of from ten to fifteen grains 
three times a day, sometimes reduces the enlargement of the spleen with 
wonderful rapidity. 

The Iodide of Ammonium and Arsenious Acid, in small doses, fre- 
quently repeated, are particularly efficacious in chronic enlargement of 
the spleen (ague cake) with chronic malarial poisoning. Take of Iodide 
of Ammonium two and a half dmms, Iodide of Arsenic one and a half 
grains, Peppermint Water four ounces. Mix. 

Dose: Take a teaspoonful from three to five times a day. A dram of 
Fowler's Solution may be substituted for the Iodide of Arsenic. 

Brushing the skin over the spleen with Tincture of Iodine, or rub- 
bing it with the Red Iodide of Mercury Ointment, will be of benefit. 

Sometimes wearing a Belladonna Plaster, on the left side, will relieve 
the pain of enlarged spleen. 

HOMOEOPATHIC TREATMENT. China should be administered at 
the onset of the treatment, if no fever of any moment existed from the 
commencement, particularly, if the disease owes its origin to marsh 
miasm, or if the accompanying fever present an intermittent type, in 
which case, it should be administered during the intervals, if impaired 
appetite and general derangement be present. Also, if the patients have 
been weakened by vomiting of blood, or diarrhcea. 

When the abuse of this medicine, or Quinine, has given rise to dis- 
ease of the spleen, benefit will often be derived from the employment of 
such of the subjoined remedies as may correspond most closely with the 
symptoms of the case. The alternation of China and Arsenicum is appro- 
priate, when the symptoms involve a combination of the indications 
afforded for each, respectively. 

Dose: If singly, when the disease presents no positive periodical 
character, and the symptoms are not violent, of a solution of eight 
globules, to two tablespoon fuls of water, give a teaspoonful every 
two hours, until positive amelioration or change. If the symptoms 
be very severe, the like dose should be repeated at intervals of one 
hour. If the disease assume a distinctly periodical character, the 
like dose should be administered, during the respite, an hour before 
the anticipated return of the attack. If in alternation with Arseni- 
cum, dissolve the like quantities of each, separately, and adminis- 
ter, first two doses of the one, at intervals of three hours, then pause 
nine hours, and proceed with two similar doses of the other, and 
bo on. 



INFLAMMATION OF THE SPLEEN. 



351 



Arsenicum is useful where the disease assumes the intermittent type, 
or is complicated with ague ; and, further, when the patient complains of 
a violent, burning pain in the region of the spleen, and a constant pulsation 
at the pit of the stomach, attended with great anxiety ; also, vomiting of a 
dark,grumous fluid, watery, or bloody discharge from the bowels, and burn- 
ing at the posterior passage ; excessive weakness, and dropsical swelling at 
the feet. The alternate administration of this medicine, with China, is 
sometimes advantageously adopted as above stated. (See China.) 

Dose: In all respects, whether singly, or in alternation with China, as 

directed for the last named medicine. 
Arnica is indicated by pressing pain in the left side, under the short 
ribs, causing difficulty of breathing, and when the vomiting of blood is very 
severe. When external violence has given rise to the disorder, Arnica is, 
especially, called for. 

Dose : In ordinary cases, of a solution of six globules to three table- 
spoonfuls of water, give a teaspoonful every three hours, until ame- 
lioration or change. But, if vomiting of blood occur, the like dose 
should be repeated every hour. 
Nux-vomica is chiefly indicated by the symptoms of deranged diges- 
tion, constipation, etc., which remain after the more threatening symptoms 
are removed, or after the use of Quinine. 

Dose : Six globules, in a teaspoonful of water, at bed-time, until ame- 
lioration or change. 



A — Sternum (Breast- 
bone). 

B— Clavicula (Collar- 
bone). 

C — Scapula (Shoul- 
der-blade). 

D — Humerus (Upper 
Arm-bone). 




E— True Bibs. 

F— False or Floating 

Bibs. 
G — Vertebra? (Spinal 

Column). 
H — Maxilla Inferior 
(Lower Jawbone). 



PART SEVETVTHo 

DISEASES OF THE KIDNEYS AND BLADDER. 



CHAPTER XVI 



DISEASES OF THE KIDNEYS. 



NEPHRITIS— INFLAMMATION OF THE KIDNEYS. 

The history of the disease, in individual cases, is in many respects 
very obscure. It occurs chiefly among middle-aged persons, and among 
men more frequently than women. 

Some of the causes are: Bruises in the region of the kidneys ; sharp, 
or adhering gravel in the kidney; violent colds, employment of various 
drugs, such as Turpentine, Spanish Fly, Nitre and Savin, whether used 
internally or externally. Sometimes, violent, extensive burns. Exces- 
sive use of stimulants. Suppression of the "courses." Long lying on 
the back. Secondarily, the disease is caused by suppurative inflamma- 
tions in other organs ; also, by diseases of the brain and spinal marrow, 
heart disease, etc. 

Nephritis usually sets in, like other acute inflammatory diseases, with 
a violent chill, which is almost immediately succeeded by the local pains. 
After they have reached the acme of their intensity, they extend over 
the whole region of the kidneys, on both sides; they are continuous, of 
different degrees of acuteness, cannot easily be described according to 
their nature, they are considerably aggravated by pressure upon the renal 
region by taking a full breath, or by motion generally; also, by lying on 
the affected side, and by the warmth of the bed. They are scarcely ever 
restricted to the kidneys; on the contrary, following the course of the 
ureters (little tubes that carry the urine from the kidneys to the blad- 
der) they radiate into the bladder, testicles, and, in the case of females, 
into the round ligaments and thighs. Sometimes the testicles are found 
drawn up spasmodically. 

With the appearance of these pains, the urinary secretion diminishes 
in proportion as the inflammation involves a larger portion of the kid- 
neys, so that the secretion of urine may be entirely suspended. At first, 
the urine is only saturated, sometimes tinged like blood; but it may, like- 
wise, preserve its normal color, if one kidney is sound and the other does 
not secrete any urine at all. The general constitutional balance is very 
much disturbed. The fever is very violent, the pulse hurried and 
soon becomes small and contracted, the skin is hot and dry, the thirst 

352 



INFLAMMATION OF THE KIDNEYS. 353 

agonizing. The patients feel sick to the core. Vomiting is a frequent 
occurrence without the stomach appearing much deranged, for the tongue 
may be quite clean. At first, the bowels are quite constipated, the appe- 
tite is gone. 

The further course of nephritis corresponds with the changes that 
have been indicated. Reco\ery may take place after the first onset of the 
disease, without any suppuration having taken place, or by arresting it. 
the completeness of the recovery being shown most conclusively by the 
urine resuming its normal quality. On the contrary, if suppuration sets 
in, the local pain decreases, becomes duller, and more like a painful pres- 
sure; the fever, however, increases, frequent chills or shiverings are 
experienced by the patient, the tongue becomes coated, the stomach is still 
more disturbed, pus is found in the urine at an early stage of the disease. 
and there is frequently an admixture of blood. The patient becomes 
anxious, restless, the pulse is more frequent and smaller. The subsequent 
phenomena depend upon how far the urinary secretion is suspended. If 
only one kidney is diseased, or only a small portion of both, there is no 
material diminution of the quantity of urine secreted ; an abscess forms, 
with the usual phenomena characterizing the suppurative process, the 
abscess either discharging, and recovery taking place, or else renal phthisis 
(consumption) setting in, with all the symptoms of marasmus (wasting 
away) gradually following. This last mentioned result may drag along 
for months, the urine containing pus all the time. Characteristic features 
of renal phthisis are, a great tendency to malignant affections of the skin, 
and a disposition to lie down. In some cases, serious symptoms set in 
most suddenly when the discharge of urine had been completely sus- 
pended from the beginning, and the patients die in a few days. They may, 
likewise, set in gradually, so that the disease, by slow degrees, assumes a 
typhoid character. The patients sink into a sound sleep, are attacked 
with a more or less violent delirium, convulsions, and finally die. 

The diagnosis of nephritis cannot always be made with perfect certainty, 
because the symptoms are sometimes very trifling, and, moreover, very 
little characteristic. In nephritis the bowels are almost always obsti- 
nately constipated ; if the disease terminates in phthisis, the constipation 
changes to diarrhoea. 

The termination is unfavorable, only, if the symptoms of poisoning 
with uraemia become more and more manifest, until they reach the highest 
degree of intensity. In other respects, the disease becomes the more 
threatening, the more protracted a course it runs, until it finally terminates 
in phthisis. 

ALLOPATHIC TREATMENT. Treatment of inflammation of the kid- 
neys will consist in the use of hot applications to the loins, hot poultices, 
dry cupping, and other remedies to relieve pain. Mild purgatives, and 
medicines to act on the skin, and by these means relieve the kidneys, 
are indicated. If there is much pain, the medicines to act on the skin, 
should contain Opium, as the powder of Ipecacuanha and Opium with 
Chlorate of Potash, or Dover's Powders, the dose of which is ten grains. 

The popular objection to Opium in this disease, in sufficient doses to re- 
lieve the pain, on account of dryi nq; up the secretions, is groundless, because 
it acts freely on the skin, and so is protective against any ill which may 
result from a diminution of exertion from the kidneys; besides this sus- 



354 DISEASES OF THE KIDNEYS. 

pension of the action of the kidneys will enable them to recover from the 
inflammation the more quickly, from simply the rest. The antiphlogestic 
effects of Opium, are, also, most important. Notwithstanding the consti- 
pating effects of the Opium, there is no difficulty in obtaining copious dis- 
charges from the bowels. 

Further effects on the skin may be secured by hot bathing, the hot 
wet pack, and the hot air bath. The hot air bath may be given by burning 
alcohol in a saucer, under the patient, sitting in a cane seated chair, well 
wrapped, (chair and patient), from the floor up to the neck with blankets. 

Jaborandi has especial power of causing the elimination of urea (a 
poisonous ingredient of the urine,) by the skin, and is, especially indicated 
in this disease. The dose of the tincture, or fluid extract is half a tea- 
spoonful to a teaspoonful. It may be repeated at such intervals as is 
required to excite a sufficient degree of sweating. 

The bowels may be freely moved with two or three grains of Jalap, 
and a half a grain of Podophyllum, or a saline cathartic may be given. 
The amount of purging and sweating required, will be proportioned to the 
decrease in the natural flow of urine. Nothing more than water should 
be given to increase its flow. Ice may be given in small lumps, and swal- 
lowed, or allowed to melt in the mouth, if there is sickness at the stomach. 

In the early stages, the diet should be light, but solid food is to be 
allowed as early and as freely as there is power to digest and assimilate it. 
If suppuration should occur, great attention must be given to sustaining 
the strength of the patient, and nourishment of milk, cream, raw eggs, 
beaten up with sugar and water, or milk, strong beef tea, juice of meats 
and aniseed essence, freely and regularly given. 

The difficulty of discriminating this disease and its various conditions, 
together with its serious, nature, dictate that its control should be placed 
wholly in the hands of a skillful physician. 

H03KEPATIIIC TREATMENT. Cantharides will be found most effica- 
cious in the treatment, and^may be taken, at the very commencement of the 
attack, even when the accompanying fever is considerable, particularly, 
when the urine passes off in drops, or is tinged with blood; or when it is 
exceedingly painful to pass water, with burning pain in the urinary canal ; 
and when there are the general symptoms of shooting, cutting, and tearing 
pains in the loins and regions of the kidneys; or even in cases of complete 
suppression of urine. 

Dose: Of a solution of eight globules, to two tablespoonfuls of water, 
give a teaspoonful every three hours, until positive change. 

Nitx-vomica is appropriate when the affection can be traced to excess 
of wine or stimulants, and sedentary habits; and where we find constipa- 
tion, feeling of faintness, nausea, vomiting, distention of the stomach, and 
drawing up of the testis, and of the spermatic cord. 

Dose: As for Cantharis. 

Belladonna. When shooting pains in the kidneys are present, extend- 
ing to the bladder— and further, when inflammation in the kidneys is 
accompanied with colic and spasms of the stomach, heat in the region 
of the kidneys, scanty flow of water of an orange-yellow, or sometimes of 
a bright-red color, depositing red or whitish thick sediment ; anxiety, 
restlessness, and periodical aggravation. 

Dose: As for Cantharides. 



INFLAMMATION OF THE KIDNEYS— BRIGIIT'S DISEASE. 355 

ITepar-suIpTiuris is useful when we have reason to apprehend the 
formation of an abscess, or the commencement of suppuration. The non- 
professional prescriber must be careful not to mistake the apparent alle- 
viation of suffering here for the subjugation of the disease, as the distinc- 
tion is difficult. The following symptoms may serve as a guide in these 
serious cases; cessation of the acute pain, a sensation of throbbing and a 
feeling of weight in the region of the kidneys, alternate chills and slight 
flushes of heat, and copious perspiration are sure signs of pus forming. 

Dose: A powder of eight pills dissolved, to be taken like Canth. 

INFLAMMATION OF THE KIDNEYS OCCASIONED BY MECHANICAL 

INJURIES. 

Arnica is appropriate for the treatment of Inflammation of the Kid- 
neys resulting from mechanical injuries (such as contusions or severe 
concussions,) and should be employed at the onset of treatment, whatever 
be the course afterwards indicated by the subsequent development of 
symptoms. 

ILL-EFFECTS FROM ABUSE OF CANTHARIDES. 

The mischievous use of Cantharides, in the application of blisters, 
whereby the kidneys often become considerably, and even seriously, 
affected, is promptly and effectively counteracted by the Homoeopathic 
antidote employed internally and externally. 

Camphor {Concentrated Tincture) should be administered without 
delay, when an affection of this kind is distinctly traced to the cause in 
question. 

Dose {internal) : One drop of the concentrated Tincture of Camphor, 
on a small lump of sugar, every hour, until three doses have been 
given ; and afterwards, every two hours, until the symptoms sub- 
side. 
Application (external): Moisten the palm of the hand with a few 
drops of the concentrated tincture, and apply with friction on the 
inner side of each thigh. 

INFLAMMATION OF THE KIDNEYS ASSOCIATED WTTn GRAVEL. 

This disease sometimes arises from the presence of stone in the kid- 
neys ; in Avhich case the symptoms of fever do not occur, until a consid- 
erable time after acute pain has been experienced. Further, a numbness 
of the thigh, and a retraction of the testicle of the affected side, are con- 
sidered as distinguishing marks of the existence of a concretion in the 
kidney or urinary duct. 



BRIGHT' S DISEASE OF THE KIDNEYS-MOBBUS 
BBIGHTII. 

Bright's disease mostly attacks persons of middle age, less frequently, 
children, and still less old people. Males appear more disposed to contrac- 
ting disease, probably, because they use such noxious substances as predis- 
pose to it, more frequently than women. Feeble individuals are more 
frequently attacked than vigorous persons. Damp and cold weather it 
considered one of the most frequent causes of this disease. If we admit 
that colds, which are so common, may give rise to renal diseases in con- 



356 DISEASES OF THE KIDNEYS. 

sequence of a suppression of the cutaneous exhalations, on the other hand, 
we must not forget that the abuse of alcoholic beverages, which is such 
a prevalent vice, likewise, is a main cause of the nephritis, which is so 
frequently met with. But it is not only alcohol, but likewise, the above- 
mentioned drugs and poisons, that cause both nephritis and Bright's 
disease. Among general febrile diseases, it is, particularly, after cholera 
and scarlatina that nephritis occurs, although, it may, likewise, develop 
itself after other acute affections, but rather exceptionally. Among 
chronic diseases, it is, such as rachitis, rheumatism and scrofulosis, which 
are often accompanied by this disease. We are no more able to account 
for the connection between these dyscrasias and Bright's disease, than w T e 
are for the frequent occurrence of Bright's disease during extensive suppu- 
rations of bones, although we may know, that the quality of the urine, 
during such conditions of the system, undergoes considerable changes. 

A division of Bright's disease into acute and chronic, is a very difficult 
task. What can at most be asserted, is that the disease only passes 
through the first stage, or, goes on its course further into the other stages. 
It is only the characteristic nephritis during scarlatina, very seldom dur- 
ing the course of other exanthematic fevers, to which the name of Bright's 
disease can properly be applied, for the reason, that in most cases, it passes 
only through the first stage. The cause of it, in our opinion at least, is not 
so much a difference in the causing influences, as the age of the patients. 
Nephritis after scarlatina is scarcely ever met with, except in children or 
young persons, in whom the reactive efforts of the organism differ greatly, 
especially, in regard to the kidneys, from those of middle-aged persons. 
This difference is, likewise, clearly manifested by the symptoms, as the 
following description sufficiently shows : 

The acute form of Bright's disease, after scarlatina, generally sets in 
with distinct febrile phenomena, sometimes with pain in the renal region, 
and almost always associated with vomiting at an early period, a circum- 
stance that deserves to be considered with great care in convalescents 
from scarlet fever. Only in rare cases, the disease develops itself without 
the above-mentioned symptoms, in a more insidious manner, or is cov- 
ered up by the other morbid phenomena accompanying the exanthem. 
From the onset, the quantity of the urine is considerably lessened, but a 
day seldom passes that some urine is not voided. The urine has a very 
dark color, red, or brown, like beer, makes a very consistent foam, and, 
after settling, deposits a dark sediment. The excretion of the urine is 
interrupted ; there is a good deal of urging, with scanty discharge. These 
symptoms of disturbance of the renal functions are very soon succeeded 
by a dropsical swelling over the whole body, which is first strikingly 
seen in the face, and attains a high degree of intensity. During this 
stage, the fever is, generally, not very violent, the patients may, even 
feel tolerably well, and have some appetite. The thirst is always s:reat, 
they desire cold drinks; the skin is entirely inactive, cool, feels dry, and 
has a pale, sickly color. The bowels are, generally, confined ; the pres- 
ence of diarrhoea is not a favorable symptom. If the disease has a favor- 
able termination, which may take several weeks, the urine is again secre- 
ted in larger quantity, the morbid products in the urine decrease, the skin 
resumes its functional activity, and, without any special signs of disor- 
dered functions, the disease soon yields to perfect recovery. Not unfre- 



bbigiit's disease. 357 

quently, however, such patients succumb to inflammations of other 
organs, or, which is less frequently the case, the second and third stage of 
the disease may appear. If the disease runs a rapid and favorable course, 
there is no great loss of strength, and the patients, generally, recover 
very rapidly. 

Where Bright's disease is not a sequela of acute diseases, it has an 
entirely different beginning. Under such circumstances, the first stage 
may, indeed, pass away very rapidly, with the more or less marked symp- 
toms of typhus, which, however, is, generally, associated with convul- 
sions, and where the accompanying oedema (puffy swelling) of the face, 
generally, shows the true character of the disease. If both kidneys are 
affected, an acute dropsy may, suddenly, cause death. But, almost 
always, the disease commences without any preliminary symptoms, 
without chilliness or heat, and without local pains; at any rate, these 
pains are not very prominent. Thus, it happens that the patients are 
unable to indicate the beginning of their trouble. 

Insensibly they begin to complain, their strength diminishes, they 
feel that some illness is about to overtake them, the appetite is less, symp- 
toms of stomach-catarrh become manifest, the intestines may, likewise, 
be similarly affected. The urine is voided as usual, seldom less, rather 
more, and, should the disease set in with much severity, the urine shows 
the above-mentioned darker color, and diminishes in quantity. Usually, 
it is feebly turbid, even while being voided, of a pale color, of a bluish- 
green tint, foams very strongly, and the foam lasts a great while. Only 
at the commencement of the disease, blood is found mixed up with it. 
The test for albumen shows decisive results. 

Much less rapidly than with the acute form, sometimes even at a 
remarkably late period, but rarely before the termination of a few weeks, 
a symptom makes its appearance, together with the dropsical phenom- 
ena, which renders any error, in diagnosis, almost impossible. Here, too, 
one of the first symptoms is oedema of the skin, which has the peculiarity 
to be more prominent in one place or the other, and, at times, to disap- 
pear entirely. It is always most marked in the face and on the lower 
extremities. While the oedema of the skin is constantly increasing, 
water, finally, accumulates in the cavities, and the patient succumbs to 
the injury which the increasing pressure of the water inflicts upon the 
most important organs. 

In the more acute cases the disease hastens, with uniform rapidity, 
onward towards a fatal termination. If the disease runs a more chronic 
course, its intensity varies; remissions that almost seem intermissions, 
and of various duration, are observed, during which, the strength of the 
patient not only increases, but the albumen disappears from the urine 
down to a scarcely perceptible trace. Accordingly, the disease at times 
lasts months, and at others, years; there are no positive landmarks by 
which the duration of the disease can be determined beforehand, even 
approximately. The prognosis is always very doubtful; in cases of long 
standing, it is absolutely unfavorable. A complete cure is most easily affec- 
ted in recent cases that do not run too rapid a course. The danger is essen- 
tially increased, if there is a tendency to inflammation of other organs, or 
by the presence of heart-disease. If the disease had been caused by exter- 



353 DISEASES OF THE KIDNEYS. 

nal circumstances, a damp climate or dwelling, or frequent colds, the 
removal of these causes may be of great importance. 

ALLOPATHIC TREATMENT. Treatment of acute Bright's disease 
(acute inflammatory dropsy) will have reference, in the first place, to com- 
bating the inflammation of the kidneys. Upon the early recognition of 
this disease may depend largely the success of treatment. 

The patient should be kept warm in bed. Hot fomentations should 
be applied over the loins, by means of wet cloths covered with oiled mus- 
lin and several thicknesses of flannel. Dry cupping should be applied 
over the loins, as the best method of revulsion. If the patient is strong 
and robust, wet cupping (blood-letting by cupping) will be of the highest 
possible service. General bleeding is sometimes necessary in the very 
robust, but should never be employed, if the patient is in any way en- 
feebled, as when the disease occurs after scarlet fever, and in persons 
given to intemperance. Saline laxatives are valuable, both by way of 
revulsion and eliminating poisonous material from the blood, and so 
relieving the kidneys, as Epsom Salts, Seidlitz Powders, or ten grains of 
Jalap, or two or three grains of the extract, with a tablespoonful of 
Bochelle Salts, or Cream of Tartar. 

Opium, as a rule, ought not to be given in this disease; while it is 
appropriate in acute inflammation, it is not suitable in Bright's disease. 
It diminishes the secretion from the kidneys, while they ought to flow 
naturally. 

Belladonna, in doses often or fifteen drops of the Tincture, twice a 
day, or sufficiently often to produce a slight dryness of the throat, is said 
to be serviceable in this disease. 

The diet should be light. The drinks should be confined to water, 
barley-water, flaxseed tea, and other nourishing drinks, which may be 
given as freely as the patient desires. Nothing acts so satisfactorily on the 
kidneys in this disease as the free use of pure water. 

Medicines, to act on the kidneys, (diuretics) ought not to be given in 
the early stage of the disease, because their action may increase inflam- 
mation. 

The dropsy is not dangerous, unless it invades the pleural cavity 
(cavity of the sac lining the chest and covering the lung,) or the lung 
cells. This will be shown by the marked dyspnoea (difficulty of breath- 
ing, or short breath;. As the danger is from urcemia (blood poisoning 
from urea, an ingredient of the urine remaining in the blood,) it is fortu- 
nate that remedies which will cause the elimination of urea from the 
blood, also, diminish the dropsy. This is done through the skin and 
bowels, the former by measures which produce sweating, (diaphoretics) 
and the latter by remedies which produce free, watery discharges from the 
bowels (hydrogogue cathartics). 

Hydrogogue cathartics are by far the most efficient. They are called 
for in proportion to the amount and location of the dropsy, and the dan- 
ger from blood-poisoning. When the dropsy invades the pleura or lungs, 
and the shortness of breath is marked, relief may be had in a few hours 
by giving Elaterium in doses of an eighth to a quarter of a grain, two or 
three hours apart, until free catharsis is produced. It may be given with 
a grain of Extract of Hyoscyamus, or a teaspoon ful or two of the Tinct- 



height's disease. $59 

ureand a grain of Pulverized Capsicum. Elaterium must be used with 
caution, on account of its prostrating effects. It is scarcely safe for weak 
subjects, but may be a necessity. 

Croton Oil maybe given in doses of a drop, repeated at the same 
intervals. The hot air bath maybe used alternately with these active 
cathartics. 

The decrease of the amount of urine passed, and its low specific grav- 
ity shows that urea is not eliminated by the kidneys in sufficient quanti- 
ties, and measures should be at once resorted to, to compensate for that 
deficiency. The most reliable means at our hands for this purpose, are 
the watery stool-producing (hydrogogue) cathartics and copious sweating, 
by means of the hot air bath. 

In case of insensibility, or convulsions from blood-poisoning by urea, 
Elaterium should be given in doses of a quarter or half a grain mixed with 
butter, and placed well back on the tongue. The hot air bath should be 
used simultaneously. 

The hot air bath may be easily given by conveying hot air from an 
alcohol lamp, through a sheet iron pipe under the bedclothes. The part of 
the pipe which rests under the clothes may be closed in a tin box for con- 
venience. Ronchette, of New York, devised a very simple apparatus for 
this purpose, called Ronchette's hot air bath. 

The elimination of urea by the skin, will be greatly facilitated by the 
use of Jaborandi. Half a teaspoonful to a teaspoonful of the tincture, or 
Fluid Extract may be given three or four times in the twenty-four hours. 
A very eligible remedy as a diaphoretic, is a solution of the Acetate of 
Ammonia, in doses of a tablespoonful three times a day. 

If the symptoms are not very urgent, the use of the saline cathartics, 
recommended in the first part of this article, are to be used instead of 
these most powerful ones just spoken of. 

The daily use of the hot air bath may be continued, during the disease 
as the most efficient means of producing elimination of urea by the skin. 
If tte effect of the bath is agreeable, its application may be continued from 
half an hour to an hour each time, or if too depressing, it may be used for 
a shorter time, at more frequent intervals. 

When the flow of urine begins naturally to increase, the use of diure- 
tics (medicines which cause a flow of urine,) may be cautiously begun, and 
the other evacuates omitted, beginning with the cathartics. Among the 
eligible diuretics for this purpose, are Cream of Tartar (Bitartrate of 
Potash,) which may be drank at will in lemonade, made of a clear solution 
of an ounce of Cream of Tartar, dissolved i 1 hot water, using a sufficient 
quantity of lemon and sugar. (See formula on next page.) Digitalis in doses 
of ten drops of the tincture three times a day, gradually increased until 
the desired effect is produced, or Broom (Scorporius,) in a tea, or half 
teaspoonful doses of the (laid extract three times a day. 

Daring convalescence, attention should be given to the diet, that the 
food is nourishing, and well digested containing tender meat, milk, and eggs. 
As the patient leaves the room, he should be clothed in flannel, and prop- 
erly protected against cold. Generally, the Tincture Muriate of Iron should 
be given in doses of from ten to twenty drops, largely diluted in sweet- 
ened water, after eating. Tonics of one or two grains Quinine, or a couple 



360 DISEASES OF THE KIDNEYS. 

of ounces of some of the simple bitter teas as Col umbo, Quassia, Gentian, 
etc., may be taken with benefit before meals. 

Chronic Bright's Disease.— It is to be understood, in the first place, 
that this disease is incurable, but life is greatly prolonged by judicious 
management. 

The indications are related to the dropsy and the uraemia (poisoning by 
that ingredient of the urine known as urea, remaining in the blood.) 

General dropsy calls for the same treatment as is directed in the acute 
disease. It is better, however, to use the saline cathartics as Sulphate of 
Magnesia (Epsom Salts.) Citrate of Magnesia, Rochelle Salts or Seidlitz 
powder, if the dropsy be moderate, but if the dropsy be great, the more 
nowerful hydrogogue (water-producing) cathartics may be used, as, 
Elaterium, Croton Oil, or Bitartrate of Potash (Cream of Tartar) and Jalap, 
as directed in the acute disease. One free watery stool may be produced 
daily. Care should be exercised not to weaken the patient by pushing 
cathartics too far. 

Remedies to act on the kidneys (diuretics) may be used in the chronic 
form of the disease, without risk of harm. Pure water may be drunk in 
large quantities. Of the diuretic medicines, the Cream of Tartar, Citrate 
or Acetate of Potash, are to be preferred. They may be used in connec- 
tion with the vegetable diuretics Digitalis, Squills, or Broom. 

The potash may be readily taken, prepared as follows: Take of Cream 
of Tartar an ounce, dissolve in hot water; when cold pour off the clear super- 
natant liquid, cut up some lemons into it, and sweeten to the taste. The 
whole of this Cream of Tarter lemonade is to be taken during the day, or: 

Take of the Citrate of Potash and Bicarbonate of Potash each four 
ounces, dissolve in a pint of soft water. Of this solution two tablespoonfuls 
may be put in a large tumbler half full of water, sweetened to the taste, 
add a large tablespoonful of lemon juice, and drink while effervescing, six 
times a day. In the absence of lemons, a tablespoonful of a solution of 
three drams of Citric Acid, in half a pint of water, may be used instead. 

Of the vegetable diuretics Digitalis is to be preferred, given in infu- 
sion, (tea) two drams of leaves to the pint of water, in doses of one or two 
tablespoonfuls. Broom in decoction (tea boiled,) one ounce of broomtop 
to a pint, in the same doses. 

The tincture of Digitalis, Vinegar of Squill and the Fluid Extract of 
Broom may be used in doses of half a teaspoonf ul to a teaspoonf ul. 

When the stomach or bowels will not permit giving diuretics, cloths 
may be soaked in an infusion of Digitalis made, with an ounce of the 
leaves in a pint and a quarter of water, and laid over the abdomen. Or 
the body may be rubbed for a time with a liniment made with equal parts 
of the Tinctures of Digitalis, Squill, and Iodine. 

Medicines which produce sweating (diaphoretics) must be depended 
on, if hydrogogue cathartics are not well borne, and the kidneys do not act 
freely with the use of diuretics. Indeed, it seems preferable to use dia- 
phoretic measures alternately with the action of cathartics. Or rather use 
diaphoretic measures regularly, and resort to cathartics to cause a greater 
elimination of water and urea. The first and best means at our disposal 
for this purpose, is the hot air bath, as described in the treatment for 
inflammation of the kidneys, and in the treatment of acute Bright's dis- 
ease. In short, the benefit from the hot air bath is so great, and it acts so 



bright's disease. 361 

nicely, that I am disposed to recommend its use to the exclusion of every 
other means. Jaborandi and Solution of the Acetate of Ammonia are 
appropriate, used as recommended in the treatment of acute Bright's dis- 
ease. 

The measures for the elimination of urea, are the same as given for 
that purpose in the acute form of the disease, namely: reliance, when the 
symptoms are urgent, on the use of the hot air bath, and the hydrogogue 
action of Elaterium, especially, when the urea has produced coma, insen- 
sibility, or convulsions. When this urgency does not exist, it is best to 
avoid the use of Elaterium, but recourse may be had to the milder cathar- 
tics, directed for the mitigation of the dropsy, in this and the acute 
disease. 

The tonic effect of Quinine and Iron, are markedly useful in this dis- 
ease. The former may be given in doses of two or three grains, three 
times a day. The form of Iron to be preferred is the Muriate Tincture of 
Iron. It should be given in doses of twenty or thirty drops, largely dilu- 
ted in sweetened water, three times a day . A change in the form of these 
tonics from time to time, is advantageous. Pills of a twentieth to a thir- 
tieth of a grain, given one three times a day, appears to be of great advan- 
tage in chronic Bright's disease. 

Food should be nutritious, and as abundant as the digestion will 
admit of. The clothing should be warm and the patient should lead an 
out door life to such a degree as his strength will warrant. 

Tor the relief of pain, Opium should be avoided, if possible, and Bel- 
ladonna, Hyoscyamus, Indian Hemp, Aconite, Conium, etc., used instead. 
When these fail to give relief, recourse may be had cautiously to Opium. 
It has acted admirably in some cases. 

Vomiting and purging are to be regarded as conservative, they only 
are nature's means for eliminating urea. They should be restrained 
only sufficiently to keep them within the bounds of safety. They may be 
relieved by aiding in throwing off the urea, by resorting to the hot air 
bath. Medicines calculated to relieve vomiting are Oxolate of Cerium in 
doses of five grains. Dilute Hydrocyanic Acid in doses of three to five 
drops, Creosote, in doses of one drop in water. Bismuth, in doses of ten 
to twenty grains, and lumps of ice swallowed whole, or allowed to dissolve 
in the mouth. 

If any remedies are necessary for diarrhoea, the remedies directed foi 
the treatment of that trouble are appropriate. 

Upon the early recognition of the disease, and the promptness with 
which its effects are met, will depend the benefit of treatment. The 
disease may be stayed, and in some cases, life may continue with comfort 
able health for years. 

Gallic Acid appears to have the power of preventing the waste ol 
albumen. It should be given in doses of five to fifteen grains in solution 
with five or six drops of Aromatic Sulphuric Acid. The following is the 
formula of Dr. Aitken: 

Take of Gallic Acid, from one to two drams, Dilute Sulphuric Acid, 
one dram, Tincture of Lupuline {the yellow powder shaken from hops) a 
dram, Infusion of Hops six ounces. Mix. 

Dose: A tablespoonful three times a day. 



362 DISEASES OF THE KIDNEYS. 

GRAVEL- BEXAL CALCULI. 

The formation of gravel in the kidneys is a common occurrence, but 
frequently remains unnoticed, because no unpleasant symptoms are caused 
by them. In most cases, the causes of this affection are obscure or very 
uncertain. 

While the gravel (calculi) are generally met with in rather fleshy per- 
sons who live mostly on animal food, yet they do, also, occur in weakly 
persons, who use a very spare diet. Without doubt, the mode of living is 
the cause of the concretions (gravel,) although a peculiar disposition of 
body must exist, which is as yet unknown to us. The urinary concre- 
tions in the kidneys vary ; at times they form a fine sandy deposit, gravel; 
at other times larger bodies, whose shapes vary according to their locality 
and their place of origin ; they may even be large enough to fill the 
cavity of the kidney. Their surface is at times smooth, at others rough ; 
the number of calculi contained in one kidney is very indefinite ; some- 
times their sides, where they had been in contact with other calculi, form 
regular facets. 

The symptoms, caused bj' renal calculi, are very imj^ortant, because 
they frequently attain a great night, and have the appearance of great 
danger, as though life itself were imperilled by them. 

Gravel may exist without any morbid symptoms; in other cases, the 
passage, and, perhaps, the formation of gravel are attended with marked 
derangements of the functions of the stomach, the main feature of which, 
generally, is an excess of acidity. We have pointed out this connection, 
when speaking of chronic catarrh of the stomach. Even larger calculi 
may exist, and be passed without any pain. This depends upon the size 
of the calculus, its smoothness, roughness, or the angularity of its form, 
upon the width of the ureters, upon the sensitiveness of the urinary pas- 
sages to the foreign body, whether and what severe disturbances the 
passage of the calculus occasions. These symptoms, together, are gener- 
ally designated by the name of renal colic. It should be observed, how- 
ever, that other obstacles to the excretion of urine, such as the presence 
of bloody coagula in renal hemorrhage, may cause renal colic, except 
that such colic is usually less persistent, violent, and distressing; for the 
reason that the obstruction is not fixed, and does not irritate or wound 
the mucous membrane. 

Renal colic generally breaks out suddenly, after a severe effort or con- 
cussion; its gradual development form indefinite pains in the renal 
region, whence they spread to adjoining parts, is of less frequent occur- 
rence; the former generally takes place, if the pains announce the 
entrance of a renal calculus into the ureter; the latter, if the pain is occa- 
sioned by a gradual irritation of the renal pelvis, or by a change in the 
position of the concretion. The pains, generally, are very violent, are 
felt in the region of the affected kidney, whence they spread to the blad- 
der and the thigh, and, when excessive, generally, affect the whole side. 
The patients suffer a great deal, are tortured by an agonizing anxiety, and 
have no rest in any position or place. Their face is, at times, pale as 
death, at others bright-red; the body is cool, the pulse small and fre- 
quent. If the parts are very sensitive, convulsive symptoms are apt to 
set in . The passage of urine is impeded and painful, sometimes the 



GRAVEL. 353 

stranguary is complete. The pains, sometimes, continue gradually to 
increase, until the abdomen shrinks from the least touch, or else they 
remain unchanged, or they remit at intervals, until they finally d-ase en- 
tirely, and the patient again enjoys perfect health. In such cases, the 
concretions usually pass off. soon after, with the urine. If the calculus 
has not p;issed the pain may continue, and nephritis result in consequence. 
The passage through the ureter, which, after the intense pain has some- 
what abated, the patient is able to watch and point oufras the calculus 
progresses, lasts from a few hours to several days. 

The diagnosis of renal colic is not always very easy. The most com- 
mon characteristic indications of the disease are: the fixed starting-point 
of the pain, together with the urinary difficulties. The prognosis is unfa- 
vorable only, if the concretions remain in the kidney, and cause a danger- 
ous irritation in this organ. An arrest of the calculus in the ureter is a 
rare exception. 

ALLOPATHIC TREATMENT. Gravel or Renal Calculus. The 

relief of pain in a "fit of gravel " (nephritic colic) is the first tiling called 
for. The most reliable means of relief, is the hypodermic injection of a 
quarter of a grain of the Sulphate of Atrophine every fifteen or twenty 
minutes until relief is obtained, (by the hands of a physician.) In case 
relief is not soon given, recourse in severe cases, may be had to the inhala- 
tion of chloroform. 

The passage of the gravel may be hastened by freely drinking water, 
which increases the secretion of urine; this will carry the gravel before 
it into the bladder. 

The most common variety of gravel is uric acid. This ingredient of 
the urine is very insoluble, and precipitates from the urine in the pelvis 
of the kidneys. The passage of this gravel causes pain. When gravel of 
this kind is passed in the urine into a vessel, it is known by its red color. 
The urine is, almost always, acid when voided. The preventive treat- 
ment of this condition consists in rendering the uric acid soluble, by the 
use of the vegetable salts of potash, as the citrate and Bitartrate of Potash. 
The Bicarbonate of Potash is, also, appropriate. The uric acid unites 
with the Potash and forms the Soluble Urate of Potash. Cream of Tartar 
lemonade may be made by the directions given in the treatment of 
chronic Bright's disease, and drank as freely as is agreeable to the 
patient. Or Citrate and Bicarbonate of Potash may be used, also, as there 
directed, as freely as is desired. 

Carbonate of Lithium should be given, two or three times a day, in 
doses of five grains. It may be taken in either of the Potash solutions, or, 
if disagreeable to the taste, in wafer or capsule 

Soda is inappropriate in this condition as with Uric Acid ; it forms a 
hard insoluble salt. 

Alcoholic drinks, wine and beer, ought to be omitted. The diet 
should be plain and simple, but nutritious. An active life in the open 
air is beneficial. 

Sometimes the gravel is composed of phosphate salts; then the gravel, 
if voided in the urine, is of a grayish or white color. The urine is, 
generally, alkaline. 

The use of Dilute Xitro-Muriatic Acid, in doses of ten to twenty drops 



364 DISEASES OF THE BLADDER. 

diluted with sweetened water until pleasant, should be taken three times 
a day. 

Benzoate of Ammonia has the power of dissolving the phosphate cal- 
culi. It may be given in doses of ten to twenty or thirty grains, two or 
three times a day. 

The diet should be generous, both in quality and quantity. 

There should be nervous and mental rest. Tonics of bark and iron 
are useful. 

The gravel may be composed of oxalate of lime. In that case, the 
color of the gravel, if voided, is dark brown or yellow. Its prevention will 
consist mainly in the use of Dilute Nitro-Muriatic Acid twenty or thirty 
drops in a glass of water, three times a day. The use of sweets, and espe- 
cially, the rhubarb or pie-plant ought to be disallowed in the diet. 

A calculus may be more easily discharged from the bladder, if the 
urine is retained for a long time, or the bladder may be washed out 
through an open mouthed catheter. 

Stone in the bladder nearly always begins with the presence of a cal- 
culus (gravel). 



CHAPTER XVII. 



DISEASES OF THE BLADDER. 



CYSTITIS— INFLAMMATION OF THE BLADDER. 

Inflammation of the bladder, in most cases, involves the mucous lin- 
ing of the bladder, and such is called Catarrhal Cystitis. 

The most frequent causes of cystitis are irritations affecting the mu- 
cous lining of the bladder, directly; they are either mechanical, catheter- 
ism, injections into the bladder, stone, or medicinal; acrid diuretics, Can- 
tharides, Copaiba, Cubebs, or even the decomposing urine itself. In 
other cases, the disease may occur as a complication ; inflammatory dis- 
turbances of adjoining organs may spread to the bladder, or the cystitis 
may simply be symptomatic of some acute general affection. In rare 
cases, only, a cold alone will be sufficient to cause an inflammation of the 
bladder. 

The symptoms of acute cystitis vary. The local symptoms may amount 
to no more than a slight feeling of pressure in the region of the bladder, 
and are scarcely ever as intense as Hartmann describes them. Amid more 
or less febrile motions, the patient always experiences at first a pain when 
urinating. When the attack first sets in, a large quantity of urine is 
voided with painful urging; soon, however, the urine is voided only in 
drops, and amid the most agonizing pains, as though burning embers were 
passing through the urethra. This symptom is most strikingly witnessed 
in the most acute form of cystitis after the use of new beer; it is charac- 
teristic of this inflammation. Very soon the difficulty of urinating be- 
comes associated with a constant pain in the region of the bladder: it is 



INFLAMMATION OF THE BLADDER. 365 

a cutting; or stitching pain, and is aggravated by motion, urging to stool, 
coughing, sneezing, pressure from without; it spreads upwards and down- 
wards to the penis, perimcum and thigh. At the outset of the disease, 
tiie urine is clear; after a while, it becomes slightly tinged with blood, 
and, in the further course of the disease, mixed with flocks of mucus and 
pus-corpuscles, turbid, inclined to decomposition. The general health is 
not always disturbed correspondingly to the abnormal sensations pro- 
ceeding from the bladder; at the commencement of the disease, the gen- 
eral health is not much impaired, and it is only at a later period that 
restlessness, chills, loss of appetite, and even vomiting, set in. 

The disease, very frequently, runs such a rapid course that an im- 
provement, and even complete recovery, may take place in a few days. 
If the disease increases in intensity, the tenesmus of the bladder may 
increase to complete retention, the bladder becomes extremely distended, 
and threatening symptoms of prostration set in, which may end in death. 
Usually, however, the disease, unless recovery takes place, assumes alen- 
tescent character, and becomes chronic. 

In the chronic form, the pains decrease considerably, only the con- 
stant urging remains. The mucus is secreted in considerable quantity, 
and along with it pus, so that the urine has a marked white-yellow 
appearance, sometimes like milk, and deposits a very tenacious mucous 
sediment. The tendency to decomposition is very great, the reaction 
decidedly alkaline, less frequentty neutral. However, the urine is decom- 
posed, only, if it remains for a long time in the bladder. Unless pecu- 
liar circumstances hasten the loss of strength, it generally takes place 
very slowly, and the disease may continue for years before death takes 
place from exhaustion. Complete recovery is a rare event. Among the 
sequela?, we distinguish ulceration of the mucous membrane, hypertro- 
phy of the walls of the bladder, paralysis of the detrusor muscle ; it is, 
particularly, the two first named sequelae that hasten the fatal termina- 
tion of the disorder, by causing hectic fever, and real phthisis of the 
bladder. 

What w r e have said, shows that the prognosis is quite uncertain. 
Even if we usually succeed in overcoming an acute catarrh of the blad- 
der, yet ailments sometimes remain for a long time after the slightest 
attacks, to which the careless or improper conduct of the patient may 
impart a high degree of gravity. Chronic catarrh of the bladder is always 
a dangerous disorder, whenever a great deal of the mucus and pus is 
secreted. 

HOMOEOPATHIC TREATMENT. This malady, like the previous one, 
ought only to be treated by non-professional persons when medical aid is 
not at hand. 

Aconitum is ever requisite in the initiatory treatment of this disease, 
if there be a considerable degree of fever, with hot, dry skin, and quick, 
hard pulse. 

Dose: Dissolve ten pills in two tablespoon fuls of water, and give a 
teaspoon ful of the solution every two hours, until the pulse becomes 
more healthy, and the skin moist, etc. After which, consult the 
indications for the following medicines, respectively, wherewith to 
continue treatment. 



366 DISEASES OF THE BLADDEE. 

Cantharides* is as valuable a remedy in the treatment of Inflam- 
mation of the Bladder, as in that of the Kidneys, and will, in the greater 
number of cases, be required to follow the initiatory administration of 
Aconitum (or even to precede the latter, when the fever has not run so 
high). 

Dose: Dissolve eight pills in two tablespoonfuls of water, and give a 
teaspoon ful of the solution every three hours, until change. 

N ax- vomica. When the affection is attributable to an indulgence 
in wine and spirituous liquors, this remedy, timely administered, will, 
in many instances, check its further progress; and, also, when it results 
from suppressed piles, or other habitual discharges, or from dyspeptic 
derangements. 

Dose: As for Canth. 

Pulsatilla is valuable in checking the development of the affection 
when arising from suppressed menstruation. It is, also, serviceable in all 
cases, from whatever cause arising, when occurring in individuals of 
phlegmatic temperament, with the following symptoms: frequent desire 
to urinate, painful and scanty emission of water, either slimy or tinged 
with blood, which deposits a purulent-looking sediment; burning and 
cutting pains in the lower part of the belly, with external heat and tume- 
faction ; suppression of urine. 

Dose: Six pills in a teaspoonful of water, every six hours, until ame- 
lioration or change. 

Helleb or us-nig. , Veratrum. These mpdicines are of considerable 
service in cases of inflammation of the bladder, which come on gradu- 
ally, but, subsequently, become very severe, attended with frequent urg- 
ing to pass water, and spasmodic pains, during which only a small quan- 
tity of water is passed ; to these symptoms are added continual inclination 
to vomit, aversion to all kinds of food, excessive distention of the belly. 

Dose: Of either of these remedies as selected, give six pills in a tea- 
spoonful of water, every two hours, until three doses have been 
given, and then every six hours, until positive amelioration or 
change. 



HEMATURIA— BLOODY UKINE. 

Bloody urine, proceeding from the bladder, originates most com- 
monly in injuries of the mucous membrane of the bladder by foreign 
bodies, or by concretions. Moreover, hematuria, and malignant growths 
in the bladder, may arise from inflammation of the bladder and its conse- 
quences, ulcerations and dilation of the vessels. It is seldom the ease 
that hemorrhage from the bladder occurs without any, evidently, mate- 
rial cause. As in the kidneys, so in the bladder, certain poisons may 
cause hemorrhage, though, in the latter, less frequently than in the 
former. 

Excepting the symptoms of the casual affection, the symptoms of 
hematuria are generally trifling, determined, for the most part, by the 
coagula that form very readily, and interfere with the easy flow of urine. 

♦When an affection of the bladder has been induced by the local application of Cantharides, in the 
form of a plaster, the Tincture of Camphor Bhould be employed as an antidote, in the manner described 
at page 89. 



BLOODY URINE SG7 

Hence, we have urging, tenesmus, spasm of the bladder, burning or cut- 
ting pains, and, very frequently, a perfect "absence of pain. The symp- 
toms are always restricted to the bladder, and do not involve the kidneys 
in any way. As a rule, the blood is not intimately mixed with the urine, 
is not decomposed, and, if the hemorrhage is at all considerable, the blood 
coagulates in such quantity, that the catheter is often required in order 
to effect a passage for the urine. The flow of blood from the bladder very 
easily exceeds the quantity flowing from the kidneys, and hence super- 
induces, more readily, the phenomena entailed by loss of blood. On the 
other hand, an hemorrhage from the bladder usually has a shorter dura- 
tion than hemorrhage from the kidneys, and scarcely ever lasts uninter- 
ruptedly for weeks. Of itself, it is scarcely ever an accident of any great 
importance. 

ALLOPATHIC TREATMENT. In the treatment of bloody urine, we 
ought to discriminate between hemorrhage from the bladder and from the 
kidneys. In hemorrhage from the kidney the blood is more evenly 
mixed through the urine, and fibrine is apt to be discharged in long 
strings, which have been moulded in the ureter (the tubes leading from 
the kidneys to the bladder). In hemorrhage from the bladder, the blood 
is apt to be passed with the very last of the urine voided. 

Internally, the remedies to be resorted to are the following: The 
Tincture Muriate of Iron, which should be given in doses of twenty or 
thirty drops largely diluted in sweetened water ; Gallic Acid may be 
given with Ergot, the former in doses of ten to fifteen grains, with five or 
six drops of Aromatic Sulphuric Acid, in water, and the latter in doses 
of a teaspoonful of the Fluid Extract, four times a day, or oftener. In 
this, as in other forms of hemorrhagic disease, a useful formula is : 

Take of Gallic Acid a dram, Ergotine and Digitalis, each, a scruple. Mate 
into twenty pills. 

Dose : One every fou r h ou rs . 

Turpentine is also a useful and available remedy. It may be given 
in the following mixture: Take of Oil of Turpentine three drams, Fluid 
Extract of Digitalis a dram, Mucilage of Gum Arabic half an ounce, Gly- 
cerine two ounces, Water an ounce, Oil of Gaultheria half a dram. Mix. 

Dose : A dessertspoonful every three hours. 

Should the disease be periodical, ten grains of Quinine once or twice 
a day, will prove the best remedy. 

The Tincture Muriate should be given alternately with any of the 
other plans of treatment given. 

In case the hemorrhage is from the bladder, it is best to wash out that 
organ by injecting into it a solution of Tannin, or Alum, or both, strong 
enough to have a styptic taste. 

When the hemorrhage is from the kidneys, hot air baths and purga- 
tives are called for, as directed in the chapter on Diseases of the Kidneys. 

Drink should be simple, as plain water, barley-water, etc., which may 
be taken freely. 

HOMCEOPATHIC TREATMENT. The best remedies for hemorrhage 
from the urinary organs are : 

Arnica. When caused by gravel in the bladder, injury from exter- 
nal causes, like a fall or blow. Especially, if caused by the awkward or 



368 DISEASES OF THE BLADDER. 

Dose : Six pills every two to four hours. 

Cannabis, The flow of blood is accompanied by retention of urine, 
or at least, by painful urination, burning, lancinating, sharp pains during 
the emission of urine, fine where the blood comes from the urethra also. 

Dose : As for Arnica. 

Cantharis is only good where there is much pain of a violent cut- 
ting, pressing, and crampy character, extending into the urethra, and, 
also, into the kidneys. Pain increased by drinking water. 

Dose : As for Arnica. 

Wux Vomica. If the difficulty is caused by the abuse of spirits, by 
suppressed menses, etc. 

Dose: As for Arnica. 

Sassafras tea, or a few drops of Oil of Sassafras on a lump of sugar, 
taken three times a day, is a sovereign remedy. The Oil is best. Take it 
for two days only. 

Witch Hazel. In any form, as a tea (home-made,) Pond's Extract, 
Humphrey's Extract, or any of the standard extracts of this remedy may 
be relied on as very good indeed, in all cases of this kind, as well as in 
many other forms of excessive bleeding. 

Ipecacuanha. Is reliable where there is profuse loss of blood, with 
cutting in the abdomen and urethra, faintness, deadly paleness, sickness 
at the stomach, oppression of the chest, and a feeling of warmth in the 
lower abdomen. 

Dose : As for Arnica. 

ENURESIS NOCTUJRN A- WETTING THE BED. 

This inconvenience would be of little consequence, except for the cry- 
ing abuses to which the endeavor to remove it has led. Physicians, as 
well as parents, have supposed that this weakness could be done away with 
by purely educational means, which were, moreover, suggested by the 
most insane views regarding its causes. Latterly, physicians have im- 
proved their methods of meeting this accident; lay-persons, however, are 
still true to their absurd prejudices in this respect. 

Wetting the bed is an accident to which children are liable; it seldom 
lasts beyond the age of pubescence, still less beyond the age of twenty 
years. Healthy individuals scarcely ever wet their beds more than once. 
This trouble, generally, dates from the earliest infancy, and rarely makes 
its appearance at a later period. Various causes have been assigned for it, 
and corresponding methods of treatment devised for its cure, however, 
with varied results. Laziness may give rise to it in many cases, but more 
frequently it is the fearof getting up in the dark. A common cause of the 
trouble is, that children sleep too soundly to be roused from their sleep by 
the irritating action of the urine upon the bladder. Yet the bladder need 
not? be weak or paralyzed; if so, the accident may take place even during a 
light sleep. The children, generally, say that they dreamed of wetting the 
bed, showing that the irritation was not sufficiently powerful to wake 
them. The quality of the urine may cause a passing attack of enuresis; 
we see this in children who are liable to catarrhal attacks, and, under such 
circumstances, immediately void a saturated urine. The irritation caused 
by pin-worms may, likewise, induce enuresis. 



WETTING THE BED. o69 

Corporeal punishment should never be resorted to as a means of curing 
this weakness, which is rather made worse by it than otherwise; older 
children are made so nervous by this treatment, that they sometimes 
remain wide awake half the night. On the contrary, their sense of honor 
and will should be appealed to. It is of no use to keep the ordinary bever- 
age from them in the evening; this may cover up the weakness for a time, 
which returns again as soon as a little more liquid is again partaken of. 
Nor is it of any more use to frequently rouse children from their sleep at 
night. If no abnormal conditions forbid, the best plan is, to gradually 
accustom the bladder to hold larger quantities of liquid. Children should 
be accustomed during the day to retain the urine as long as may seem 
proper, and not to yield to the least desire to urinate, as is their usual cus- 
tom. This system, if carried out consistently and vigorously, is often 
alone sufficient, in otherwise normal cases, to effect a cure, of course not 
in a few days. By measuring the quantity of urine at every discharge, we 
can determine a priori the time when the enuresis will cease. The more 
the quantity increases the nearer we are to a cure. This method has the 
advantage of being readily adopted by the children, provided they are 
promised a speedy delivery from their trouble. 

ALLOPATHIC TREATMENT. The involuntary flow of urine during 
sleep, so frequently met with in young children, may result from any of 
the causes of incontinence. The character of the urine is to be examined 
in all cases. If it is alkaline when first voided Dilute Nitro-Muriatic Acid 
should be given in doses of from five to twenty drops, in from a quarter to 
half a glass of sweetened water, three or more times a day, to cause an 
acid reaction of the urine. If the patient is weakly, ten drops of the Tinc- 
ture Muriate of Iron should be given in the same way as the acid, after 
each meal. Should the urine be exceedingly acid when first voided, 
alkalies ought to be given. A drink of Cream of Tartar Lemonade may 
be used: 

Take from two to four teaspoonfuls of Cream of Tartar, dissolve in hot 
water ; when cold pour of tlie clear liquid, cut some lemons into it and 
siceeten. Drink as desired. The patient ought to be made to drink spar- 
ingly of water, or other fluids, during the latter part of the day. During 
the night he should sleep on the side. He ought to be wakened if he turn 
on his back. The next indication, is to overcome the irritability of the 
bladder. There is no remedy, which so positively accomplishes this as 
Belladonna. 

Take of Sulphate of Atropine one grain, dissolve in one ounce of distilled 
water. Give five drops at bed-time, and increase the dose by tvoo drops each 
night, until the incontinence ceases, or marked dryness of the throat, or dila- 
tion of the pupil is produced. The Tincture of Belladonna may be used for 
the same purpose, in doses of five drops. The ratio of increase of the 
Tincture may be five drops, until the same results are produced. If the 
trouble does not cease under the use of the Belladonna alone, the Tincture 
of Xux-vomica may be given, in doses of three drops three times a day, to 
a child of three to five years old. If the child is five years old or over, five 
drops may be given. Ergot is often efficacious in this disease, twenty to 
thirty drops of the fluid Extract may be given in water, two or three times 
a day. 

24 



370 DISEASES OF THE BLADDER. 

Iodide of Iron is often, especially serviceable in this trouble. It seems 
adapted to cases of weak, pale, scrofulous children. The Syrup of the 
Iodide of Iron may be given in doses of twenty drops, largely diluted in 
water, three times a day. If it is used, it is not necessary to use the Muri- 
atic Tincture. 

If these means fail, it is best to awaken the patient once or twice in 
the night to empty the bladder. A large ball, roll of cloth, or something of 
the kind may be tied to the back of the patient, which will awaken him if 
he turns upon his back, when he may arise and empty his bladder. 

It is claimed, that the trouble is caused in some boys by a long prepuce 
having a very small opening, giving rise to irritability of the bladder: 
That, in that case, drugs are useless, but circumcision removes the diffi- 
culty. 

H0M(E0PATHIC TREATMENT. Where, in spite of every precaution 
on the part of the nurse, children wet the bed every night, and no other 
symptom of derangement can be detected, the following remedies are 
often effectual in surmounting the weakness. 

Sepia is to be preferred, when the mishap generally occurs during the 
first sleep. 

Dose; Six pills in a teaspoonful of water at bed time, for four nights 
in succession; then pause four days, and resume the administration, 
if necessary, on alternate days, four times and so on. 

Acidum-phosphoricum will prove useful in some cases when large 
quantities of urine are emitted, so that the child's bed is "flooded" 
nightly. 

Dose : As for Sepia. 

Belladonna is appropriate in cases in which the weakness is evi- 
dently incidental to a relaxed condition of the bladder, or, to cerebral irri- 
tation. 

Dose: Four pills in a teaspoonful of water, repeated, if necessary, 
every day. 

Sulphur should be perseveringly employed in almost all chronic 
cases occurring in delicate children, but particularly in those who are, or 
have been subject to eruptions on the skin. 

Dose : As directed for Sepia. 

Cina is a useful remedy when the existence of worms appears to be 
the irritating cause. 

Dose: Eight pills, as directed for Sepia. 



CYSTOSPASMUS-SPASM OF THE BLADDER. 

This spasm is a symptom in many affeetions of the urinary organs, 
and, as such, is not referred to in this place. There is no doubt, that it 
may, likewise, present a pure nervous condition of the bladder, although 
its occurrence, as such, is comparatively rare. 

The disease may break out at any age, but is most frequent in middle- 
aged individuals of the male sex. All persons with weak and irritable 
nerves are predisposed to this affection, hence it is most frequently met 
with among hypochondriac and hysteric individuals. Hence, a sudden 
emotion, an outburst of passion, great depression of strength, violent 
exertions during sexual intercourse, onanism, may be proximate causes of 



SPASM OF THE BLADDER. 371 

the disease. Whether a simple spasm of the bladder may be caused by a 
cold, is questionable. 

A spasm of the bladder commonly sets in quite suddenly, (the patient 
being otherwise in the enjoyment of good health,) as a violent, constrictive 
pain, proceeding from the neck of the bladder, and extending along the 
under side of the penis towards the glans, and attended with partial or 
complete erection ; sometimes radiating to the groin, testes, thighs, and very 
often, at the same time, along the perinseum towards the anus, accom- 
panied by a pain resembling tenesmus. If the spasm affects the detrusor 
muscle (the muscle that forces the urine from the bladder) alone, the least 
accumulation of urine excites a violent desire to void it, so that the 
patients are sometimes unable to prevent the flow of urine ; if the sphincter 
(the muscle that retains the urine in the bladder) is affected, the urine 
is either voided drop by drop, or cannot be voided at all ; if the detrusor 
and sphincter are affected at the same time, we have the most violent 
urging to urinate, attended with a more or less complete inability to void 
the urine : this last-mentioned case is most apt to cause nervous phenom- 
ena of a different kind, such as anguish, restlessness, trembling, convul- 
sions, violent tenesmus. An attack of spasm may last from one or more 
minutes to half an hour. After the pains begin to abate, the urine some- 
times passes off in a full stream, clearer and paler than usual. The return 
of the paroxysm is not governed by any rule, since the spasm sometimes 
only takes place once, sometimes a number of times, even on the same 
day. 

ALLOPATHIC TREATMENT. Spasm of the bladder is best and most 
quickly relieved by an injection into the bowel, of a teaspoonf ul of Laud- 
anum, and thirty drops of the Tincture of Belladonna, in one or two table- 
spoonfuls of thin starch. The injection should be made with a hard- 
rubber syringe. Hot applications may be made over the bladder and 
between the legs. This may be well done with a hop poultice. 

The removal of the cause is more difficult. A gouty condition and a 
highly acid urine, is to be met by the use of alkalies, as the Cream of Tar- 
tar Lemonade, made by dissolving an ounce of Cream of Tartar in hot 
water ; after cooling, the clear, supernatant liquid is to be poured off and 
drank during the day, with the addition of lemons and sugar. Or Citrate 
of Potash may be taken as follows : dissolve four ounces, each, of Citrate 
and Bicarbonate of Potash in a pint of water. Two tablespoonfuls of this 
may be drank in half a glass of sweatened water, after mixing with it a 
tablespoonful of Lemon Juice, or a solution of Citnc Acid two ounces to the 
pint of water. The dose may be repeated four to six times a day. This 
makes the urine bland and unirritating. Wine of Colchium may be given 
in doses of ten to thirty drops, three or four times a day, omitting its use 
when the bowels move too freely. 

Should the trouble be caused by an inflamed (or abscess of) kidney, 
anodynes should be given as needed, and the person treated as directed in 
that disease. 

If caused by a stone in the bladder, as denoted by severe pain after 
voiding urine, the removal of the stone by a surgeon, is the only certain 
treatment. Opium and Belladonna can only temporarily relieve pain. 

Excessive venery is one cause which is removed only by continence. 

The diet should be plain and nutritious. All stimulants should be 



372 DISEASES OF THE BLADDER. 

avoided. Milk may be allowed freely. Barley-water and Flaxseed tea are 
appropriate as drinks. 

In Paralysis of the Bladder, if there is an overflow of urine (con- 
stant passing water.) the catheter ought immediately to be used, the bladder 
emptied, and then washed out with warm water. The use of the catheter 
twice a day, or of tener, is necessary, as long as the paralysis continues. 
The catheter used should be large, and the bladder completely emptied 
each time. The bladder ought frequently to be washed out with warm 
water. 

Remedies calculated to restore the muscular power, are: Strychnine, 
Electricity and Ergot. The dose of Strychnine is one-thirtieth of a grain 
three times a day. It may be given in solution with Dilute Phosphoric 
Acid. Take of the Sulphate of Strychnine one grain, Dilute Phosphoric 
Acid half an ounce. After solution is effected, add Syrup of Ginger three 
and a half ounces. Mix. 

Dose : A teaspoonf ul three times a day. 

If the patient is feeble, half a dram of the Pyro-phosphate of Iron may 
be added to the mixture, and also half a dram of Sulphate of Quinine, if 
its tonic effect is needed. 

Ergot is also valuable in this trouble. The dose of the Fluid Extract 
is half a teaspoonful to a teaspoonful, in water, three or four times a day. 

The form of Electricity most appropriate, is the direct current. 

Hot hip baths, the cold douche, blisters over the lower part of the 
spine, are said to be serviceable. 

Aloes is the most suitable purge. 

HOME REMEDIES. Acid, or alkaline drinks, in any of the various 
forms usually present in the house. Hot poultices, hot bricks, or other 
hot applications to the region of the bladder. Camphor, freely inhaled, 
sometimes relieves ; a very weak tea made from a few sprigs of Deadly 
Nightshade, will be good, but must be used very carefully. 



PART EIGHTH 



DISEASES OF THE MALE SEXUAL ORGANS. 



CHAPTER XVIII 



OMCHITIS-IXFLA3I3IATION OF THE TESTES. 

Now and then, this affection is met with, as the result of mechanical 
injuries, but most frequently originates in gonorrhoea. It not only super- 
venes during the course of acute urethritis, but it may, likewise, set in 
suddenly during gleet, generally, without any apparent exciting cause. 
Severe exertion, or the discontinuance of the use of suspensories, are said 
sometimes to cause the disease, but this is not an established fact. The 
excessive use of beer or wine is a much more active cause of the disease, 
probably because the inflammation is very much increased by such stim- 
ulants. Both Cubebs and Copaiba hold the same relation to gonorrhoea. 
They have a specific effect upon the urethra, and it is easily conceivable 
that, instead of effecting a cure when given in large quantities, they 
aggravate the inflammatory symptoms, and, owing to the specific action 
which they likewise exert upon the testicles, communicate the inflam- 
mation to these organs. 

Symptoms. Orchitis seldom sets in suddenly. Ordinarily, it com- 
mences with slight drawing pains in the spermatic cord, which is sensi- 
tive to contact. At the same time, the patient experiences violent tearing 
pains in the thigh of the affected side. The weight of the testicles at 
first is troublesome, then becomes painful, and, finally, intolerable. In 
one or two days the epididymis becomes painful to pressure, swells with 
more or less rapidity, and shortly after is succeeded by an inflammatory 
effusion into the tunica propria, in consequence of which the testicle very 
soon enlarges to the size of a fist. The pains now become agonizing; 
the patient has to confine himself to a horizontal posture, with the testicle 
properly supported. The pain is a burning, tearing pain, most frequently, 
with remissions after the fashion of rheumatic pains. The general con- 
dition of the patient does not suffer much, only in violent cases, there 
is fever or even vomiting. The discharge usually disappears after the 
orchitis is fully developed, and does not re-appear until the inflamma- 
tion has run its course; only in a few cases, it does not re-appear after the 
subsidence of orchitis. 

The inflammation, in its acute form, does not often last beyond the 
tenth day, sometimes the improvement commences on the fourth day. 

3~3 



374 DISEASES OF THE MALE SEXUAL ORGANS. 

This, however, is not very rapid, since it sometimes takes weeks before 
the testicle resumes its former size; very fequently an obstinate swelling 
of the testicles remains. 

ALLOPATHIC TREATMENT. Inflammation of the testicle is to be 
treated, first, by absolute rest. The patient should be confined to his bed, 
and should not be permitted to rise for anything. The bowels should 
move into a bed pan, and the urine be voided while lying down ; above all, 
he must not walk about, nor even sit in a chair. The testicles must be 
supported by a roll of soft cloth between the thighs, while the patient lies 
upon his back. The support must be sufficient to relieve the pain as 
much as possible. 

Such applications should be made as will give the greatest relief to 
the pain. This is, generally, best done by hot applications, as flannels 
wrung out in hot water, covered with oiled silk to retain their moisture, 
and heat or warm poultices. Sometimes cold applications are more grate- 
ful; they should then be resorted to, and even ice applied, if it relieves 
the pain more than other means. I have often found cloths, dipped in a 
solution of ten grains of the Acetate of Morphine, and two scruples of 
Sugar of Lead, in a quart of soft water, a grateful application. 

A brisk purge may be given at the beginning of the trouble. For 
this purpose, nothing is better than a couple of tablespoonfuls of Epsom 
Salts. (If this amount is boiled a couple of minutes with two and a half 
teaspoonfuls of roasted coffee in an earthen vessel, and allowed to draw 
for a few minutes, then strained, it can be taken without trouble) or the 
same amount of Citrate of Magnesia, or Rochelle Salts taken in lemonade 
or a couple of Seidlitz Powders may be used. 

During the hight of the inflammation, a quarter of a grain of Mor- 
phine, or twenty-five drops of Laudanum, with ten or fifteen drops of 
Tincture of Belladonna maybe given sufficiently often to relieve the 
pain. Or a teaspoonful of Laudanum, and thirty drops of Tincture of 
Belladonna, with a couple of tablespoonfuls of thin starch may be given 
by injection into the bowel, once or twice a day, and any additional ano- 
dyne, if needed, given by the mouth. 

If the inflammation leaves the testicle in a hardened condition, which 
does not disappear, it may be removed by applying Tincture of Iodine 
once a day, or every other day. 

HOM(EOPATHXC TREATMENT. Orchitis, or inflammation of the 
testicles, when depending on an injury can be relieved by Arnica. A dose 
every four to eight hours ; also, apply exterally. 

If the result of gonorrhoea, by Clematis or Aurumifa dose is taken 
every evening. 

Pulsatilla is, also, a reliable remedy, if the swelling is considerable, 
without fever or thirst. 

Aconite, if there is much fever and thirst, and, especially, if this 

should occur at the beginning of the attack, which it should, usually, be 

expected will be the case. 

«. — 

SPERMATORRHCEA. 

By this heading, we, strictly speaking, comprehend a flow of semen 
without any sexual excitement. However, in order to avoid the necessity 



SPERMATOHRHCEA. 375 

of resorting to a number of sub-divisions, we have classed together in this 
chapter abnormal nocturnal emissions, as well as various other morbid 
derangements of the male sexual organs; an additional motive fortius 
arrangement, is the circumstance that the treatment of most of these con- 
ditions is the same. 

The functions of the male sexual organs, vary in accordance with tem- 
perament, mode of life, constitution, etc., to such an extent, that it is often 
difficult to decide, whether, these differences are of a morbid nature, or 
belong to the normal standard. This can only be determined by the man- 
ner in which the male sexual sphere is, generally, affected by the local 
phenomena; whether the organs are not abnormally disturbed, or whether 
the procreative powers are impared or even suspended. 

The history of these various abnormal conditions of the sexual sphere 
is pretty much the same. Debilitating constitutional diseases, or acute 
diseases during the period of convalescence, are apt to cause a so-called 
irritable weakness in the sexual sphere, which, in the former case, is per- 
manent, and in the latter case only temporary. This fact is most strikingly 
witnessed in diabetes and tuberculosis. In the last-named condition, the 
excessive irritability of the sexual organs contribute to hasten the gen- 
eral decay. A second cause are cardiac and nervous diseases, which may, 
however, likewise, result from the sexual weakness. Hypochondria is a 
frequent cause, and still a more frequent consequence of sexual weakness. 
The most common cause of sexual weakness is the vice of onanism, which 
is too much overlooked by physicians. Yet it is certain, that thousands 
might, by a timely warning, be saved from unspeakable mental and physi- 
cal disease. 

Excessive nocturnal emissions, generally, take place between the years 
of twenty and twenty-five, and, exceptionally, at an earlier age, even six- 
teen. They are of a morbid nature, if they occur almost regularly without 
rousing one from sleep, and if they do not occur often, yet leave for days a 
sensation of languor and debility, and of mental depression. They are, 
likewise, abnormal if they occur several times in one night or week. More- 
over, every emission that takes place in the waking state, with or without 
any special cause, at stool for instance, is to be regarded as abnormal. 
The consequences of such abnormal losses very soon show themselves : 
Paleness of the face, with dark margins around the eyes ; insufficient 
sleep; drowsiness, with inability to sleep; dullness of the head; aching, 
pressing pain in the head ; vertigo; irritable, sensitive temper ; aversion 
to society, to work, and, after a while, a deranged appetite and digestion ; 
deficient assimilation. 

Spermatorrhoea, properly speaking, consists of a loss of semen at 
every emission of urine, at stool, without any cause, or after the most tri- 
fling erections. The pernicious consequences of this sort of spermator- 
rhoea, manifest themselves much more speedily than after nocturnal 
emissions, most probably because spermatorrhoea never occurs in organ- 
isms, whose physiological functions had been carried on in a normal 
manner. 

Irritable weakness of the sexual organs is sometimes the cause, but 
more frequently the consequence of both the previously-mentioned 
anomalies. The sexual excitement occurs too easily and too vehemently 
without possessing sufficient energy and consistence, for the act of coition. 



376 DISEASES OF THE MALE SEXUAL ORGANS. 

The ejaculation of the semen takes place too soon, or even not at all, or 
the introduction of the penis into tiia the vagina is prevented, by a prema- 
ture cessation of the erection. The sexual weakness may be characterized 
by all sorts of abnormal manifestations in the sexual sphere. The mental 
disposition exerts a powerful influence in this direction. Hypochondriacs 
are particularly disposed to irritable weakness, which, under abnormal 
mental influences, sometimes attains to such a degree of intensity, that it 
seems to amount to complete impotence. 

Complete impotence, by which is meant an entire suspension of the 
ability to perform the sexual act, is, upon the whole, a very rare and, fre- 
quently, only temporary disorder, except when depending upon debilitat- 
ing incurable constitutional diseases, such as diabetes or tuberculosis, or 
when depending upon the loss of one testicle. 

An excess of sexual excitement (satyriasis) besides taking place at the 
commencement of gonorrhoea, as we have already stated, may, likewise, 
occur in consequence of debilitating conditions, first as a passing increase, 
and subsequently, to be succeeded by a decrease of excitability. It is fre- 
quently met with, in the case of persons who have been addicted to the 
vice of onanism, or among worn-out roues ; very rarely without such a 
cause, and then, mostly as a symptom of some deep-seated disease of the 
brain. 

In treating most of these forms of sexual weakness, the diet, mode 
of life and psychical (mental) agencies exert an important influence ; hence 
we place them in the front rank. 

We cannot lay it down, as a rule, that these morbid conditions 
require either a lean or strengthening diet. Some are afflicted with 
weakness of the sexual organs, more especially with excessive pollu- 
tions, because they live too well; it is a mistake to suppose that this 
waste is repaired by a nourishing diet, since it is well known that some 
persons are living in circumstances which preclude the possibility of 
indulging in good living. Hence, it becomes a matter of interest to 
inquire whether a lean or rich diet is the more suitable. All such patients 
must be cautioned against going to sleep with a full bladder or a full 
stomach, either in the daytime or at night. Certain beverages, such as 
spirits and hop beer, must be strictly avoided. Beer-drinkers are very 
apt to deny the debilitating influence of hop beer on the genital organs ; 
that this influence exists, must be evident to all who are acquainted with 
the effects of Lupulin. It is well known that drunkenness, either partial 
or total, causes an irritable weakness of the sexual organs. Coffee, and, 
in some, even tobacco, have to be interdicted ; among the secondary effects 
of coffee, we notice a depressing excitability and irritability of the 
nervous system. 

In general, all strongly spiced and stimulating food is hurtful. As 
regards bodily exercise, it is certain that bodily fatigue diminishes sexual 
excitement, and brings it back again to a normal standard; muscular 
exercise has also the advantage of preventing the mind from dwelling 
upon erotic subjects. Viewed from this point, walking is not the best 
kind of exercise, for the reason that it leaves the mind free to revel in all 
kinds of fancies ; onanists are very apt to be fond of walking. Severe 
mental labor is sometimes preferable to bodily exercise, especially in the 



SPERMATORRHOEA. 377 

case of hypocondriacs and onanists. This leads us to a consideration of 
psychical influences, as a means of cure. 

Every physician knows, that the evil consequences of nocturnal emis- 
sions, and even, to some extent, of self-abuse, are more imaginary than 
real. Numbers are made hypocondriacs by reading books that fill them 
with fear and trembling at the excess they may have been guilty of in 
former days. Encouraging advice does more good than medicine. Self- 
abuse is prevented much more certainly by comforting encouragement 
than by picturing the consequences of such a crime in the most frightful 
colors. In dealing with sexual weakness, it is, in the first place, necessary 
to depress the fancy, and in the second place, to strengthen the will. On 
this account, reading novels is so hurtful, and cold-water treatment has 
such an excellent effect. 

Prof. O. S. Fowler, the world-renowned Phrenologist, and keen 
observer, makes these truthful remarks about the prevention of this fear- 
ful vice, self-abuse, by knowledge : 

" What Salvation remains for those yet guiltless ? To forestall is 
infinitely better than to cure. Must all our noble boys, all our pure, lovely 
girls, be defiled by this moral leprosy, and lost if not redeemed?" 

"Is there no prevention ? Can they not, somehow, be kept from this 
fell destroyer? Must all fall over this moral precipice, only to be marred 
and defiled for life ? What a pity, this offering up of human life on this 
vile alter! We cannot spare our sons, we must not lose our daughters 
thus! They are too infinitely precious. Think what a darling child is 
worth ! Its entire future, and all its decendants are at stake. The risk 
is too awful. No parents should sleep until they have first so hedged their 
children around that they cannot sin. How can this plague be stayed? 
Not by Ignorance. That has been tried, only to fail, quite too long 
already. All who fail, sin for want of knowledge. Nothing can be 
clearer. Say, ye who have sinned, did you not err through ignorance ? 
Would not one seasonable word have prevented all the suffering it has 
caused you? Let universal experience decide. Parental warning and 
counseling are its great forestallers and preventers. Parents are bound 
to feed, clothe and educate their children, and guard them against lying, 
stealing, etc., then why not against this secret sin, as well, as much the 
most, as it is ruiuous to soul and body. God in nature puts on parents 
the sacred duty of guarding their children against all sinful and self- 
ruining practices; and their first duty is to guard them against this vice. 
And the guilt of those who do fall, rests not on the poor, life-long suffering 
victims, but on their parents." 

"An eighteen-year old liliputian, in Portland, Me., when told that this 
had made him small and weak, clinched his fist, gritted his teeth, and 
muttered curses upon his father and elder brother who lately deceased, 
who died by this sin, because they allowed him to fall by not warning him, 
and he w r as right. So has any other child, whose parents let him or her 
contract this vice. Parents are their children's keepers, not the children 
their own. Choose your own means, but use some effectual end I Give 
them no occasion to curse your neglect. The mother is more especially 
adapted and required to teach this class of truths. In ordaining that she 
nurse them, nature commands that she supply their other physical wants, 
and also mould their morals ! Those who defile themselves, may justly 



378 DISEASES OF THE MALE SEXUAL ORGANS- 

blame her most; yet blame is too weak a term. She should teach them 
the sacredness of this structure, and to guard it as the apple of their eye.'' 

"All communities contain sufferers from sexual abuses; let her make 
such her walking examples of breaking this law of chastity. Parents 
should teach sexual truths, aided by good books, as early as they can be 
understood . You must plant knowledge before the sin has taken root ; 
much best— before the seeds of sin have been sown." 

11 To the Sexual Education of Girls, these principles apply with 
redoubled force. Young America learns such things early and easily.'* 

Stop the act, and that and cold water will complete the cure. 

ALLOPATHIC TREATMENT. In Spermatorrhoea, if the discharges 
are only occasional, and the general health is not affected, no special treat- 
ment is required if the patient is unmarried ; as soon after marriage the 
annoyance will cease without treatment. It is best, however, that he 
should not eat a hearty meal for four or five hours before retiring ; he 
should empty the bladder before retiring ; the bed should be hard and the 
coverings rather light ; he must lie on his side, never on his back, and 
rise about the middle of his night's rest, and stepping on the cold floor, 
empty his bladder again. 

In instances in which the health has become debilitated, and the 
functions of the mind impaired.it will be necessary to institute medical 
treatment. In these cases, the whole nervous system has lost tone. The 
diet should be nutritious but plain; cold bathing and tonics should be 
resorted to. If the patient is unmarried, I would put him upon the use 
of Strychnine and Quinine dissolved in Dilute Phosphoric Acid, as: Take 
of Sulphate of Strychnine a grain, Dilute Phosphoric Acid one ounce; after 
the Strychnine is dissolved, add half a dram of tlie Sulphate of Quinine, 
and three ounces of Syrup of Orange Flowers, or Simple Syrup. 

Dose : A teaspoonf ul three times a day. 

If the patient is married, I would give two or three grains of Pyro- 
phosphate of Iron in syrup, after eating, giving the former mixture before 
eating; or, instead of the first mixture, Phosphide of Zinc and Nux-vomica, 
a quarter of a grain each, may be taken in pill three times a day ; or the 
pills of Phosphorous, Nux-vomica and Quinine may be used. In addition, 
teaspoonf ul doses of Fluid Extract of Ergot may be taken one, two or three 
times a day ; from two to twenty drops of Tincture of Belladonna may be 
given with the Ergot, at night, with benefit. The dose should be increased 
until benefit or dryness of the throat is produced. 

In cases more extreme, with greatly reduced health, it may be neces- 
sary to resort to Cod Liver Oil, in addition to other tonic treatment. 

In rebellious cases, Mr. Erichsen's method of applying a solution of 
Nitrate of Silver to the neck of the bladder, through a silver catheter hav- 
ing several fenestrations (openings) should be resorted to. The strength 
of the solution should be five grains to the ounce, at first ; but, after two 
or three weeks, if no improvement result, the strength may be increased. 
The solution is driven out of the openings by a sponge fastened to the end 
of a wire stylet, being pushed through the catheter to the end next the 
bladder. Occasionally, the daily introduction of cold steel sounds, will 
answer the same purpose. 




THE HEART AND LUNGS IX SITU. 



SPERMATORRHEA. 379 

The measure, which succeeds in the end, without fail, is life in wed- 
lock. In some extreme cases, the cure is not attained for a year, or, per- 
haps, more. Only a temporary lack of capacity exists, and, eventually, a 
complete cure results, if the patient lives a married life, and the general 
health is good, or restored with the use of appropriate tonics. 

If the person is unmarried, and in robust health, it is best to use the 
following prescription : Take of Bromide of Potassium an ounce, Infu- 
sion of Digitalis eight ounces. Mix. 

Dose : A tablespoonful twice a day, and, after the emissions cease ; 
give at night only. 

In this class of persons, from two to five two-grain pills of Monobro- 
mated Camphor, taken twice a day, is appropriate treatment. As with 
the Bromide of Potassium, after the involuntary emissions cease, the 
medicine need only be taken at night. When the Bromides of Camphor 
or Potassium are used, and the discharge is not stopped, a pill of a third 
of a grain of Extract of Belladonna, and one or two grains of Extract 
of Hyoscyamus should be taken, at bed time, in addition. 



THE HEART AND LUNGS. 

The Heart and Lungs in their natural position, showing how the air is 
passed to, through and from the lungs, and how the blood is distributed 
through the lungs. The left side of the illustration shows the small air-cells 
all removed, exposing all the bronchial tubes of the right lung. The right 
side of the illustration shows how the blood passes from the heart through 
the pulmonary artery/, (/, and by means of the very numerous branches of 
that artery is distributed to every part of the left lung, where it comes in 
close contact with the air in the lung, and is changed and purified, throwing 
off the impure gases gathered up in its circuit through the body, and is 
further changed by chemical action of the air on the blood, a process too 
complicated to permit of an explanation here. There is a very thin parti- 
tion through which the blood will not pass, separating the blood from the 
air in the lungs. The lungs must be filled with air every few seconds from 
15 to 25 times^every minute, and the blood is forced into them by the heart's 
pulsations from 60 to 100 times per minute, varying in either case with the 
age of the individual; and all these numbers are further varied by the 
effects of various diseases, as indicated in the body of this work. Usually 
the heart beats four times for every time the lungs are filled with air. This 
illustration is very fine, and to any person desiring to make a minute study 
of anatomy the reference letters will render much assistance. 



PART NINTH. 

— ♦ 

DISEASES OF THE RESPIRATORY ORGANS. 



CHAPTER X IX. 



DISEASES OF THE LARYNX AND TRACHEA-WINDPIPE. 



CATABBH OB COMMON COLD— CAT ABBHAL FEVEB. 

This term is given to an affection, which consists of a inild degree of 
inflammation of the lining membrane of the nostrils and windpipe, and 
occasionally, also, of the ramifications of the latter, induced by exposure 
to sudden changes of temperature, or to a damp or chilly atmosphere with 
insufficient clothing, particularly as regards children. 

Symptoms. This complaint is characterized by slight fever, impaired 
appetite, obstruction of the nose, sneezing, unusual languor, pains in the 
head, or in the back and extremities, and subsequently hoarseness or 
cough, generally preceded by transitory chills or shiverings ; there is, also, 
a slight degree of wheezing and difficulty of breathing. When the disease 
is confined to the nose and sinuses, it is termed a cold in the head. 

ALLOPATHIC TREATMENT. The treatment of catarrh, or common 
cold, is given in Chapter X, under the head of catarrh, and under the 
head of acute bronchitis. Sub-acute laryngitis often occurs in colds, either 
alone, or with coryza (acute catarrh of the nose,) or with acute bronchitis, 
but may occur alone. The inflammation is of a low grade. There is either 
hoarseness, or loss of voice (aphonia,) and a hoarse cough. In children, 
spasm of the larynx is apt to be excited, known as false croup, but this is 
rarely the case in the adult. Besides the treatment, as recommended for 
acute bronchitis, strong irritations over the larynx (Adam's apple) is use- 
ful. This is best made by the frequent application of Tincture of Iodine. 
When the coloring of the skin is an objection, the Decolorized Tincture of 
Iodine may be used, or a blister can be applied over the larynx. 

The inhalations of warm vapor is, especially, useful in all inflamma- 
tions of the larynx. The steam from a solution of Chloride of Ammo- 
nium from a croup kettle, or a spray producer may be inhaled with ben- 
efit. 

Glycerine may be applied freely to the epiglotis, and orifice of the 
larynx, with benefit, in some cases. It should run into the larynx. A 
large camel's hair brush should be used. 

380 



COMMON COLD. 381 

Should the fever run high, and the pulse rapid, great benefit will be 
derived in this, as in other catarrhal inflammations, by giving Tincture 
of Aconite, in doses of half a drop to a drop, every half hour, until an 
impression is made on the fever, and then given one or two hours apart. 
It may be used without interfering with other treatment. 

A couple of drops of Tincture of Belladonna may be advantageously 
given with each dose of Tincture of Aconite, especially, when the secre- 
tion of phlegm is profuse. 

Tincture of Iodine, dropped in hot water, will yield a vapor which 
may be inhaled frequently, during the day. The vapor may be made to 
ascend through a funnel made of stiff paper, and so conveyed to the 
mouth. 

Chronic hoarseness of the throat occurs, most frequently, in persons 
of sedentary habits, in a somewhat debilitated state of health. The indi- 
cations are, in the first place, for life in the open air, and less at the desk. 
These persons, also, need tonics, and, possibly, an alterative. Such a med- 
icine we have in the Syrup of the Iodide of Iron, which may be given in 
doses of thirty drops, in water, three times a day. 

An equally serviceable, and more elegant preparation, is the follow- 
ing : Take of the Iodide of Potassium five drams, Pyroplwsphite of Iron 
one dram, Water one ounce, Simple Syrup three ounces, Spirits Peppermint 
half a dram. Dissolve the Iron in half the Water, and add the Syrup; dis- 
solve the Iodide of Potassium in the remainder of the Water, mix and add 
the Spirits of Peppermint. 

Dose: A teaspoonful three times a day. 

In robust persons, the Iron may be omitted. Other tonics, which 
may be useful, are Citrate of Iron and Quinine, in doses of from three to 
five grains, three times a day, dissolved in water or syrup of Orange. 

Two or three grain doses of Citrate of Iron and Strychnine, given in 
the same way, may be found useful, in restoring the general health. 

Three to five drops of Fowler's Solution may be given, often with 
advantage, with the above remedies. A dram and a half, to two and a 
half, is proper for a four-ounce mixture. 

Pills of the Phosphide of Zinc, and Extract of Nux-vomica, will often 
prove serviceable. 

The following mixture of Iron may be given in connection, if Iron 
seems required: Take of Pyroplwsphate of Iron a dram, Water sufficient 
to dissolve, Syrup of Ginger sufficient to make four ounces. Mix. 

Dose: A teaspoonful three times a day. 

Nervous hoarseness is often relieved by from five to ten grains each 
of the Bromide of Ammonia and Bromide of Potassium, in water, tbree 
times a day. Atrophine, in doses of a hundred and twentieth to an eighti- 
eth of a grain, twice a day, will often prove effectual in relieving this 
form of hoarseness. 

Counter-irritation, by means of Tincture of Iodine, or Decolorized 
Tincture of Iodine, applied by a camel's hairbrush; or a liniment of 
equal parts of Croton Oil, Turpentine and Sweet Oil; or by the use of 
Ointment of Tartar Emetic (made by mixing two drams of Tartar Emetic 
with an ounce of Lard,) rubbing it well into the skin twice a day. 

Applications to the diseased surface, the vocal cords, and interior of 
the larnyx, can best be made by inhalation. Iodine may be inhaled by 



3S2 DISEASES OF THE RESPIRATORY ORGANS. 

dropping the Tincture into hot water. Carbolic Acid may be combined 
with Tincture of Iodine in the proportion of half a dram to a dram, to 
half an ounce ; a sufficient quantity of Iodide of Potassium should be 
added, to prevent the Iodine from precipitating. 

Iodoform vapor may be inhaled with benefit often. The vapor may 
be generated by heating a plate or saucer with some of the powder upon 
it, and may be conducted to the mouth by a stiff paper funnel. Bromine 
vapor may be inhaled by warming a vial having a few drops of the 
liquid, and holding to the mouth. 

A solution of Nitrate of Silver, containing ten to twenty grains to 
the ounce, is, perhaps, the most useful of all the local applications. It 
should be applied with a brush or probang, with the aid of a laryngo- 
scopy mirror. 

Various substances, besides the above, may be used by means of the 
steam atomizer, or the air spray producer, but they have no special 
advantage over the methods given. 

Persistent cases of excessive hoarseness (chronic laryngitis) depend, 
generally, upon tuberculosis or syphilis. If ulceration has gone on to 
any extent, the hoarseness, or loss of voice is incurable. The former dis- 
ease is treated in the article on consumption. The latter disease does not 
come within the scope of this work. 

This trouble must not be confounded with the hoarseness which exists 
in chronic pharyngitis (inflammation of throat) frequently called clergy- 
man's sore throat, which is treated of in chapter XI. 

The treatment of this form of catarrh (sub-acute laryngitis) in chil- 
dren does not differ materially from its treatment in adults. The child, in 
the majority of cases, should be kept within doors until the inflammation 
— cough and hoarseness— disappear. Then he may be gradually accus- 
tomed to his out door play, by beginning first at mid-day. In fact, some 
children may be permitted to go out for a little while in the middle of the 
day, during the course of the attack. The clothing should be warm enough 
to keep the skin warm and moist. Flannel should be next to the skin. A 
stimulating application should be made to the neck, as rubbing the skin 
thoroughly and often with Turpentine, or Turpentine and Spirits of Cam- 
phor and a flannel saturated with Camphorated Oil, (Camphor one scruple, 
Olive Oil one ounce,) may be worn around the neck. 

Cough should be relieved by the use of Paregoric, in doses suited to 
the age of the child, with an equal quantity of Tincture of Hyoscyamus, 
from ten to thirty drops each, can be given to children two to six years 
old in Syrup, or Syrup of Squills or Ipecacuanha. 

A hot foot bath at night will be useful. The cough mixture, or ten to 
thirty drops of Paregoric, or three grains of Dover's Powders (to a child 
three to five years old,) should be given upon going to bed. 

If the disease becomes chronic, as in the adult, it probably depends 
upon tuberculosis or syphilis, and is amenable to treatment proper for 
these diseases. 

Should the chronic affection be of scrofulous origin, benefit will result 
from the internal use of the following mixture: Take of Iodide of 
Potassium a dram and a half Pyrophosphite of Iron half a dram, Simple 
Syrup four ounces, Spirits Peppermint half a dram. 



COMMON COLD. 3S3 

Dose : A teaspoonful may be given three times a day. 

Cod Liver Oil will be useful. The diet should be good, the clothing 
flannel, and warm. The Tincture of Iodine should be applied upon the 
neck, over the larynx, every day, or if the neck becomes very sore, every 
other dav. 

HOMEOPATHIC TREATMENT. Premonitory Stage. Camphor 
(concentrated tincture) is frequently effective in arresting the develop- 
ment of incipient cold or influenza, particularly if the exciting cause, 
to which it is immediately traced, has been wet feet. The symptoms 
which, usually, identify the propriety of resorting to Camphor under 
these circumstances are as follow: unusual weariness, heaviness, and 
general uneasiness, attended with shivering and dryness or coldness of 
the skin, and symptoms of approaching fever. 

Dose: One drop of the concentrated tincture on a small lump of 
pure loaf sugar every three hours, until three doses have been 
given. 

Xux-iomica is the most generally useful, particularly when the 
symptoms have accrued after exposure to a draught, or prolonged expo- 
sure, in winter, to a cold, dry, frosty atmosphere. 

Dose : Six pills in a teaspoonful of water at night, repeated, if neces- 
sary, after an interval of six hours. 

Chamomilla is preferable when a copious outbreak of perspiration 
has been suddenly checked by a current of dry, cold air, or by a sudden tran- 
sition from heat to cold. In the case of children, and highly sensitive 
females, this remedy is more especially useful. 

Dose : Six globules in a teaspoonful of water, as is directed for Nux- 
vomiea. 

Bryon ia should be employed when the symptoms of incipient catarrh 
have been excited by prolonged exposure to a cold easterly wind ; or when 
in adults, who are subject to liver complaints or to rheumatism, the 
natural sweat has been suddenly suppressed, whilst they were somewhat 
heated. 

Dose : Six pills in a teaspoonful of water, repeated, if requisite, after 
the lapse of twelve hours. 

Dulcamara is the most appropriate remedy to be taken by those 
who are subject to severe coughs, or to sore throat, whenever they are 
exposed to a close, damp atmosphere (either during the day or late in the 
evening.) or after getting the feet wet. Its alternate administration with 
Mercurius is sometimes of great advantage. In other cases, when Dulca- 
mara fails to arrest the symptoms, it should be promptly followed by Mer- 
curius. 

Dose: As for Nux. If in alternation with Mercurius, six pills, first 
of the one then of the other, in a teaspoonful of water, at intervals 
of four hours between them. 

Arsenicum is, especially, appropriate for the treatment of ill- 
effects resulting from a chill whilst bathing, or from long-continued 
immersion in the water, either voluntary or otherwise. Chills in the 
stomach, produced by partaking of raw, cold fruits, or by eating ices, or 
drinking very cold water when heated, are also most readily counteracted 
by this medicine. 

Dose: Four pills in a teaspoonful of water, repeated, if necessary, 
every three hours. 



384 DISEASES OF THE RESPIRATORY ORGANS. 

Pulsatilla should, however, be preferred under similar antecedent 
circumstances, if drinking whilst heated, or eating cold fruit, ices, etc., 
has caused the indisposition. 

Dose ; Six pills, as directed for Nux. 

Fever Stage. Aconitam is one of the principal remedies in fever- 
ish attacks, provoked by cold, and particularly from exposure to a dry, 
cold wind, or to a draught, when hot, dry skin is present, or general shiv- 
ering chills, alternating with burning heat of the surface ; great thirst, 
especially towards evening, with a sensation of dryness, and roughness or 
scraping, slight burning, and sensation of excoriation in the upper part of 
the windpipe, or even throughout the whole of the chest, which gives rise 
to an incessant short, dry, hollow cough (more of a hoarse or rough des- 
cription at night;) restless sleep. 

Dose: Six pills every two hours in a teaspoonful of water. 

Bryonia when there is an excessively dry, hollow cough, accompanied 
by tenderness of the upper part of the windpipe, on pressure ; inclination 
to vomit, and pain in the chest, as if it would be torn asunder ; severe 
headache, aching pains in the limbs, increased by the slightest movement, 
violent cold in the head. 

Dose: Four pills rn a teaspoonful of water, every two hours. 

Nuoc-vomica. Dry cough, particularly in the morning, and some- 
times during the day, rarely during the night ; occasionally a small quantity 
of adhesive phlegm is with difficulty expectorated after a fit of cough- 
ing: and the paroxysms are frequently attended with a painful sensation 
in the region about the navel, as if arising from the effects of a bruise or 
blow. This remedy is, further, of great utility in catarrhal fever, with dis- 
position to chilliness or wandering fever-chills, worse during movement, 
coming on and gradually increasing in the after part of the day, and alter- 
nating with flushes of heat. Warmth and absolute rest mitigate these 
symptoms. 

Dose : As for Bryonia. 

Chamomilla. In the treatment of children, this medicine is gene- 
rally preferable to Nux-vomica, in arresting the attack. It is extremely 
valuable in restoring the suppressed perspiration, and removing the fol- 
lowing symptoms: colic, with pains in the head, ears, and teeth, thirsty 
and ill hu«mor, and impatience ; dry heat of the skin, or chilliness in any 
part of the body which may happen to be uncovered for a short time, or 
on lifting up the bed-clothes; burning heat in one part (as for instance one 
cheek) and chilliness in another; severe, dry cough, especially, at night, 
excited by tickling in the upper part of the windpipe. 

Dose : As for Aconite. 

Belladonna is indicated when there is a throbbing, bursting head 
ache, attended with tendency of blood to the head, and increase of the pain 
from movement, or exposure to cold air, pain and heat in the head, eyes, 
and nose; cough at night. 

Dose : As for Bryonia. 

Mercurius, when the lining membrane of the eyelids, nostrils and 
air-tubes is highly irritated, and gives rise to copious shedding of tears, 
cold in the head, and cough with profuse expectoration ; headache, or feel- 
ing of tightness and fullness in the head, with pulsation extending to the 



INFLAMMATION OF THE LARYNX. 385 

nose ; pains in the limbs and joints, accompanied with profuse sweating, 
which affords no relief. 

Dose : As for Bryonia. 

Sepia is indicated in cases of catarrhal fever, with shivering chills on 
every movement in a warm room, rarely alternating with heat; nocturnal 
spasmodic cough, with shortness of breath and inclination to vomit; cold 
in the head, pain at the back of the head. 

Predisposition to Cold. Precautionary Management. Some 
individuals, particularly among those of the fair sex, are tormented with 
an extreme degree of susceptibility to cold, the best corrective of which is, 
to rub the throat, chest, and indeed, the whole body, every morning with 
a wet tow T el, until a glow of heat is produced, drying one part before 
another is commenced; also, to acquire a habit of going out every day, pro- 
vided there is no inherent predisposition to pulmonary consumption; 
extremes, either of heat or cold, should at the same time be avoided, and 
care taken, wiien the body is heated, to let it cool gradually. The shower- 
bath is another useful means of overcoming an unusual susceptibility to 
cold. It should, generally speaking, be begun in summer and used tepid 
at first. 

ACCESSORY MEASURES. In many instances catarrh is carried off, or 
runs to a salutary termination, in a day or two; and this desirable result 
is frequently obtained by having timely recourse to the simple expedient 
of remaining a little longer in bed, and encouraging a gentle sweat by 
drinking a warm demulcent fluid, such as gruel ; bathing the feet and legs 
in warm water, at the temperature of about 98 to 100 degrees Fahrenheit, 
is, also, a useful auxiliary mode of restoring perspiration, but the patient 
should go to bed immediately afterwards. Yery robust persons who are 
accustomed to be in the open air in all weathers, but who have caught cold 
after having overheated themselves, will frequently prevent any bad 
effects by drinking one or two glasses of cold water on going to bed. 
Others again, recover quickly, especially, when the cold is confined to the 
head, by totally abstaining from all fluids for forty-eight hours, or by tak- 
ing a tablespoonf ul of fluid, thrice a day only (at breakfast, dinner, and 
tea,) for seventy-two hours. 



INFLAMMATION OF THE LARYNX, OR UPPER PART 
OF THE WINDPIPE. 

The disease consists in a suppurative inflammation, having its seat in 
the lining membrane of the upper part of the windpipe, or the connecting 
cellular tissue between it and the subjacent parts. The disease bears a 
considerable resemblance to croup, of which it very generally, forms a 
part; but occasionally the inflammation is exclusively restricted to the 
upper part of the windpipe ; and it is a frequent cause of a fatal termina- 
tion in scarlet fever and smallpox. It is distinguished from croup by a 
constant hawking (which the patient voluntarily exercises in order to 
clear the air-passage) rather than a violent and involuntary cough, and by 
the character of the expectoration, which consists of a thick, tenacious 
phlegm, rather than of a coaguable and membranaceous looking exuda- 
tion. 

25 



386 DISEASES OF THE RESPIRATORY ORGANS. 

Symptoms. The invasion of the disorder is announced by the usual 
signs of inflammatory fever; the voice soon becomes hoarse and inarticu- 
late, whilst a painful sense of constriction is experienced in the throat; the 
breathing is laborious and shrill during inspiration ; the upper part of the 
windpipe is extremely sensitive to the touch, so that the slightest pressure 
against it, either externally, by the hand, or internally, from the perform- 
ance of the act of deglutition is productive of the most distressing spasms, 
which threaten death from suffocation. The heat of the skin is great, the 
pulse rapid and hard, the thirst considerable, but incapable of being satis- 
fied from the suffering that is occasioned by the attempt. On examining 
the throat, it is often found to present a red, inflamed, and turgid appear- 
ance ; in some cases the epiglottis (the small, oblong body, attached to the 
root of the tongue, which protects the opening of the windpipe) is 
involved, and the motions of the tongue are thereby rendered painful and 
difficult. As the disease gains ground, the face becomes swollen, and 
sometimes livid, the eyes protruded as in threatened strangulation, and 
life is speedily cut short by suffocation. 

Results. The disease, if not arrested, occasionally terminates fatally 
within a few hours, or in a day or two, at the farthest. It ought not to be 
treated by the non-professional reader. 

HOMCEOPATHIC TREATMENT. Aconitum must immediately be 
exhibited when the signs of inflammatory fever declare themselves, and 
continued until it gives evidence of having effected an abatement of the 
fever. 

Dose : Of a solution of six globules to two tablespoonf uls of water, give 
a teaspoonf ul every half hour. 

Spongia, should, in the generality of cases, be administered with 
Aconite every two hours ; after the last dose of Aconite, or, as soon as the 
breathing becomes shrill, and the pain and sensibility in the upper part of 
the windpipe are more decided, with increase of hoarseness and difficulty 
of articulation. - 

Hepar-snlphuris should be given six hours, or sooner, if needful, 
after the last dose of Spongia, when the latter remedy appears to have done 
all that it is capable of effecting; in which case, this medicine will either be 
adequate to complete the cure, or, at all events, to bear the patient out of 
danger, and thus to leave more leisure for appropriate selection in treating 
the remaining symptoms. Hepar-s. may, however, be selected to follow 
Aconitum in preference to Spongia, if the fever and burning heat of the 
skin continue, notwithstanding the previous administration of Aconitum. 

Belladonna has, likewise, rendered very appreciable service, espe- 
cially, when there were considerable heat of the skin, much thirst, but 
complete inability to swallow liquids, owing to the spasms which the 
attempt occasioned ; further, when, on looking into the throat, it was found 
to present an inflamed and swollen appearance. Belladonna is, however^ 
not to be administered in cases in which it has previously been employed; 
as, for instance, if the affection of the windpipe occurred immediately 
after an attack of pure scarlet fever. 

Hoarseness, or roughness of the voice, arises from some morbid con- 
dition of the upper part of the windpipe. In the majority of cases, the 
seat of the affection is in the mucous membrane, which lines that part, 



INFLAMMATION OF THE LARYNX. 387 

which is extremely liable to be affected by the common causes of catarrh ; 
hence, it is a frequent accompaniment of the latter disorder. 

Pulsatilla is indicated by almost complete loss of voice, particularly, 
when accompanied with loose cough, or thick, yellow discharge from the 
nostrils. 

Dose: Six pills in a teaspoonful of water, night and morning, but if, 
after the course of a week's treatment, although much improved, the 
case be not cured, but appears to have become stationary, proceed 
with one or the other of the following medicines, according to symp- 
toms. 

Mercurius, This remedy will be found useful in removing any 
symptoms remaining after the above, but it is to be preferred, should the 
hoarseness, from the commencement, be attended with thin discharge from 
the nose; and, also, when a sensation of burning or tickling is complained 
of in the upper part of the windpipe, with the characteristic indication of 
Mercurius, namely, a disposition to profuse sweating, especially at night. 

Dose: Six pills in a teaspoonful of water, repeated at intervals of 
twelve hours, until amelioration or change. 

Nux-vomica. Hoarseness, accompanied with a dry, fatiguing cough, 
worse in the early hours of the morning, with dry obstruction of the nose. 

Dose : As for Pulsatilla. 

Rhus-toxicodendron. Hoarseness, accompanied with sensation of 
excoriation in the chest; oppressed breathing, with frequent and violent 
sneezing, unaccompanied by cold in the head, but occasionally by a great 
discharge of phlegm from the nose. 

Dose: As for Mercurius. 

Stannum is more particularly required when symptoms, such as the 
following, are present: cough, with copious expectoration of a greenish- 
yellow color, and of a sweetish or saltish taste, attended with great weak- 
ness, and disposition to sweats; soreness at the chest, as from internal 
excoriation; feeling of weakness or sinking in the chest, as if it were 
empty, particulary after expectorating, or even after speaking; or dry, 
shaking cough, worse at night or towards morning, excited or aggravated 
by speaking or laughing, and occasionally followed by vomiting of food. 

Dose: Four pills, as directed for Pulsatilla. 

Lycopodium is very efficacious in obstinate coughs, which are worse 
at night, and are attended with expectoration of tenacious phlegm, and 
sometimes vomiting; paleness of the face, emaciation, pains and oppres- 
sion in the fore part of the chest, flatulence, ill-humor, etc. 

Dose. Six pills in a teaspoonful of water, morning and evening, until 
change. 

Phosphorus is appropriate to the following symptoms: dry cough 
excited by tickling irritation in the throat or chest, or by laughing, talking 
or drinking, or by cold air, and accompanied with pricking in the wind- 
pipe; hoarseness, or pains in the chest as if from excoriation; cough, with 
hoarseness, fever and depression of spirits, sometimes with apprehensions 
of death; dry-sounding cough, followed by expectoration of viscid or 
bloody phlegm, and attended with oppressed breathing and livid hue of 
lips and face; cough occurring in consumptive habits. 

Dose : Six pills in a teaspoonful of water, night and morning, until 
change. 

Arnica is of great value in coughs, attended with bleeding from the 



388 DISEASES OF THE RESPIRATORY ORGANS. 

nose and mouth; headache, pricking in the chest, rheumatic pains in the 
loins and extremities, and soreness or pain, as from a bruise, in the chest 
and belly. 

Dose : As for Phosphorus. 

Spongia. In acute inflammation of the lining membrane of the air- 
tubes, this remedy is often of essential service; but it is of equal utility in 
the chronic variety, when the chronic symptoms prevail; cough, with 
muco-purulent expectoration, emaciation, redness and deformity of the 
points of the fingers, lividity and incurvation of the nails, hectic fever. 

Dose : Four pills, as directed for Lycopodium. 



COUGH. 

Symptoms. Forced and audible expiration, with or without fever; 
either dry or accompanied with expectoration. 

Cough, although not dangerous of itself, may become so, or form an 
important feature of other diseases. As a precursor of consumption, it is 
too often neglected. 

Causes. It may arise from an irritation of the air-passages or lungs, 
from disease of these organs, or from cold or other causes, or be merely 
sympathetic— or the consequence of derangements of other important 
organs. 

We purpose here to treat more particularly of simple mucous or moist 
and dry cough. 

nervous coughs. 

Obstinate nervous coughs, occurring in highly-irritable, nervous, and 
hysterical subjects, and which are generally dry, or attended with scanty 
and difficult expectoration, consisting of a little dear phlegm, are often 
relieved by change of air and scene, or even by exhilerating or active occu- 
pation, when medicinal resources fail to insure a permanent cure. 

HOMCEOPATHIC TREATMENT. Aconitum is indicated by violent, 
short cough, with quick, hard pulse and feverish heat; pricking in the 
chest when coughing, or during inspiration. 

Dose : Six pills in a teaspoonf ul of water. 

Dulcamara. The following are indications for the selection of this 
remedy: moist or loose cough, with copious expectoration after exposure 
to a cold damp atmosphere; or cough with hoarseness and copious secre- 
tion of phlegm in the ramifications of the windpipe, sometimes accompa- 
nied by expectoration of bright-colored blood during the night; barking, 
shaking cough, increased or excited by taking a deep breath. 

Dose: Of a solution of six pills to two tablespoonfuls of water, give 
a teaspoonf ul every three hours. 

Belladonna. Short, dry, barking, (spasmodic catarrhal, or nervous) 
cough at night, in bed, and, also, during sleep, renewed by the slightest 
movement; dry cough day and night, with irritation or tickling in the 
pit of the throat, or sensation as if a foreign body were in the windpipe, 
or as if dust has been inhaled; spasmodic cough, which scarcely allows 
time for respiration. This medicine is also sometimes useful in cough, 
with rattling of phlegm in the chest, pricking in the front or sides of the 



COUGH. 889 

chest, and expectoration of thick, white phlegm, coming on, especially, 
after meals; lancinating pain in the belly ; hoarseness, redness of the face, 
headache, sneezing after coughing, and pain in the nape of the neck. 

Dose: Dissolve six pills in four tablespoonfuls of water, and give a 
teaspoonful of the" solution every three hours; but if only partial 
relief has resulted, within three hours after the fourth dose, pause 
three hours longer, and proceed with the next medicine. 

Hyoscyamus frequently answers when Belladonna has only afforded 
partial relief, and may be preferred to that remedy when the dry, tickling, 
nocturnal cough is mitigated for the time by sitting up in bed; also, when 
there is mucus rattling in the throat. 

Dose: A solution of four globules, as directed for Belladonna. 

Ignatia-amara is preferable to Belladonna and Hyoscyamus in very 
tickling coughs, which continue day and night with equal severity, and 
are accompanied by a running cold in the head. Ignatia is, moreover, 
especially, indicated by the subjoined symptoms, — shaking, spasmodic 
cough, or short, hacking cough, as if arising from the presence of dust or 
feather-down in the throat, which becomes aggravated the longer the 
paroxysm of coughing continues; dry, tickling cough, with cold in the 
head, occurring both day and night. This remedy is, further, particularly 
efficacious, when the attacks of coughing become aggravated after eating, 
or on lying down at night, or on rising in the morning, and when the 
patient is of a mild and placid temper, or subject to alternations of high 
and low spirits. 

Dose : As for Belladonna. 

Nux-vomica, This is a valuable remedy in many cases, either 
of catarrhal, or nervous character, and is particularly efficacious where 
there is a dry, hoarse, fatiguing, and sometimes spasmodic cough, which 
occurs in an aggravated form in the morning, and occasionally, also, towards 
evening; or which recurs more or less during the day, but relaxes again 
at night, and is then occasionally supplanted by oppression at the chest, 
on lying down, or on awaking during the night, accompanied with a 
feeling of heat, and dryness in the mouth; if there be any expectoration, 
it consists merely of a little phlegm, which is detached with great diffi- 
culty. The cough is, generally, excited by a disagreeable tickling or scrap- 
ing, with a feeling of roughness, or rawness in the throat, sometimes 
attended with hoarseness, and feeling of roughness in the chest, but 
more frequently with severe headache, or pain, as if from a blow or bruise 
in the pit of the stomach, under the false ribs; it is frequently aggravated 
after meals, or by movement, not unfrequently, also, by reading or medita- 
tion, and is, occasionally, followed by vomiting. 

Dose: Six pills in a teaspoonful of water, every three hours. 

Pulsatilla. Severe shaking, catarrhal or nervous spasmodic cough, 
worse towards evening, and at night, frequently followed by vomiting; 
sensation of suffocation, as if from the vapor of sulphur; increase of 
cough, when in a recumbent posture; cough which is, at first, dry; then 
followed by copious expectoration of yellowish or whitish phlegm, some- 
times of a salt or bitter taste; or expectoration of mucus, streaked with 
blood; wheezing, or rattling of mucus in the chest; the paroxysms of 
coughing are, frequently, accompanied with soreness in the belly, as if 
from a bruise, or blow, or painful shocks in the arms, shoulders, or back, 



390 DISEASES OF THE RESPIRATORY ORGANS. 

and sometimes, followed by a sensation, as if the stomach became inver- 
ted from the violence of the cough ; involuntary emission of urine when 
coughing; loose cough, with aching in the chest, hoarseness, cold in the 
head ; excited by a sensation of scraping, or of erosion in the throat ; shiv- 
ering. 

Dose : Six pills in a teaspoonf ul of water, every four hours. 

Chamomilla is indicated by dry cough, excited by continual tick- 
ling, or irritation in the upper part of the windpipe and chest, and 
increased by talking; the cough is most troublesome during the night; 
but also occurs during the day, particularly, in the morning, and toward 
the evening; accumulation of tenacious phlegm in the throat; wheezing in 
the chest, cough during sleep, sometimes accompanied with paroxysms, 
as of threatening suffocation ; cough, with scanty expectoration of tena- 
cious, bitter phlegm. This medicine is well adapted to the treatment of 
coughs in children, accompanied with more or less of the symptoms above 
described, or with hoarseness, cold in the head, dryness in the throat and 
thirst; great fretfulness; fever towards evening; paroxysms of coughing 
after crying, or after a fit of passion. 

Dose : Of a solution of eight pills to three tablespoonf uls of water, 
give a teaspoonful every four hours. 

^Bryonia is indicated by catarrhal cough, occurring in winter, during 
the prevalence of frost, and cold easterly winds, with aggravation of the 
fits of coughing on coming from the open air, into a warm room. The 
following are the general indications for its employment: dry cough, with 
or without hoarseness, and excited by constant irritation in the throat — 
or as if caused by vapor in the windpipe, with greatly accelerated respira- 
tion, as if it were impossible to obtain sufficient air ; spasmodic, suffoca- 
ting cough, after partaking of food or drinks, and, also, after midnight ; 
cough with prickings or shootings in the chest, and violent, bursting 
headache, especially at the temples — also, with prickings in the pit of the 
stomach, or in the side ; further in loose cough, day and night, with scanty 
expectoration of whitish, or yellowish, viscid phlegm, or slight spitting 
of blood, the paroxysms being sometimes followed by vomitings, and 
accompanied by pain, as from a bruise under the collar-bones, and pain 
and fullness in the forehead, as if the contents of the head were forced out, 
this remedy , will, frequently, be found of great service ; and, likewise, in 
dry, nervous cough. 

Dose : Of a solution of twelve pills to three tablespoonfuls of water, 
give a teaspoonful every three hours. 

Mhus-toxicodendron is indicated by short, dry cough, worse 
towards evening, and before midnight, excited by tickling in the chest, 
attended by hoarseness, or a feeling of roughness, or rawness in the 
throat, congestion in the chest, a sensation of suffocating constriction, 
anxiety, and shortness of breath ; cough on waking in the morning, or 
short cough, with bitter taste in the mouth, on lying down at night, and 
on waking in the morning, with expectoration of viscid phlegm, some- 
times followed by vomiting, pains in the stomach, and dartings, or prick- 
ing in the thigh. Cough with expectoration of bright blood with sensa- 
tion of sinking, or exhaustion of the chest, or shooting pains in the chest 
and sides. 

Dose : Eight pills in a teaspoonful of water, night and morning. 



COUGH. SOI 

Ipecacuanha is, more particularly, required when the following 
symptoms occur; catarrhal, nervous, or spasmodic cough, particularly at 
night, attended with painful shocks in the head and stomach, and fol- 
lowed by nausea, retching, and vomiting; or dry cough, arising from 
tickling in the throat; or severe, shaking, spasmodic cough, with oppressed 
breathing, almost amounting to suffocation. In the case of children, this 
remedy is frequently valuable, when they appear to be threatened with 
suffocation from the accumulation of phlegm, or where the paroxysm is 
so severe as scarcely to afford time for respiration, causing the face to 
assume a livid hue, and the frame to become quite rigid. 

Dose: Of a solution of twelve pills to three tablespoonfuls of water, 
give a teaspoonful every hour, until positive change. 

Mercurius is indicated by catarrhal cough, with hoarseness, or 
watery discharge from the nose, or accompanied with diarrhoea; or dry 
cough, excited by irritation in the throat, or the upper part of the chest, 
which becomes particularly troublesome towards evening, and at night; 
sometimes with slight pricking in the chest when coughing or sneez- 
ing; excited, or increased by talking; cough in children, "with discharge 
of blood from the nose, vomiting, and headache; dry, spasmodic cough, 
with pain in the head and chest, as if they would burst, retching after the 
paroxysms, and occasional expectoration of blood. 

Dose: Four pills in a teaspoonful of water, night and morning, until 
distinct change; or, if retching be present, the like dose, every two 
hours, after fits of coughing. 

Carbo-vegetabilis is, particularly, indicated by hollow cough, exci- 
ted by irritation, or a troublesome sensation of crawling in the throat, and 
attended with burning pain and sensation, as if from excoriation in the 
chest ; catarrhal or nervous spasmodic cough, frequently followed by incli- 
nation to vomit, or vomiting, occurring in paroxysms throughout the day; 
cough with hoarseness, especially towards evening, or morning and even- 
ing, increased by speaking. Obstinate cough with expectoration of 
greenish phlegm, or even of yellowish matter, or with expectoration of 
blood and burning sensation in the chest (a characteristic indication for 
this remedy as well as for Arsenicum). 

Dose: Four pills in a teaspoonful of water, night and morning, for 
four days. 

Arsenicum is required for cough with oppression at the chest, and 
tenacious phlegm in the upper part of the windpipe and chest; cougli 
excited by a sensation of dryness and burning in the windpipe. Dry cough, 
chiefly in the evening after lying down, often with difficult respiration and 
fear of suffocation {suffocative catarrh, catarrhal asthma,) as if arising 
from inhaling the vapor of Sulphur ; dry cough, excited by eating or drink- 
ing, or by ascending stairs, or cough which arises as soon as the open air is 
encountered; thin acrid discharge from the nose; sneezing: periodic dry 
cough, nocturnal cough with general burning heat, cough, with expectora- 
tion of bloody phlegm , catarrh in the lungs of old people, attended with 
tenacious mucus expectoration, which is extremely difficult to eject, and 
causes rattling in the chest, oppressed respiration, and frequently, symp- 
toms of impending suffocation, or paralysis of the lungs. 

Dose: Three pills in a teaspoonful of water, every two hours. 

Ammonium-carbonicum is indicated by dry, tickling, suffocative 
cough, especially, in the morning, sometimes with fever, occurring during 



392 SEASES OF THE RESPIRTORY ORGANS. 

the prevalence of a cold, stormy, bleak state of the atmosphere, and 
attended with a sensation of heat or burning behind the breast-bone, resem- 
bling that which is occasioned by drinking spirits; hoarseness; cold in 
the head, with copious discharge of acrid, watery fluid. 

Dose: As for Arsenicum. 

Causticum, which may sometimes be of service in cases analogous to 
that which has been named as suggesting Ammonium-c, either before, 
after, or in place of that medicine, is, especially, indicated by dry, hollow 
cough, which even wakes the patient from sleep ; short cough, excited by 
tickling, crawling, or a feeling as if the throat were excoriated, or by 
talking; and cold, attended at times with burning, or a sensation of sore- 
ness in the chest, and rattling of phlegm ; pain in the hip, and, occasion- 
ally, involuntary emission of urine when coughing; pain in the chest, 
as if it were raw and sore, (the patient comparing his feelings to those 
which he could conceive to arise from the application of a blister to the 
exterior of his chest). 

Dose: Three pills, as directed for Arsenicum. 

Silicea is indicated by cough, with oppressed breathing on lying on 
the back, or cough attended with tightness and oppression at the chest, 
as if something stopped the respiration while speaking or coughing. 
Fatiguing, or deep hollow cough, day and night, aggravated by movement 
or by speaking, and sometimes attended with aching and pain, as if from 
a bruise in the chest; cough icith copious expectoration of transparent 
phlegmov purulent matter, sometimes streaked with blood ; cough with asth- 
matic breathing and emaciation, and with dread of suffocation at night; 
cough irritated or excited by a sensation as if a hair were on the tongue. 

Dose: Six pills in a teaspoonful of water, night and morning, for 
four days. 

Sulphur is of paramount importance in some cases of obstinate 
coughs, and particularly in dry cough, which disturbs the patient at night 
as well as during the day; the cough is frequently excited after partaking 
of food, or during a deep inspiration, and is, generally, attended with a 
sensation of spasmodic constriction in the chest, sometimes followed by 
inclination to vomit, or the involuntary escape of urine, or pain as if 
from excoriation, or pricking pains in the chest ; headache, pains in the 
chest, belly, loins, and hips ; also, cough, with expectoration of thick, 
whitish or yellowish phlegm, or of a greenish-yellow, fetid mucus, or pur- 
ulent matter, of a saltish or sweetish taste ; feverish cough with spitting 
of blood. 

Dose: Three pills in a teaspoonful of water, morning and evening, 
for four days. 

Calcarea-carbonica is particularly indicated, when the following, 
symptoms occur: dry cough, aggravated towards evening, or a^ night 
excited by tickling in the throat, or by a sensation as if there were feather 
down in the throat; also, loose cough, with rattling of mucus in the chest, 
and expectoration of offensive, thick, yellow phlegm; anxiety. 

Dose : Six pills, in every respect as for Sidphur. 

Sanguinaria-canadensis. Dry cough ; pain and stitch in the 
right side of the chest; diseases of the lungs; it has a certain reputation 
in the cure of coughs. 

Dose : The same as Calc. carb. 



CUOUP. 393 

Septa. The symptoms which indicate this medicine are as follows: 
cough, with copious expectoration of phlegm of a saltish taste, and of a yel- 
low or greenish color; also, dry, spasmodic cough, particularly, at night, or 
on first lying down, attended, in children, with crying, fits of choking, nau- 
sea, retching, and bilious vomiting. This remedy is, especially, adapted to 
individuals having a constitutional taint, such as scrofulous, scorbutic, 
etc., and, in chronic coughs, with thick, yellowish, greenish, or even puH- 
form expectoration, with a putrid taste, it is, also, a valuable remedy. 

Dose r Four pills in a tablespoonf ul of water, night and morning, until 
change. ^ 

CROUr— LARYNGITIS. 

In an attack of Croup, it is of the utmost importance to afford help 
before the dangerous stage sets in. The mother, who has the best oppor- 
tunity of watching her child, may, avert the danger by the care and treat- 
ment recommended here. 

If the family physician is in reach he should be sent for at once. If 
no physician is near, this treatment may be used in perfect confidence of 
its ultimate favorable effects. Persons who have once heard the croup 
cough will never forget it; those who have not heard it may know it by 
the following signs; It is very much, like the hoarse barking of the com- 
mon cur dog; sometimes shrill (crowing,) sometimes deep and hollow, 
but rough; it is an anxious sound. The cough occurs in paroxysms. 

The inspirations are long and labored ; the expirations interupted 
and jerking. The little patients frequently toss about the bed iii great 
agony, stretch the neck, and bend the head backwards, boring it into the 
pillow, which last should not be prevented, as, if forced to raise the head 
too high suffocation may take place in consequence. The pulse is feverish 
and the urine is deep red. True membraneous croup is not near so fre- 
quent as most persons imagine; most cases of croup would remain without 
any danger, if the proper treatment was at once pursued. 

ALLOPATHIC TREATMENT. Laryngitis with spasms of the larynx 
(spasmodic, catarrhal or false croup,) is the form of croup, which is most 
common with children who are said to be "subject to croup." As the 
attack generally occurs suddenly, and is quite alarming in its symptoms, 
it is very important that the parent should know what is to be done. If 
the little patient is put into a warm bath at the temperature of one hun- 
dred degrees, the great probability is, that the spasm of the larynx, and 
the difficulty of breathing will soon cease. The bath should continue from 
ten to twenty minutes, or until the full relaxing effect is produced. The 
patient, if four or five years old, should then have a dose of twenty drops 
to three-fourths of a teaspoon ful of Paregoric with half a teaspoonful of 
Syrup of Ipecacuanha, and placed in a warm bed. The throat should 
then be w r ell rubbed with Turpentine, or a Liniment composed of Aqua 
Ammonia one part, Olive Oil two parts, mix and add one part of Turpen- 
tine. The severe smarting (counter irritation,) of the application will 
prove most serviceable. 

If the spasm is not relieved by the warm bath, an emetic should be 
given. The Syrup of Ipecacuanha is very suitable in doses of a teaspoon- 
ful from ten to twenty minutes apart, until vomiting occurs, or the par- 
oxysm ceases. In very robust children the Hive Syrup is admissible for 



394 DISEASES OF THE RESPIRATORY ORGANS. 

this purpose in closes of fifteen to thirty drops every fifteen minutes, 
but on account of the extreme and continual depressing effect of the 
Tartar Emetic it contains, it should be given only to the strongest chil- 
dren. Twenty grains of Powder of Ipecacuanha may be put in two or 
three tablespoonfuls of warm water and a teaspoonful given at a dose. 
Bloodroot given with Ipecacuanha has proved serviceable with both 
catarrhal and true croup, in the hands of Dr. Eansom, of Burlington, 
Iowa. The following is a suitable formula: 

Take of Powdered Ipecacuanha a dram, Powdered Bloodroot a scruple . 
mix and divide into three powders. Put one powder in a wineglass of warm 
water and give one or two teaspoonfuls . 

Or, one dram each of the Fluid Extract of Ipecacuanha and Tincture 
of Bloodroot may be given, in doses of five or six drops every ten or twen- 
ty minutes in syrup or sweetened water. The dose of the emetic should 
be repeated until vomiting occurs or the paroxysm ceases. If neither 
result can be produced by these means, a teaspoonful of Powdered Alum 
may be given, mixed with syrup or honey, to produce vomiting, which 
will relieve the difficult breathing. The use of Ether by the mouth and 
inhalations would be prudent at the hands of a physician, and is useful ; 
the same may be said of Chloroform. 

As soon as the sickness of the stomach has subsided, unless the bowels 
are well open, a saline catharic should be given, as, a teaspoonful or two 
of Rochelle Salts in lemonade or from five to ten grains of Calomel. If 
the emetic has been given at night the cathartic can generally be given 
the next morning. 

A poultice or a flannel wet with a saturated solution of Gum Camphor 
in Olive Oil or Belladonna Ointment, may be applied to the neck after 
thorough rubbing with the Turpentine Irritating Liniment. 

During the day the patient should have an anodyne sufficiently often 
to relieve the cough, as two parts of Paregoric and one part Tincture of 
Hyoscyamus may be given in doses of twenty to forty drops to children 
old enough to run out of doors. 

The Tincture of Belladonna may be given instead of Hyoscyamus 
in doses of two to ten drops. The anodyne and a hot foot bath should be 
given at night. 

The following is a suitable mixture for an anodyne to be administered 
through the day : Take of Paregoric half an ounce, Syrup of Ipecacuanha 
half an ounce, Tincture of Hyoscyamus two drams, water and simple syrup 
each three drams; to this may be added a dram of Citrate of Potash previ- 
ously dissolved in the water. 

Dose: Haifa teaspoonful may be given from two to four hours apart, 
to a child two or three years old, a teaspoonful to older children, 

If the fever and pulse should run high, a quarter or half of a drop of 
Tincture of Aconite may be given, without reference to other remedies, 
every half hour until an impression is made on the fever; then at inter- 
vals of two or three hours, as : Take of Tincture of Aconite a dram, Syrup 
three drams. Mix. 

Dose : One or two drops. 

If the child is weakly, a. grain of Quinine (in pill or powder) should 
be given three or four times a day, and a teaspoonful of a solution of half 
a dram of Pyrophosphate of Iron in four ounces of simple syrup. 



CROUP. 



895 



The child should be confined to the bed during the acute stage, and 
after this passes, should be kept in the room for a few days, and then 
gradually accustomed to the open air by going out for a short time only, 
in the middle of the day. 

As a preventive of this annoying trouble, children of all ages should 
be clothed in flannel during the later autumn, winter and spring. The 
dress should be high in the neck, the sleeves long and warm. The legs 
and feet should, also, be warmly dressed with woolen stockings and 
drawers. Then, if warmly clad and the feet kept dry and warm, out of 
door life will be beneficial. In weakly children tonics of Quinine and Iron, 
will prove serviceable. The sugar-coated pill and Pyrophosphate of Iron 
recommended above, will be found appropriate given three times a day. 

It is needless to say that a recurrence of the paroxysms of difficult 
breathing occurring at any time in the course of the disease, demands the 
repetition of the hot bath or emetics, or both. 

True Croup. Inflammation of the larnyx, with exudation (false 
membrane,)— the most dangerous of all the forms of Laryngitis— is not, as 
a rule, marked in the beginning of the disease with such alarming symp- 
toms, as accompanies the various forms of false croup, yet, upon its early 
recognition, and prompt measures of treatment, depend the degree of 
success which will follow our efforts. 

In order, if possible, to render the distinction between false and true 
croup, the following table is inserted, which is compiled from various 
authorities. 



Simple Laryngitis with Spastn 
or False Croup. 

Begins with nasal catarrh, or cold 
and hoarse cough, or, with a sudden 
attack at night with suffocation. 
The throat is natural or slightly 
reddened. 



After the paroxysm, the child 
6eems well, or nearly so, the fever 
disappears or diminishes greatly* 
Voice is nearly natural, never whis- 
pering. 



If a paroxysm returns, it is during 
the following night, but not as se- 
vere; the hoarseness disappears and 
the cough becomes loose. 

Seldom lasts more than three days. 



Seldom destroys life. 



Laryngitis ivith Exudations or 
True Croup, 

When epidemic, begins as an in- 
flammation, with exudation of false 
membrane. When not occurring 
epidemic, the invasion is more grad- 
ual, with a slight hoarseness one or 
two days. There is fever, hoarseness 
increases, the cough is hoarse, muf- 
fled, crammed. 

Generally, there is exudation in 
the throat, and later, paroxysms of 
suffocation. 

Fever continues ; breathing is dif- 
ficult, labored, and each act greatly 
prolonged ; cough hoarse and smoth- 
ered ; voice hoarse and whispering. 

The difficulty of breathing and 
suffocation increases; the cough and 
voice are smothered, or gone alto- 
gether; the stridulous (harsh sound) 
breathing continues. 

Seldom lasts less than five or six 
days. The hoarseness lasts several 
weeks. 

The majority of cases prove fatal 



396 DISEASES OF THE RESPIRATORY ORGANS. 

So that if a case recovers, and no false membrane has been discovered 
in the expectorated matter, the case was almost positively not one of true 
croup. 

The child should be confined in bed. The food should be digestible and 
nutritious, such as milk, strong beef tea (made by putting a pound of finely 
minced, lean beef into a pint of cold water, and slowly raising the temper- 
ature to one hundred and sixty degrees Farenheit, and maintaining it there 
for four hours— a little water may be supplied from time to time, to supply 
loss by evaporation) or beef essence, raw eggs beaten with sugar and water 
or milk. Starchy food may be allowed in limited amount. 

In this disease, the writer believes that local applications hold the first 
rank, and the best of all local means is the constant inhalation of steam. 
This end is accomplished the best by maintaining the room at a temperature 
of eighty-five or ninety degrees, and fill the air with steam from kettles of 
boiling water. The breathing of this warm, moist air has the best effect 
upon the local inflammation, relieves the spasm of the larynx, and facili- 
tates the ease of breathing and, also, contributes to the separation of the 
false membrane by allaying inflammation and hastening separation. A kettle 
may be made of tin, with a spout so fixed, that sitting on a stand at the 
side of the bed, a jet of steam can be thrown across the patient's face. 
By this means the moisture inhaled can be greatly increased. This kettle 
can be heated by a spirit lamp. A simply constructed kettle for this pur- 
pose was invented and sold in New York at $3.00. It is called Ronchette's 
Croup Kettle, but any tinner can make one which will answer the same 
purpose. The inhalation of steam should be continued through the whole 
course of the disease. The freedom from spasm and other difficulty of 
breathing while this warm, moist air is inhaled, greatly decreases the need 
of emetics, which will be spoken of hereafter. 

Counter irritation to the neck over the larynx, should be thoroughly 
made with Turpentine, or the Liniment of Ammonia and Turpentine 
directed for false croup, or Tincture of Iodine applied twice a day, after 
which Belladonna Ointment, containing a scruple or half a dram of Cam- 
phor to the ounce, should be freely applied to the neck, and then cover 
with a flax-seed poultice. The Camphor can be more easily incorporated 
in the Ointment by dissolving it with a little Ether. In the case of some 
strong children, cold applied to the neck over the larynx and windpipe, is 
more effective in the earliest part of the disease. A piece of pork should 
be applied to the sides of the neck to keep it from getting cold, and a nap- 
kin wrung out of ice water, or containing a lump of ice, should be laid over 
the larynx, and then covered with a dry towel to prevent wetting the 
patient's clothes and bed. 

The best known solvent for the false membrane is Lime Water It is 
best applied, from time to time, by means of an atomizer or spray appa- 
ratus, and should be used warm. The air of the room may be purified 
every hour or two, slaking a lump of quick lime in the room. 

The other most useful applications, which may be applied to the in- 
flamed surface, are: Lactic Acid, Nitrate of Silver, Tincture Muriate of 
Iron, Tannin and Alum. Three and a half drams of Lactic Acid to ten 
drams of distilled water may be used with a spray apparatus. The eyes 
should be protected from the spray. 

Bromine may be used as directed in diphtheria. Half a dram of 



CROUP. 397 

Carbolic Acid to four ounces of water, may be applied with an atomizer. 
It is, doubtless, especially useful after suppuration, and separation of the 
false membrane has begun. 

Nitrate of Silver, if used, should be applied to the patches of false mem- 
brane only, but in strong solution by a physician. 

Tannin in Glycerine (one or two drams to the ounce,) may be applied, 
with a large camel's hair brush, to the orifice of the larynx, with the aid of 
a laryngeal mirror. 

Tincture of Iron, one or two drams to the ounce of distilled water and 
Alum in saturated solution, may be applied by a spray apparatus. Of 
these, the writer considers them all inferior to Lime Water. 

In the treatment of croup, emetics hold an important place. They 
aid in expelling the false membrane when it becomes detached. They 
should be given at once, when the labored, smothered breathing indicate 
the presence of false membrane in the larynx. Many physicians prescribe 
an emetic in the beginning of the disease, believing its tendency is to pre- 
vent the developement of false membrane, and hasten its separation. 
If the patient is strong, an emetic of Ipecacuanah may be given at once. 
Mix a teaspoonful of Ipicac in Iwilfa glass of water, and give from a desert- 
spoonful to a tablespoonful every fifteen minutes, until vomiting takes 
place. Bloodroot, to one-third the amount of Ipecacuanha, may be given 
in the same mixture. The efficiency of the Ipecac emetic is increased by 
giving, at the same time, a teaspoonful of powdered Alum. 

In cases of feeble children, the Sub-Sulphate (Yellow Sulphate) of Mer- 
cury is the best emetic, and after the disease has progressed for a time, as 
it causes the least exhaustion of any of the emetics, it is to be preferred. 
Three to five grains, rubbed up with sugar, may be placed on the base of 
the tongue, and swallowed with a little water. If vomiting does not occur, 
the dose should be repeated at the end of fifteen minutes. Professor 
Barker, of New York, prescribes this remedy immediately, when called to 
a case of croup, and claims not to have lost a case since he began this 
treatment. 

Alum, powdered, given in doses of a teaspoonful, in syrup or honey, 
with or without a teaspoonful of Syrup of Ipecacuanha, repeated every 
fifteen minutes, until vomiting occurs, is a serviceable emetic. 

One or two grains of Sulphate of Copper, given in powder, with two 
or three grains of Ipecacuanha, given every ten minutes, until vomiting 
occurs, is, after the Yellow Sulphate of Mercury, probably the best emetic 
in true croup. After vomiting has been produced by Sulphate of Copper, 
many German physicians claim it has a specific effect on the croup, which 
may be obtained by giving it in doses of a quarter of a grain every two 
hours. 

While it is true, that in the majority of cases, which have recovered, 
emetics have formed a prominent part of the treatment, the writer 
believes they have been beneficial only by removing during the act of 
vomiting, the false membrane that was already detached or separable, 
and not by any specific effect. Hence, in his opinion, the indication for 
their use is the difficult breathing. They should be given from time to 
time, to accomplish that purpose, three or four times in the twenty-four 
hours. In extreme cases, every three or four hours. 



398 DISEASES OF THE RESPIRATORY ORGANS. 

In order to sustain the strength of the patient, some nourishing and 
quickly-digestible food should be given immediately after the action of an 
emetic. 

Mercury is thought, by many physicians, to diminish the inflammation 
and exudation of false membrane. This opinion is held by Prof . H. C. 
Wood, in his recent work on the therapeutics, second edition. He says 
when the patient is robust and the general symptoms active, no time 
should be lost in bringing the patient under its influence. From half a 
grain to a grain, may be given every two or three hours, or three grains, 
with three grains of Dover's Powder may be given two or three times a 
day, until the patient is mercurialized (salivated.) The writer is skeptical 
as to the benefit from this practice, but in so dangerous a disease, if the 
good which may come from it is ever so small, the voice of any one ought 
not to be raised against it. It is not used in the writer's practice. Alka- 
lies are more serviceable. 

In the use of alkalies, the following formula maybe used: Take of 
Chlorate of Potash two drams, Citrate of Potash two drams, Tincture 
Muriate of Iron a dram, Simple Syrup two ounces, water sufficient to make 
four ounces. Mix. 

Dose : One or two teaspoonf uls every four hours. 

A dram and a half of the Muriate of Ammonia may be used instead 
of the Citrate of Potash, or two or three grains may be given separately, 
in water. This treatment should be continued night and day, until the 
cough becomes loose, or treatment is abandoned on account of the hope- 
lessness of the case. 

Anodynes are, generally, required in this disease. The most useful is 
Opium, but on account of the tendency of the disease to destroy life by 
suffocation, much caution should be used in its employment. It is best 
to give it alone, or add it to other medicines as they are given, that it may 
be discontinued at any time, which should be done on the appearance of 
asphyxia (symptoms of suffocation.) 

The Deodorized Laudanum in doses of four or five drops, or three 
grains of Dover's Powder, sufficient to maintain such an impression as 
will relieve excitement and spasm. Paregoric may be used for this pur- 
pose. In some cases, the Bromide of Potassium, with a little Hydrate of 
Chloral acts better : Take of Bromide of Potassium two drams, Hydrate of 
Chloral half a dram, Syrup ofTolu half an ounce. Water, an ounce and a 
half. Mix. 

Dose : A teaspoonful three or four hours apart, until spasmodic symp- 
toms cease. 

If spasmodic action is marked, it can be given every half hour until 
relieved. To those who have never resorted to it, the little call for ano- 
dynes when the patient is kept in a warm room, filled with vapor, will be 
surprising. 

When all remedies are proving unavailing, and the difficult breathing 
increases and marches on to suffocation, the operation of tracheotomy 
opening into the windpipe,) should be resorted to by the medical attend- 
ant, 'ks offering the only hope for recovery. The friends ought not to 
object. After this operation, the treatment is simply to keep the patient 
in the warm moist atmosphere. Keep the tracheotomy tube clean, and 
support the powers of life by nourishing food. The other danger is from 



CROUP. 399 

the disease traveling down the windpipe, and causing death from suffoca- 
tion, or from the development of bronchitis, or pneumonia. The steady 
continuance of the moist air at 90° of temperature is the best preventive, 
should they occur (bronchial-pneumonia) the chest should be wrapped in 
an oiled silk jacket, and the skin of the chest frequently rubbed with 
Turpentine, or the Ammonia and Turpentine Liniment before recommen- 
ded for the throat. Should the patient recover, the tracheotomy tube may 
have to be worn for months, or until the larynx is clear of obstruction. 

At any time during the disease, if the patient becomes enfeebled, 
stimulants may have to be given in addition to nourishment, as, a tea or 
dessertspoonful of brandy in milk, beef tea or essence, or egg. Wine whey 
may be given, if preferred. 

In the paragraph on emetics Tartar Emetic (and Hive Syrup), were 
not mentioned because deemed unnecessary, as having no special benefit 
on the disease, and frequently doing harm, and sometimes even causing 
death by its prostrating effect, when given at a time when danger was 
apparently not immediate. 

HOMEOPATHIC TREATMENT. Aconite is the remedy in the first 
stage, when there is high fever, dry hot skin, and great restlessness. On 
attempting to swallow, the child cries as if from soreness aud pain in the 
throat. Loud breathing during expiration, but not during inspiration. 

Hepar-sul. Croup with loose, rattling, choking cough; the air pas- 
sages appear clogged with mucus. The child cannot bear to be uncovered 
and coughs whenever any part of the body is uncovered enough to get 
cold. Great drowsiness and profuse sweat. 

Iodine* Soreness and pain in the throat and chest, which the child 
manifests by grasping the parts with its hand. Dry, short, hacking cough, 
with difficulty of breathing. Membraneous croup with wheezing, sawing 
respiration. Face pale and cold, voice deep, rough, and hoarse. 

Kali-bichromicnm, in true membraneous croup. The disease 
approaches gradually; at first there is slight dyspnoea (short breathing) 
with hoarse, croupy cough; as it progresses, the difficulty of breathing 
increases, and the air, as it passes in, sounds as if it were passing through a 
metallic tube. Hoarse, dry, barking cough ; tonsils and throat red, swollen, 
and covered with a membrane; head inclined backwards; violent wheez. 
ing and rattling in the windpipe, heard at a distance. This is one of the 
very best remedies known, in true croup; use crude, finely powdered. 

Spongia in non-membraneous croup, where there is a rough, crowing 
sound to the cough. Slow, loud, wheezing and sawing respiration, or 
suffocative fits with inability to breathe, except with the head thrown 
backwards. Discharge from the nose or sneezing, or dribbling of saliva 
from the mouth. 

Dose: Any of these remedies need to be repeated rapidly during the 
most critical part of the attack, say a dose every thirty minutes to 
two hours. 

HOME REMEDIES. Take three or four thicknesses of linen or 
domestic, wrung out of cold water, leaving it so that it will just drip, apply 
it closely around the neck, allowing it to extend over the chest; cover the 
parts well with dry flannel. If not relieved in from five to ten minutes, 
repeat. 



400 DISEASES OF THE LUNGS. 

If not relieved by application of cold cloths, as just directed within 
twenty minutes, give broken doses of Tincture of Lobelia. If the breath- 
ing is very difficult at the end of the twenty minutes, give a full dose of 
one-fourth to one-half teaspoonful of Tincture of Lobelia, that vomiting 
may be produced as quick as possible. 

Take a lump of Unslaked Lime, put it in a bowl of water, inclose 
the head of the child and bowl together by throwing a light cloth of some 
kind over the head, allowing the child to breathe the steam made by the 
dissolving lime. This has been known to save life after all other means 
had failed. 



CHAPTER XX 

DISEASES OF THE LUNGS. 



CONGESTION OF THE LUNGS. 

Symptoms. The symptoms of congestion of the lungs vary greatly, 
according to the condition of the lungs and the degree of congestion 
The lower grades of acute congestion only cause a sensation of oppression 
with shorter and more hurried breathing, at times passing away rapidly, 
at other times more slowly, or having remissions, but being otherwise 
painless. In the higher grades, the breathing suddenly becomes oppressed 
to an extraordinary degree, so that the patient seems on the point of suf- 
focation. The respiration is hurried, superficial, noisy ; the pulse increases 
in frequency and fullness, the face looks flushed. Most commonly these 
symptoms are associated with a deske to cough, and the frothy sputa are 
tinged with blood. There is no pain, if the lungs are otherwise sound, 
whereas, consumptive persons experience a great deal of pain. In the 
highest grades of congestion, the dyspnoea (difficult breathing) increases so 
rapidly, and the congestion becomes so great, that the patients die of 
asphyxia, sometimes so suddenly that an accident of this kind has been 
termed apoplexy of the lungs. 

The lesser grades of the affection, generally, terminate sooner or later 
in complete recovery. 

Passive congestion has almost the same symptoms as the active form, 
great oppression of breathing, red face, accelerated action of the heart. 

The prognosis in the acute congestion is almost always favorable; con- 
gestions caused by violent emotions are the least promising. A frequent 
repetition of the attacks is always a very bad sign ; they show that either 
the heart is intensely diseased, or else that consumption is their exciting 
cause. 

ALLOPATHIC VIEWS. The treatment of acute congestion of the 
lungs does not differ in the first place, if it be general, from that given fur- 
ther on in this chapter for the invasion of acute bronchitis (see page 390;) 
or if the congestion be limited to one (or more) lobes of the lung, the 
treatment will be the same as that of pneumonia during the stage of 
invasion, (which see). Should the disease not end at once, the subse- 




THE HEART AND LUNGS, SHOWING THE BLOOD VESSELS IN THE LUNGS : 
THE BUPTUBB OF ANY ONE MAY CAUSE SPITTING OF BLOOD. 



CONGESTION OF THE LUNGS. 401 

quent treatment will be that for bronchitis or pneumonia, whichever the 
affection proves to be. If the congestion produces hemorrhage, the treat- 
ment given for hemorrhage from the lungs should be used, (see page 3S0). 

Cold may be applied for the relief of acute congestion in the same way 
as hereafter directed in hemorrhage from the lunirs. 

A passive congestion in the lungs may arise from any cau3e which 
obstructs the return of blood through the pulmonary veins to the heart. 
In asthma or emphysema of the lung (dilation of the air-cells of the. 
lung) imperfect oxygination of the lung causes passive congestion in the 
pulmonary circulation. A diseased condition of the mitral orifice of the 
heart, which obstructs the flow of blood, or allows the blood to regurgitate 
from the left auricle into the right ventricle, is another cause. Tumors 
pressing on the pulmonary veins may be another cause. In other instan- 
ces the whole veinous system will become congested and the skin livid. 
Dropsy will occur in the case of heart disease, or an obstructive tumor. 
The treatment will have reference to the relief of the disease causing the 
obstruction. 

It should be borne in mind, that the congestion is in an entirely differ- 
ent part of the circulation in acute congestion of the lungs, which is in 
the nutrient circulation from the bronchial arteries, and, in passive con- 
gestion which is from obstruction to the return flow of blood, which 
passes through the lungs for the purpose of being purified. 

H03ICE0PATHIC TREATMENT. The main remedy for all active con- 
gestions of the lungs is undoubtedly Aconite. Aconite is particularly 
appropriate in congestion depending upon heart affections, or indicating 
and accompanying Consumption ; such individuals have a delicate skin, 
bright complexion and sanguine temperaments. If the disease was 
caused by a fit of anger, or vehement chagrin, or mortification, Aconite is 
indicated so much more fully. 

Dose : Six pills in a teaspoonful of water, every hour to three hours. 

Belladonna has, likewise, many symptoms pointing to pulmonary 
congestion, but it is not so easy to determine the conditions for which 
Belladonna is indicated; they, likewise, occur less frequently. Belladonna 
is preferable, if not only the lungs, but, likewise, the brain is involved in 
the congestion, and it is less depending upon disease of the heart than 
upon some other affection. Leading symptoms distinguished from those 
of Aconite are : dark redness of the face, bluish redness of the lips, glist- 
ening eye; anguish and restlessness; a constant, dry, hacking cough, or 
else a spasmodic and dry cough. 

Dose : As for Aconite. 

Xux-vomica is an excellent remedy for certain kinds of pulmonary 
congestion, if the following conditions prevail : The attack is occasioned 
by sedentary habits, excessive mental efforts, the use of coffee, ardent 
spirits, in tne case of sanguine, robust individuals who are free from dis- 
ease of the heart; after a copious meal in the night. The symptoms 
resemble those of Belladonna more than they do those of Aconite. 

Dose: As for Aconite. 

Difjitalis-purpurea is inappropriate, in an Isolated attack, but is, 
on the other hand, indicated, if the congestions occur very frequently, or 
evidently point to tuberculosis. In such affections, however, there is 

26 



402 DISEASES OF THE LUNGS. 

every reason why the medicine should be given very cautiously. It is 
not absolutely necessary for the heart to be the starting point of the dis- 
ease, for uncomplicated, tubercular congestions of the lungs are, likewise, 
most easily relieved by Digitalis. 

Dose: As for Aconite. 

Bryonia is the next best remedy to this latter drug. In very acute 
cases, which may become dangerous to life by the premature superven- 
tion of an acute oedema of the lungs, no time should be lost, unnecessarily, 
by awaiting the effect of the first named three remedies ; if they act at 
all, they will show their curative influence after the very first dose. If 
they do not afford speedy relief, Phosphorus should at once be used; or, 
in case of heart affections, Arsenicum. 

Dose : Six pills every two hours. 



SPITTING OF BLOOD— DISCHARGE OF BLOOD FROM 
THE LUNGS-RUPTUBE OF A BLOOD-VESSEL. 

Symptoms: Expectoration of blood, in greater or less quantity, 
induced by coughing, attended by symptoms more or less severe. 

Various Forms. This disease discovers itself in three varieties : 
First, by an effusion of blood from the mucous lining of the air-tubes; 
secondly, by congestion of the lungs; and, thirdly, by the rupture of a 
blood-vessel in the tubular cavity of the lungs, during the course of con- 
sumption. It is, however, proposed to deal, generally, with the subject, 
and to point out the different remedies found useful in the treatment, 
according to the symptoms present. 

Distinctive Characteristics. We must be careful not to con- 
found this disease with affections of the mouth or gums, or the occur- 
rence of discharge of blood from the nose, escaping through the posterior 
opening of the nostrils, and being returned by the mouth. When the 
blood proceeds from the chest, it is, almost invariably, attended with a 
sensation, as if it came from a deep-seated source, is warm, generally 
tastes sweet, and there is, frequently, a simultaneous burning, and pain- 
ful sensation in the chest. 

Precautions to be Observed. When the attack is imminent, and 
is preceded by well-known premonitory symptoms, the patient should 
refrain from loud or prolonged speaking, calling, singing, blowing wind 
instruments, violent exercise of the arm, running, ascending stairs, or, in 
short, from anything calculated to increase the respiratory action, or 
otherwise, to fatigue the chest. 

Issue and Results. When spitting of blood occurs, in a robust and 
healthy person, of sound constitution, it is not very dangerous; but when 
it attacks slender and delicate persons, it is more serious and difficult of 
removal. It is, however, chiefly when the patient has had a succession 
of severe attacks, and the blood is discharged in a large quantity, that the 
case may be considered dangerous. 

Symptoms. The disease may present itself without any marked pain 
or difficulty of breathing, and pass off with no return of the attack ; or 
be preceded by dry cough, oppression, or tightness at the chest, shivermg 

;reat lassitude, and high pulse — and beaccom- 



SPITTING OF BLOOD. 403 

panied by hacking or husky and distressing cough, anxiety, quick pulse, 
pale and livid countenance— cease, and then return in a few hours, and 
be followed by difficulty of respiration, and cough; in still more severe 
cases, when a marked tendency to consumption exists, the anxiety, 
oppression at the chest, and febrile symptoms are more severe, pure blood, 
is coughed up, and the paroxysms frequently return. 

Rupture of a Blood-vessel. [The rupture of a blood-vessel is a 
rare occurrence, although it sometimes occurs in consumption. When, 
however, a blood-vessel of any consequence, included in a tuberculous 
excavation, does give way, the result is generally fatal.] 

Causes. Indulgence in spirituous beverages, overheating the body 
by immoderate exertion, or too great external heat ; blowing wind-instru- 
ments; contusion of the chest or back ; falls; injury of the lungs; breath- 
ing a vitiated atmosphere, or vapors charged with acrid substances ; colds 
or coughs ; violent mental emotions ; diseased state of the lungs ; whether 
■ as the immediate result of inflammation or during the progress of actual 
consumption ; a general scrofulous habit ; suppressed menstrual, hemor- 
rhoidal, or other discharges; or repelled cutaneous eruptions. 

ALLOPATHIC TREATMENT. In hemorrhage from the lungs, quiet 
in bed is to be insisted on, the head and shoulders should be raised, the 
food cool, drinks should be cold, and small pieces of ice may be frequently 
taken into the mouth, the voice is not to be used. Food should be simple 
and nutritious. Liquids are preferable to solids, as milk, raw eggs beaten 
up with sugar and water, and beef tea. 

Regarding treatment by medicines, the remedies which are constantly 
on hand, and are appropriate, are Turpentine, Alum, Sugar of Lead and 
Ice. Ten to twenty drops of Turpentine may be given every hour. One 
or two teaspoon fuls of Glycerine, flavored with three or four drops of Oil 
of Gaultheria, will almost completely cover the taste of Turpentine — it 
may be given on sugar. Sugar of Lead may be given in doses of two to 
five grains two to four hours apart. Two to five grains of Alum may be 
given with an equal quantity of sugar every two hours. In case there is 
pain small doses of Opium should be given at the same intervals, as long 
as required ; as, half a grain of Opium, five grains of Dover's Powder, or 
ten or fifteen drops of Laudanum. In applying cold to the chest, large 
linen clotljs may be wrung out of ice water, and wrapped around the chest, 
or, what is better, cold may be applied to the chest and back by means of 
ice-bags. It is unnecessary to resort to this, unless the bleeding is severe, 
especially, if the patient is in good strength. Tight bandaging of a limb 
at its junction with the body, will be serviceable by preventing the return 
circulation. 

Other remedies which are most important are Ergot, Ipecacuanha, 
Digitalis, Gallic Acid, Subsulphate of Iron. 

Ergot may be given in connection with other remedies in doses of one 
or two teaspoonfuls of the powder or fluid extract as often as every half 
hour, if required. The following is a good mixture: Take of Fluid 
Extras;t of Ergot three ounces, Fluid Extract of Ipecacuanha and Deodor- 
ized Tincture of Opium each half an ounce. Mix. 

Dose: A teaspoonful every half hour or hour. 



404 DISEASES OF THE LUNGS. 

Or, Take of Fluid Extract of Ergot an ounce, Fluid Extract of Ipecac- 
uanha, Fluid Extract of Digitalis each half an ounce. Mix. 

Dose: From thirty drops to a teaspoonful, as is required. 

It will be observed in the use of Ipecacuanha, in frequently repeated 
doses, for hemorrhage, that when vomiting occurs the bleeding ceases. 
Digitalis is especially serviceable when a little bleeding occurs constantly 
with the expectoration, with an occasional mouthful of blood. Gallic 
Acid, in doses of ten grains with ten drops of Aromatic Sulphuric Acid 
in a wineglass of water, is a valuable internal astringent in cases of hem- 
orrhage. This dose may be repeated every two hours. The solutions of 
Sub-Sulphate of Iron, in doses of twenty drops in Glycerine, have proved 
effectual. 

Astringent inhalations are a very useful form of medication, given 
from an atomizer or spray apparatus. The following solutions may be 
used for atomizing: Tannin twenty grains to the ounce of Distilled 
Water ; Alum in saturated solution ; and the solution of the Sub-Sulphate 
of Iron from ten drops to half a dram, in an ounce of distilled water. 

Persons who have hemorrhage from the lungs may be saved a great 
deal of unnecessary alarm by a knowledge of the fact, that the trouble, of 
itself, very seldom leads to serious results. Aside from the fact that it is a 
symptom of tuberculous or some serious disease, no uneasiness need be felt. 

HOMOEOPATHIC TREATMENT. In by far the greater number of 
cases the discharge or spitting of blood soon ceases of its own accord ; the 
most important object, therefore, is to seek tocure the complaint when the 
hemorrhage has ceased, and thereby to prevent its return, or to check the 
development of organic disease of the lungs (that is, disease attended with 
alteration of structure.) 

Pulsatilla, Cocculus, Sepia, Sulphur. One or more of the last 
three of these remedies will sometimes be required, successively, after 
the previous employment of Pulsatilla, when this remedy is insufficient, 
to restore the regularity of the periodical discharges, and the spitting of 
blood is associated with suppression of the menses. 

Pulsatilla is, however, the medicine which is most appropriate 
wherewith to commence treatment, in the majority of cases arising from 
suppression of the monthly discharge in females, or of a hemorrhoidal 
flux in either sex, (particularly when the individual is of leuco-phlegmatic 
temperament,) and also in other instances characterized by the following 
symptoms : expectoration of dark, clotted blood, attended with shivering, 
especially towards evening, or at night, and great anxiety ; pain in the 
lower part of the chest ; feeling of flaecidity in the region of the stomach, 
and weakness. 

Dose: Six pills in a teaspoonful of water night, morning and noon, 
for a week ; then pause four days, after Which the course may be 
resumed as before, if necessary, and so on, until change. 

Refer also to the articles on "Greensickness" and "Suppression of 
the Menses." 

Bryonia is a good remedy in cases where the expectoration of blood, 
which is often in a coagulated state, is excited by a tickling cough ; and 
where there is oppression at the chest, with frequent necessity to take a 
deep inspiration ; anxiety and irascibility. 

Dose : In every respect as directed for Pulsatilla. 



SPITTING OF BLOOD. 405 

Xu.r-romica is adapted to individuals of an irritable temper, in 
whom this affection owes its origin to a hemorrhoidal suppression, a fit of 
passion, or exposure to cold. It is further indicated by dry cough, which 
causes headache, with excessive tickling in the chest, and exacerbation 
of the symptoms towards morning. 

Dose: Four pills in a teaspoon ful of water, night and morning, for a 
week, then pause four days, after which repeat the same course, if 
yet requisite, and so on until permanent relief or change ensues. 

Rhus. When the blood expectorated is of a bright-red, the mind 
much agitated, and the patient irritable and rendered worse after the 
slightest vexation or contradiction. 

Dose : In all respects as directed for Nux-wmica. 

Am ica-montana is principally useful in cases arising from exter- 
nal injury, such as a severe blow on the chest, or from lifting a heavy 
weight, or any other exertion, even blowing wind instruments; but, also, 
in almost all cases, where the stethoscope detects effusion of blood into 
the air-cells, attended with a sensation of constriction, and burning in the 
chest, pain as from contusion in the back and shoulder-blades, and diffi- 
culty of breathing. Moreover, profuse expectoration of dark-colored 
blood or clots, brought up without much exertion, or bright, frothy blood, 
mixed with mucus and clots ; sensation of tickling behind the breast-bone, 
general heat, great weakness and fainting. 

Dose: Of a solution of eight pills to three tablespoonfuls of water; 
give a teaspoonful every hour, until six doses have been given, and 
then every six hours, until manifest improvement or change. 

Treatment of Very Severe Cases. Aconitum is often found 
most serviceable in warding off an attack, by the great power which it 
posesses in controlling the circulation, and is indicated, previous to the 
paroxysm, by the premonitory symptoms of shivering, with accelerated 
pulse, palpitation of the heart, a sensation of ebullition of blood in the 
chest, with burning and fullness in the same region; paleness, and 
expression of anxiety in the face; great anguish and anxiety, aggravated 
by lying down; or during the attack, when the expectoration is profuse, 
coming on in gushes, and excited by a slight, dry cough. 

Dose: Four pills in a teaspoonful of water, repeated at intervals of 

two hours, until manifest change. 
Ipecacuanha is required when a taste of blood remains in the 
mouth a few hours after the employment of Aconite has been commenced, 
and there is frequent cough, with nausea, weakness, and expectoration 
streaked with blood. In some instances, in which neither this remedy nor 
Arsenicum avails singly to subdue the symptoms, the altei'nate adminis- 
tration of both has been resorted to with admirable results 

Dose: If singly* six pills in a teaspoonful of water, repeated at inter- 
vals of an hour, until change. If in alternation with Arsenicum, a 
solution of ei<rht pills of each, separately, to four teaspoonfuls of 
water, administered by teaspoonfuls every half hour in rotation, 
until manifest improvement or change. 
Arsenicum becomes necessary when the anxiety, anguish, and pal- 
pitation of the heart increase, notwithstanding the previous administration 
of Aconite or Ipecacuanha (or both;) and when, in addition, we find 
extreme restlessness, and general, dry, burning heat. 

Dose: If singly, four pills in a teaspoonful of water every hour. If in 
alternation with Ipecacuanha, as directed for that medicine, above. 



406 DISEASES OF THE LUNGS. 

Sulphur* followed by the subsequent administration of Arnica, is of 
essential service in cases in which the spitting of blood recurs, after 
having previously yielded (with the associated symptoms) to the action of 
the foregoing medicines. 

Dose: Three pills of sulphur in a teaspoonful of water, repeated in 
three hours, and followed by a pause of six hours, and then by the 
consecutive administration of similar doses of Arnica every three 
hours, until manifest improvement or change results. 
China is one of our best remedies in restoring the vital energies of 
the patient, after considerable loss of fluids, whether blood or other secre- 
tions; it is, therefore, particularly efficacious after a severe attack of this 
affection; but it is, also, indicated during its course, when the spitting of 
blood takes place after a violent cough, or when there is a continual taste 
of blood in the mouth, or when we find shivering alternately witli access 
of heat, frequent, and short-lived perspirations, tremor, and confusion of 
vision, with a sensation of vacuity, or lightness in the head, weakness, and 
desire to remain constantly recumbent. 

Dose: If against actual discharge of blood, give six pills in a teaspoon- 
ful of water, every hour, until change. If as a restorative agent after 
an acute attack, give four pills in a tablespoonful of water, night and 
morning, until manifest improvement or change. 
Ferrum- metallic am may be exhibited with advantage after China, 
in severe cases, and when the fourth dose of the last named medicine has 
been productive only of partial effect ; or may be preferred if the expec- 
toration follow a slight cough, and is scanty, but consists of pure bright- 
red blood, attended with pain between the shoulder- blades, with inability 
to remain long in a sitting posture ; the patient feels the concomitant symp- 
toms relieved by movement, but is speedily fatigued, especially, by con- 
versation. 

Dose : If against actual discharge of blood, six pills ; if as a restorative 
remedy, four globules, as directed for China. 

HOME REMEDIES. Salt, freely used by taking in the mouth, will 
frequently stop the bleeding. 

The following has permanently cured many cases where the bleeding 
was so profuse as to apparently leave no hope: Take Spikenard-root one 
pound, Liquorice root one pound, Comphrey root one pound, Horehound 
four ounces, Hops four ounces, Bloodroot {Sang ulnar ia) one-half ounce, 
Water five gallons. 

Boil in an iron kettle, until reduced to one gallon, strain through a 
woolen cloth, and boil the liquor down to one-half a gallon. Then add 
one and one-half pints strained honey, and three pounds loaf sugar, boil 
three minutes. 

Dose: One tablespoonful three times each day. 



ACUTE BRONCHITIS-INFLAMMATION OF THE MUCOUS 
MEMBRANE OF THE BRONCHIAL TUBES. 

History. Acute bronchitis is one of the most frequent diseases of 
the human kind generally. It is not, generally, a dangerous disease when 
attacking middle-aged persons; it is, on the contrary, very dangerous to 
children and old people, and therefore, constitutes one of the most im- 



ACUTE BRONCHITIS, 407 

portant diseases of these two periods of human existence. It is unde- 
niable that the first years of childhood, are peculiarly predisposed to this 
disease. A predisposition of this kind, likewise, exists among- persons of 
a more advanced age, and may almost always be attributed to the follow- 
ing circumstances : An effeminate mode of living, without adequate exer- 
cise iu the open air, and not admitting of a free, and easy respiration; con- 
stitutional diseases, even such as do not emaciate and debilitate the 
system, more especially scrofula and consumptive irritability of the mucous 
membrane in consequence of frequent attacks of bronchitis; acute and 
chronic diseases of the lungs. 

The exciting causes cannot well be traced with positive certainty. A 
cold and consequent suppression of the perspiration is, undoubtedly, one of 
the most ordinary causes, but not quite as common as is generally sup- 
posed. The atmosphere doubtless exerts a powerful influence, not only in 
consequence of rapid changes in the temperature, but principally through 
the changes in atmospheric electricity, and, as modern investigations seem 
to have confirmed, through consequent changes in the amount of ozone in 
the atmosphere. This becomes so much more probable, if we observe that 
a large number of cases of bronchitis are not so much caused by a damp 
and cold, as by a dry and cold wind, such as prevails in our region of 
country when the wind blows from the northwest and north. If the tem- 
perature of the wind were the main cause of the trouble, an east wind 
would cause bronchitis most easily, which is certainly not the case. An epi- 
demic bronchitis spreading over a large tract of country, and being even 
considered contagious, the so-called influenza or grippe, depends upon 
conditions which we designate as miasmatic, but of the true nature of 
which we are as yet ignorant. Secondary bronchitis develops itself secon- 
darily in persons afflicted with heart disease, congestion of the lungs or 
during the presence of acute exanthems (measles, scarlet fever, etc.,) or 
various intensely acute constitutional diseases. 

The lighter form of bronchitis, generally designated as bronchial 
catarrh, frequently sets in without any fever; at any rate, generally, it is 
scarcely perceptible; sometimes no fever at all is present, or the fever is at 
most indicated by a succession of creeping chills. This form of bronchitis 
scarcely ever exists isolated, but is almost always attended with catarrh 
of the nose and larynx. After experiencing a feeling of malaise for several 
hours, and a marked sensation of languor, the patients are attacked with 
a dry and spasmodic cough, attended with a raw or sore feeling in the 
chest; at the same time the breathing is somewhat oppressed, and there is 
no expectoration at the outset of the disease. The appetite is less, but not 
gone, the tongue is not always coated; the patients are able to remain up, 
but feel drowsy, and often complain of violent headache. Very often the 
cough remains dry for a long time, but more frequently a tenacious, 
greenish-yellow scanty expectoration commences on the second day, which 
it is very difficult to hawk up. At the end of three to nine days, very rarely 
at a later period, and then only if the patients neglect themselves, the expec- 
toration becomes more copious, whiter, lumpy, and is raised more easily, 
the normal feeling of health is restored, and, while the cough is gradually 
decreasing, the disease passes off. The attack seems so slight, that many 
patients go about as usual, but, by pursuing this course, expose themselves 
to relapses, which are very apt to take place and beget a tendency towards 



408 DISEASES OF TIIE LUNGS. 

the inflammatory form of bronchitis, or else originate the consequences 
that will be more fully described in a subsequent paragraph. 

INFLAMMATORY OR ACUTE BRONCHITIS- 

This form of bronchitis, which is marked by much more violent phe- 
nomena, is not, by any means, a purely simple form of bronchitis of a 
higher degree of intensity. It does not, ordinarily, result from an existing 
catarrh of the upper respiratory organs, unless the catarrh is suddenly and 
violently increased by severe neglect; but, most generally, it occurs as a 
primary disease. It generally commences with a violent chill, which is 
distinguished from the chill that initiates acute inflammations, by the cir- 
cumstances that it is not followed by as high an increase of temperature, 
and that there is a frequent recurrence of the chill, especially, on motion. 
The patient feels very weary and languid, complaius, mast generally, of a 
violent headache, exhibits frequent changes of complexion, experiences a 
rheumatic drawing in the limbs, and great restlessness, and is scarcely ever 
.Capable of remaining out of bed. Very soon these general symptoms, 
which do not point out more particularly the locality of the disease, are 
followed by a burning, sore pain in the chest under the sternum at every 
deep inspiration, which is felt more severely when coughing. The cough 
sets in at the same time as the pain is felt; it is more or less violent, some- 
times spasmodic, at first dry, but not hoarse, but very soon accompanied by 
the above-described expectoration. There is no dyspnoea, properly speak- 
ing, but the breathing is more labored, less full, and hence somew r hat more 
hurried. The pulse is accelerated, bui it is only in the severe grades of 
the disease that it exceeds one hundred pulsations. In this form of bron- 
chitis, the digestive organs are always involved, the appetite is entirely 
gone, the bowels are constipated, there is seldom any vomiting. 

Even in simple bronchitis, when not complicated with tubercles, the 
expectoration is easily tinged with blood, whereas, raising a quantity of 
pure blood is a rare occurrence, and always points to a more dangerous 
and more deep-seated constitutional disease. All the phenomena, espe- 
cially the cough, exacerbated in the evening, and about midnight. The 
further course of the disease is governed by a variety of circumstances. 
The. importance of bronchitis of any degree in the case of tuberculous 
consumptive patients; will be more fully inquired into when we come to 
treat of consumption. 

In favorable cases, uncomplicated forms of bronchitis terminate in 
four or five days, or, exceptionally, at an earlier period, in simple bronchial 
catarrh. The general symptoms moderate in intensity, the fever abates 
almost entirely, the expectoration becomes more profuse, more fluid, of a 
whitish-gray color, and is more easily raised by the cough, which is now 
much less painful. The patients do not often feel well again before the 
tenth day. If the course of the disease is less favorable, its different 
phases are either more protracted, or else other morbid conditions become 
associated with it. In the former case, the dry, spasmodic, distressing 
cough may last beyond the seventh, or even to the fourteenth day, after 
which the period of a more profuse secretion of mucus lasts equally long. 
Although this longer duration of the disease shows, as a rule, that it is of 
a secondary nature, yet a purely primary form of bronchitis may run an 
equally long course, an occurrence peculiar to old age. 



ACUTE BRONCHITIS. 409 

The patient's age exerts a greatly modifying influence over the course 
of the disease, as well as over its danger to life. Among old people, or 
only somewhat advanced in age, the danger is quite considerable, and 
seems to depend more particularly upon the increased liability of the 
bronchial mucous lining to swell; upon the profuse quantity of the secre- 
tion at the same time as the respiratory process becomes feebler, and upon 
the consequently increased danger of oedema of the lungs. 

Hence the bronchitis of old people differs greatly from that which we 
have described in the preceding paragraphs. The disease originates in the 
same manner, only the fever symptoms seem to be less violent. The 
pulse soon becomes smaller and weaker, the skin becomes moist and cool, 
the tongue dry and brown, and the senses are powerfully affected by the 
disease; sopor, delirium and grasping at flocks, setting in. In this man- 
ner the patient may succumb to the disease in a few days, the increase of 
the mucus rales (rattle) and the decrease*, and final and total cessation of 
the expectoration, constituting the most ominous signs of approaching dis- 
solution. 

One of the most common terminations of bronchitis is chronic bron- 
chial catarrh, which succeeds the acute form the more rarely, the younger 
and healthier the individual. 

Having described the other forms of bronchitis, we here devote a few 
lines to a description of infantile bronchitis, which, as regards its course 
and importance, differs most essentially from the corresponding bronchitis 
of adults. 

In inflammation of the larger bronchial tubes, be it slight or severe, 
has almost the same phenomena in the case of children, as in that of 
adults, except that the fever is much more violent and the breathing, is in 
almost every case, interfered with very considerably, at an early period. 
The importance of this process, in the case of children, is much greater 
than in that of adults, for the reason that in the former it is apt to spread 
to the smaller bronchial tubes, after which the children, who at first gave 
no cause for alarm, suddenly appear attacked by % dangerous disease. 

The symptomatic development, generally* takes place as follows: 
After the children have had for some days a simple catarrh, attended with 
severe fever, the breathing becomes more hurried and, progressively, more 
oppressed, and the children become more and more restless and anxious. 
The respiration, during inspirations as well as expirations, now becomes 
wheezing, more especially during an inspiration. The cough continues to 
increase in vehemence, without anything being expectorated ; or, if any- 
thing is raised, it is only with great difficulty a small quantity of mucus, 
which is swallowed again as soon as raised. The general organism, 
in such a severe disease, is, of course, correspondingly affected. The diffi- 
culty of breathing now increases from hour to hour, and soon reaches a 
degree of intensity that is in no respect inferior to the worst attack of 
croup, and becomes still more distressing in consequence of the unceasing 
efforts on the part of the children to obtain relief by coughing. The pulse 
becomes frequent and small, the skin on the extremities and head is 
covered with perspiration, the face is pallid or livid, becomes bluish dur- 
ing an attack of cough, the anxiety and restlessness reach the highest 
degree of intensity. If, at this stage of the disease, there is no improve- 
ment, by an increase of the expectoration and a relief from the difficulty of 



410 DISEASES OF THE LUNGS. 

breathing, the disease presents the same picture as in the last stage of 
croup, only the hissing sound caused by the stricture of the glottis is want- 
ing. The children become calmer, pallid and cool ; they are lying in a 
state of unconsciousness or sopor, the respiration becomes very superficial, 
the paroxysms of cough abate more and more, and the children die coma- 
tose. This fatal termination sometimes takes place in the first week of 
the disease, less fequently, after the fourteenth day. 

Recovery always takes place slowly, the liability to relapses is very 
great; the strength does not easily return, and the cough sometimes con- 
tinues for many weeks. The diagnosis is only difficult in the case of very 
small children; here the characteristic cough is almost always entirely 
absent; in general, the reaction against the disease is either slight or non- 
apparent. The prognosis is the more doubtful the younger the patient; 
That dentition complicates the prognosis cannot be taken for granted, 
the greater liability to the disease, at this period, is probably owing to the 
increased susceptibilities of the infantile organism. ,» 

ALLOPATHIC TREATMENT. A common catarrh or cold affecting 
the bronchial tubes, is known to physicians as acute bronchitis. It fre- 
quently begins as a coryza (catarrh or cold in the head) and may often be 
cut short by a full opiate and a diaphoretic (medicines which produce 
sweating). A remedy which fulfills these indications the best is the 
Dover's Powder (Compound Powder of Ipecacuanha.) It may be given in 
doses of ten to fifteen grains at bed-time. Twenty or thirty drops of Laud- 
anum, a quarter of a grain of morphine, or half a grain of Codia may be 
given instead. The proper time to take this remedy is before going to bed. 
It should be accompanied with a hot foot bath, and a copious drink of gin- 
ger tea. The next morning a free cathartic should be given, as a Seidlitz 
Powder, or a tablespoonful of Rochelle Salts in lemonade, or a tablespoon- 
ful of Citrate of Magnesia, or a tablespoonful of Epsom Salts. (The dis- 
agreeable taste of Epsom Salts is removed by boiling with one-third of its 
bulk of roasted coffee in an earthen vessel for a couple of minutes, then 
let it draw a few minutes and strain.) This plan of treatment is effectual 
in stopping or lessening the effects of a cold. 

If the disease becomes established, it will yield more readily, if the 
patient remains in bed, to secure uniform warmth and moisture of the 
skin. 

In severe cases, the room should be charged with steam in the man- 
ner described for croup. 

If there is much pain or soreness of the chest, a mustard plaster, or a 
liniment of one part of Aqua Ammonia, two parts Olive Oil, and one 
part Spirits Turpentine, will be found useful. Spirits Turpentine, alone, 
or with an equal part Spirits Camphor, may be used for this purpose, 
with equal benefit. 

Three to ten drops of the Fluid Extract, or teaspoon ful doses of the 
Syrup of Ipecacuanha, or ten drops to half a teaspoonful of Hive Syrup, 
can be given at such intervals, through the day, as will keep the skin 
slightly moist. 

Morphine, in doses of a twelfth to an eighth of a grain, or Paregoric, 
in closes of a teaspoonful, may be given three or four times, or oftener, 
during the day, to relieve cough. 



ACUTE BRONCHITIS. 411 

I find a mixture of equal parts of Paregoric, Tincture of Hyoscyamus 
ond Fluid Extract of Wild Cherry Bark, in doses of one or two teaspoon- 
fuls, an exceedingly efficacious remedy for the relief of cough in all forms 
of bronchitis; if the Fluid Extract of Wild Cherry Bark has been 
deprived of astringency as is done by Chapman, Green & Co., of Chicago, 
the remedy is an agreeable one to take. 

In case there is fever with the attack, or much secretion of mucus, 
Aconite may be used with the best effect, and is not incompatible with 
other treatment, which may be needed. The Tincture of Aconite may 
be given in doses of half a drop, or a drop, every half hour, until an 
impression is made on the fever movement, and then continue in doses 
of a drop every hour, or two or three hours. In the continued use of the 
Aconite, if the bronchial secretion is very profuse, the Tincture of Bella- 
donna may be given with it, as follows: Take of Tincture of Aconite a 
dram, Tincture of Belladonna two drams. ' Mix. 

Dose: Three or four drops from one to three hours apart. 

If the inflammation linger, and appear disposed to become chronic, 
Quinine should be given in doses of two or three grains three times a day. 
If the patient is pale and feeble, fifteen or twenty drops of the Tincture 
Muriate of Iron should be given, with a dessertspoonful of a Saturated 
Solution of Chlorate of Potash, in Syrup enough to make a pleasant mix- 
ture, after each meal. The diet should be nutritious. 

Warm clothing, hearty food, and life in the open air, are the best pre- 
ventives against " taking cold." 

Acute Buonchitis. Some points in the treatment of acute bron- 
chitis, in young children, require special consideration. 

Young children do not expectorate (throw the phlegm oft" from the 
bronchial tubes,) and suffocation may be caused from its accumulation. 
This may be supplied in the act of vomiting. An occasional emetic 
should, therefore, be given. Teaspoonful doses of the Syrup of Ipecacu- 
anha are appropriate. Or one or two grains of Powdered Ipecac may be 
given in water, and repeated every fifteen minutes, until vomiting occurs. 
Alum may be given, with Ipecac, in doses of a teaspoonful, if vomiting 
does not soon produce an emesis. 

The emetic should be repeated every day, or oftener, or when the 
breathing becomes impeded by the accumulation of phlegm. After vom- 
iting is produced, no nauseant medicines should be given until vomiting 
is again required. A warm bath should be given at the commencement 
of the disease. This, with an emetic in the first twelve hours, may cut 
the attack short. 

The chest should be wrapped with a flannel saturated with Cam- 
phorated Oil (Olive Oil containing twenty or thirty grains of Gum Cam- 
phor totheounce.)and this covered with oiled muslin. If this oil does not 
redden the skin, a little Turpentine may be added, until it does; or a 
thin poultice made of flaxseed meal, containing one-sixteenth part of 
pulverized Mustard, may be applied to the chest, and covered with oiled 
muslin. 

The bowels should be moved, regularly, and if this does not occur, 
naturally, a laxative .should be given. Castor Oil, with an equal quantity 
of Glycerine, flavored with a couple of drops of Oil of Gaultheria, or Cin- 



412 DISEASES OF THE LUKGS. 

namon, to each dose, may be used for this purpose, in doses of one or two 
teaspoon fuls. 

For constitutional treatment, the following formula may be used: 
Take, of Syrup of Squills two drams, Acetate of Potash half a dram, Syrup of 
Tolu, and Anise Watei\ each seven drams. Mix. 

Dose: For a child of six months or a year, a teaspoonful every three 
or four hours. 

Twenty or thirty drops of Tincture of Bloodroot may be added to 
this formula. 

If the kidneys, or skin, are not acting freely, twenty or thirty drops 
of Spirits Mendirerus may be given at the same time, or separately. 

Opiates ought not to be given with any freedom, but if there is much 
cough or restlessness, it should be relieved with from fifteen to thirty 
drops of the mixture of Paregoric, Hyoscyamus and Wild Cherry Bark, 
as spoken of in the treatment of adults, at such intervals as is required; it 
may be given in the syrup above mentioned. 

If there is much fever, and the child is two years old, or over, eight 
to twelve drops of Tincture of Aconite Root may be, also, added to the 
above syrup mixture. 

The patient should be allowed the breast, freely, and have, in addi- 
tion, if that is insufficient, creamy milk, juice of lean meat, or strong 
beef tea. 

The object of treatment, is to supply the lack of expectoration by the 
proper use of emetics, to support the powers of life by nutritious food, 
and diminish the congestion of the bronchial mucous membrane by 
warm and mildly irritating applications, and by diaphoretics, laxatives, 
and, last and least, anodynes. 

Capillary Bronchitis. The treatment of capillary bronchitis, 
(i.e., in the small bronchial tubes,) does not differ, essentially, from the 
treatment of ordinary bronchitis, except that as the disease is infinitely 
more grave, much more attention must be given to supporting the 
strength of the patient, and, in children, relieving the lungs of mucus, 
by the use of emetics. 

When the fever runs high, Aconite should be given as before directed. 
In capillary bronchitis, Snakeroot, Carbonate of Ammonia and Iodide of 
Potassium, seem, especially, useful. 

Take of Fluid Extract of Snakeroot an ounce, Carbonate of Ammonia a 
dram, Iodide of Potassium a dram and a half, Syrup of Tolu and Water, 
each an ounce and a half Mix. 

Dose: A teaspoonful for a child, and a tablespoonful for an adult, 
three or four hours apart. 

HOMCEOPATHIC TREATMENT. Aconitum. Marked indications 
are, hot, dry skin, with strong, hard, and accelerated pulse ; roughness of 
the voice ; short, dry, and frequent cough, excited by tickling in the 
throat and chest; obstructed respiration, wheezing or sonorous noise in 
the chest ; anxiety, restlessness, headache, and thirst, with occasional 
scanty expectoration of a sticky phlegm. 

Dose: Of a solution of six pills to two tablespoonfuls of water, give 
a teaspoonful, repeated at intervals of an hour, until the indicative 
symptoms are allayed. 

Bryonia is of great service, in a large number of cases of bronchitis, 
at the commencement of theattack,andshould be administered two hours 



ACUTE BRONCHITIS. 413 

after the third dose of Aconitum, in the event of the unmodified con- 
tinuance of the fever symptoms— the following indications being present: 
laborious, rapid, and anxious breathing, with constant inclinations to 
make a deep inspiration; hoarseness; headache; dry cough, attended 
with a burning, pricking pain, extending from the throat to the middle 
of the breast-bone; or cough, day and night, with scanty and difficult expec- 
toration of viscid white or yellow-colored phlegm, in some instances tinged 
with blood ; wheezing; dryness of the mouth and lips; hot, dry skin, or 
dryness of the skin during the day, and copious perspiration at night; 
excessive thirst. When a pain, as if arising from the effects of a bruise, is 
experienced under the breast-bone, with aching and sensation, as if the 
contents of the cranium would be forced through the forehead, after each 
fit of coughing, or when the breathing is impeded by shootings in the 
chest, and the affection threatens to become complicated with pleurisy, 
this remedy is still more particularly called for. 

Dose: A solution of six pills, as directed for Aconitum. 

Spongia is often of great service after the previous administration of 
Aconite, when there still remains a considerable degree of inflammation 
in the air-tubes, especially the larger, with wheezing or sonorous noise 
in the chest; and, also, at a more advanced stage of the disease, when rat- 
tling of mucus is distinctly audible; hollow, dry cough day and night, 
but worse towards evening; or cough with scanty, viscid, ropy expector- 
ation ; heat in the chest ; burning, tickling irritation in the top of the 
windpipe; quick, anxious, laborious respiration; inability to breathe 
unless the head is thrown backwards; hoarseness. 

Dose: Of a solution of six pills to two tablespoonfuls of water, give a 
teaspoon ful every two hours. 

Belladonna. This remedy is useful when there is severe headache, 
materially aggravated by coughing; flushed face; oppression of the chest, 
and constriction, as if bound, with loud wheezing and rattling of mucus 
in theair tubes ; short, anxious, and rapid breathing, dry, fatiguing cough, 
especially at night, which is endeavored to be suppressed on account of the 
pains which it creates ; heat of the skin, and thirst ; soreness of the throat. 
Belladonna is often exceedingly efficacious in children, particularly in 
those insidious cases which commence with a slight wheezing, and then 
suddenly become aggravated to such a degree as to threaten suffocation ; 
the heat of the skin being at the same time considerable, and the pulse 
excessively rapid, and sometimes even intermittent. 

Dose : Of a solution of six pills to two tablespoonfuls of water, give a 
teaspoonful every three hours. 

Mercurius. This remedy may, occasionally, be found useful in the 
second or secretive stage, when the symptoms of bronchitis are accom- 
panied by excessive perspiration; when the cough is fatiguing, worse in 
the evening and at night, and excited by a tickling irritation, or sensation 
of dryness in the chest, with quick, short, oppressed breathing, and louder 
breathing than ordinary; hoarseness; cold in the head, with watery, 
acrid discharge ; swelling of the nose. 

Dose: As for Belladonna. 

Phosphorus. This important remedy is frequently of great utility 
in bronchitis, when the more inflammatory symptoms have been subdued 
by Aconite, but the breathing continues much oppressed, accompanied 



414 DISEASES OF THE LUNGS. 

with great anxiety, and heat in the chest ; dry cough, excited by tick J g 

in the throat or chest, aggravated by talking or laughing, and follow jd 

by expectoration of stringy phlegm of a saltish taste. Further, whet, the 

disease has been neglected, or when, from the symptoms which present 

themselves at the commencement, we have reason to dread complication, 

or an extension of the inflammation to the substance of the lungs, there 

will be additional reason for administering Phosphorus. 

Dose: Four pills in a teaspoonful of water every four hours, until 
distinct change. 

Pulsatilla. This remedy is often required in the second or secre- 
tive stage to complete the cure, after the previous exhibition of Aconitum, 
when the acute inflammatory symptoms have been subdued, and the 
expectoration has become thicker and more copious. It may, however, be 
prescribed before or after any of the medicines we have named, especially 
when the disease occurs in persons of mild disposition, or Emphatic con- 
stitution, and the symptoms are as follow : breathing short, accelerated, 
and impeded, attended with rattling of phlegm, heat in the chest and 
anxiety; hoarseness; shaking cough, worse towards evening, at night, or 
in the morning, accompanied with considerable expectoration of tenacious, 
or thick, yellowish phlegm, sometimes mixed with blood; cold in the 
head, with copious discharge of thick, discolored phlegm. 

Dose: Of a solution of six pills to two tablespoon fuls of water, give a 
teaspoonful every two hours, until improvement or change. If 
improvement occur, the intervals should be extended to six hours, 
and the administration thus continued, until the subsidence of the 
symptoms. 

BRONCHITIS IN CHILDREN. 

Chamomilla is often a most useful remedy after the previous exhi- 
bition of Aconitum in cases occurring amongst children, when a slight 
degree of whistling or sonorous noise in thechest still remains; dry cough, 
worse at night, occurring even during sleep. (See also Belladonna) . 

Dose: Four pills in a teaspoonful of water, given every three hours. 

Ipecacuanha is, also, a very serviceable remedy for children, when 
there is wheezing or rattling in the chest, and when on coughing they are 
almost suffocated by the excessive secretion of phlegm, and become livid 
in the face; shortness of breath and perspiration on the forehead after 
each fit of coughing. 

Dose: Same as Chamomilla. 

Arsenicum, should be given two hours after the third dose of Ipecac- 
uanha, if the latter remedy has only been productive of partial benefit, 
and is indeed to be selected in preference to Ipecac, if the following indi- 
cations occur; the pulse very quick, feeble, and irregular, and the patient 
reduced to a state of extreme debility and collapse, the breathing 
obstructed almost to suffocation, and attended with a wheezing and whist- 
ling noise in the chest, cough and hoarseness. 

Dose: Of a solution of eight globules, to four teaspoonfuls of water, 
give a teaspoonful (or two globules dry on the tongue.) at intervals 
of five, ten, fifteen, and twenty minutes, and so on, adding five min- 
utes to the length of each succeeding interval. 

HOME TREATMENT. In the commencement of this disease, the 
patient should take a profuse sweat. After this has continued for three or 
four hours, and then been allowed to cool off, the whole surface of the 



CHRONIC BRONCHITIS. 415 

body should be bathed with a warm, weak ley- water, and then be thor- 
oughly dried. Immediately after this, place mustard poultices to the 
soles of the feet, and along the whole course of the backbone, but be very 
careful not to allow them to blister; and cover the whole chest, or upper 
part of the body, with a fomentation of Hops, Lobelia leaves and Tansy, 
equal parts of each, steeped for a short time in hot water, and applied as hot 
as the patient can bear; this should be changed as often as it becomes 
tepid. If the inflammation continues, this should be repeated every day, 
for three or four days, if the patient's strength will bear it. 

To relieve the cough the following may be used : Take of Flaxseed 
or Slippery Elm Bark, two ounces ; Lobelia leaves, one ounce; Bloodroot 
or Red Puecoon, in powder, two teaspoonfuls ; add to these one quart of 
boiling water, cover the vessel and let it steep near the fire for an hour; 
then, when cold, strain and sweeten with honey or molasses. 

Dose : A teaspoonful of this may be given every hour or two. Should 
this vomit or nauseate too much, the dose must be lessened. 



CHRONIC BRONCHITIS.— CHRONIC PULMONARY OR 
BRONCHIAL CATARRH. 

In the majority of cases, chronic bronchitis owes its existence to one 
or more attacks of acute bronchitis, out of which it arises by gradual 
development. Even as thus arising as a secondary disease, the affection is 
exceedingly frequent, but this frequency is still more increased by the cir- 
cumstance that it accompanies most of the material changes of structure 
in the lungs, particularly, consumption, and that it likewise, occurs as a 
complication of diseases of other organs. The latter occurs more particu- 
larly in diseases of organs, that obstruct the return of the blood from the 
lungs, such as heart disease and affection of the liver. As a primary dis- 
ease, chronic bronchitis is more particularly met with among persons who 
are upwards of forty -five years old; every chronic pulmonary catarrh of 
young people excites a well-founded suspicion that it emanates from some 
other pulmonary disease as its source. Men are ranch more frequently 
afflicted with chronic bronchitis than women; children are seldom 
attacked. In northern climates, chronic pulmonary catarrh becomes much 
more frequent; in the countries with a damp and cold climate it is almost 
endemic; it likewise, prevails among individuals whose business confines 
them to damp and cold places. Persons who have to inhale a good deal of 
dust during their work, such as stone-cutters, millers, and sculptors, are 
likewise, exposed to frequent attacks of chronic bronchitis. Smoking is, 
likewise, a frequent cause of this disease. The use of tobacco causes 
chronic catarrh of the bronchial lining membrane much more frequently 
than one imagines, without any acute attack having preceded the chronic 
form. 

Considering our mode of living, and when affecting persons beyond 
the age of fifty, the milder cases of chronic bronchial catarrh do not pre- 
sent any marked symptoms. The parties cough a little, most generally, in 
the morning, and after that they expectorate some, but assimulation is not 
affected by the disease, nor is the respiratory process interfered with, and 
the condition sometimes remains unchanged for years. The more violent 



416 DISEASES OF THE LUNGS. 

cases, on the contrary, cause constant and most commonly increasing 
trouble. 

After the termination of an acute bronchial catarrh, for chronic 
catarrh seldom sets in gradually, without any preliminary acute stage, 
cough and expectoration remain and continue with slight variations until 
made worse again by another acute attack. The cough is marked by two 
essentially distinct features. If the bronchial secretion is scanty, tena- 
cious and firmly adhering, the paroxysms of cough occur less frequently, 
but in such a case the cough is most severely spasmodic, and not unfre- 
quently leads to gagging and vomiting. The paroxysms occur most fre- 
quently at night, less commonly in the day-time. After violent exertions, 
some of the above-described mucus is expelled; sometimes a little mucus 
is not hawked up till some time after the cough. If the secretion is more 
copious, the cough sets in chiefly in the morning-hours, or after the use of 
warm food; it may continue for a long time, but is not spasmodic, for 
after a few energetic spells of cough, the mucus is detached and expector- 
ated. 

Sooner or later the cough becomes associated with more or less violent 
oppression of breathing, which may even creep along without being per- 
ceived, and corresponds with the increasing thickening of the bronchial 
mucous membrane, a diminution of its elasticity and the copious quantity 
of the secretion. At first this oppression is only perceived by the patients 
when making an effort, during a rapid walk, going up hill; soon, however, 
it is felt even during an ordinary walk, even during rest, and causes a 
great deal of annoyance. In the higher grades of the disease, the patients 
are threatened during the paroxysm of cough with danger of suffocation; 
even between the paroxyms the nature of the existing affection is revealed 
at first sight by the elevated thorax and consequent shortening of the 
neck. The most intense pain, however, is endured by the patients, if an 
acute aggravation of the disease takes place. Under such circumstances, 
they exhibit such a picture of distress, that it seems as though they could 
not possibly live longer than twenty-four hours. These acute exacerba- 
tions occur almost certainly once, at least, every spring and fall, even if 
the patients have not knowingly been exposed, or have not even left their 
room. 

In the beginning, the general organism is not effected by the complaint; 
even tolerably severe forms of this disease are borne for a long time with- 
out any perceptible detriment. Very seldom, and only if the secretion is 
very profuse, emaciation gradually supervenes, in spite of which the 
patients may live, however, for many years. The greatest danger is occa- 
sioned by the influence exerted by the impeded respiration over the cir- 
culation. The functions of the heart become abnormal; the deficiency of 
blood in the lungs and its imperfect aeration, either cause passive conges- 
tion of the lungs, and a corresponding chronic intestinal catarrh, or diturb- 
ances in the functions of the spleen or kidneys, or passive congestion of 
the brain, with its inherent dangers, so that it is not, without reason, that 
a raised thorax and short neck are designated as an apoplectic habit. 

If the catarrh has become an inveterate disease, it is apt to last to the 
end of life; but that such a noble organ as the lungs should be capable of 
bearing for so long a time, even a severe degree of an apparently dangerous 
disease, is indeed remarkable. It is not marasmus, wasting of flesh, the 



CHRONIC BRONCHITIS. 417 

patient need dread, but the constant succession of acute attacks, which 
indeed, are rarely immediately fatal; most patients die of this disease 
amid symptoms of general dropsy. If an acute attack assumes the form of 
capilliary bronchitis or pneumonia, the lives of such patients are indeed 
in extreme peril. 

In recent cases, the prognosis is not altogether unfavorable, so far as 
a cure is concerned ; life is very seldom endangered by such a disease. The 
chances, of course, depend upon what structural changes have taken place, 
and to what extent. The worst omen is heart disease, which almost always 
terminates in dropsy in a very short time. 

ALLOPATHIC TREATMENT. In chronic bronchitis, the general 
health demands attention in the first place. To this end the diet should 
be good and nutritious, but plain; meat, milk, eggs, fowl, fish, and fari- 
naciou3 food will be required. As a rule, alcoholic stimulants are not 
to be used. In case of feeble persons, Quinine and Iron should be 
given. The Quinine may be given in pills, and the Muriate Tincture of 
Iron (the preparation which I prefer) in doses of fifteen or twenty drops, 
largely diluted in sweetened water, three times a day. Cod Liver Oil may 
be called for, and when there is much secretion, the Hypophosphites or 
Phosphates are serviceable in supporting the patient. If the Compound 
Syrups are used, which contain Iron, the Muriate Tincture of Iron need 
not be given : Take of the Compound Syrup of Hypophosphites (containing 
Iron) three and a half ounces, Dilute Phosphoric Acid half an ounce. Mix. 

Dose. A teaspoonful three times a day. 

Out of door life is often to be insisted on, and sometimes a change of cli- 
mate is not only beneficial, but necessary, to effect a cure. The surface of 
the body is to be kept warm, and the skin active. Frequent warm baths 
should be taken, though cool baths are not to be prohibited, if the reaction 
after them is good, and they prove beneficial. Special attention should be 
given to the clothing. In cold climates, woolen or silk underclothing 
should be worn, and the other clothing sufficiently heavy to avoid chilli- 
ness. A vest and drawers of chamois or buckskin, worn immediately over 
the underclothing, affords the required protection, and avoids the necessity 
of an inconvenient weight of clothes in cold weather. This simple device 
secures a uniform temperature and activity of the skin, which will, to a 
degree, relieve the bronchial mucous membrane. Counter irritation is 
many times a successful means of securing the same result. For this pur- 
pose, the use of Croton Oil, or a liniment of equal parts of Croton Oil, 
Turpentine, and Olive Oil, to maintain a slight eruption over the chest, is 
often very appropriate. Tartar Emetic Ointment (one part of Tartar 
Emetic to five of Lard) is a suitable preparation. A " warming plaster " is 
often worn with benefit. 

Borne medicines often exert a curative influence. The Iodide of Potas- 
sium, or Ammonia with Fowler's Solution of the Arsenite of Potash are 
among these ; as in the following: Take Iodide of Ammonia or Potassium 
five drams, Fowler's Solution a dram and a half, Simple Syrup four ounces, 
Spirits of Peppermint half a dram. Mix. 

Dose: One or two teaspoonfuls in water three times a dav aftei 
eating. If the patient needs Iron, a dram of the Pyrophosphate may 
be added to the mixture. 

Muriate of Ammonia is considered by many physicians a valuable 

27 



418 DISEASES OF THE LUNGS. 

remedy in this' disease. Liquorice disguises the taste. It may be given 
as follows: Take of Muriate of Ammonia two drams, Extract of Liquorice 
two drams, Syrup of Tolu four ounces. Mix. 

Dose: A teaspoouful in water four to six times a day. 

Copaiba often exerts a wonderfully curative effect. It may be given 
in doses of fifteen or twenty drops three or four times a day. It may be 
given on sugar, or in Aromatic Mucilage, as: Take of Copaiba, Balsam 
Tolu and Powdered Acacia, each one ounce, Aromatic Sulphuric Acid half a 
dram, Peppermint Water six ounces. Mix. 

Dose : A tablespoonf ul three or four times a day. 

The remedy is so unpleasant that few take it willingly. Gelatine Cap- 
sules of Copabia, as sold in the drug stores, is the most convenient form 
for many to take the remedy. 

Chlorate of Potash in saturated solution, given in doses of a tea- 
spoonful to a tablespoonful three or four times a day is often curative. 
The taste is pleasant, if mixed with syrup. When Iron is required, the Mur- 
iate Tincture can be given in this solution. 

A form of medication which is often useful in cases with profuse 
secretion, and is adopted largely by quacks, is inhalation. Steam is the 
simplest, and one of the best. A solution of Morphine, one-half to one 
grain to the ounce of water, Extract of Belladonna in the same propor- 
tions. Extract of Hyoscyamus four to five grains to the ounce, and 
inhalfjd from an atomizer, or spray producer, wonderfully relieves the 
cough and irritation of the bronchial tubes. 

Astringent solutions may be used in this way. Tannin from one to 
twenty grains to the ounce, Alum from five grains to the ounce, to a satu- 
rated solution. Morphine can be added to the solution in the strength of 
one-quarter to one grain to the ounce, if local anodyne effect is desired. 
Sugar of Lead in solution three to ten grains to the ounce, are among 
the indications appropriate to inhale from the atomizer, or spray 
apparatus. 

Should the expectoration be fetid, Carbolic Acid— the spray of a soh>- 
tion of Carbolic Acid, one to four grains to the ounce, Sulphurous Acid 
one to four drams to the ounce — may be used. The vapor of Carbolate of 
Iodine (half an ounce of Tincture of Iodine, Iodide of Potassium fifteen 
grains, Carbolic Acid one dram,) produced by warming the bottle with 
the hand, may be inhaled with advantage. The solution should be weak to 
begin with, and its strength gradually increased as is required. 

For anodyne remedies to relieve the cough, if anything is necessary, 
the preference should be given to Hyoscyamus and Belladonna, to the 
exclusion of Opium, because of the latter deranging the digestion, and the 
danger from the indefinitely continued use of the drug, establishing the 
opium habit. Tincture of Hyoscyamus in doses of a teaspoonful, or Tinc- 
ture of Belladonna in doses of ten or fifteen drops, may be given as often 
as is required to relieve cough. The mixture of Paregoric, Hyoscyamus 
and Wild Cherry, recommended for acute bronchitis, may be appropri- 
ately used. 

The use of Bromide of Potassium, or Ammonia and Chloral Hydrate, 
is frequently very serviceable in relieving the cough, either alone, or given 
in connection with other anodyne medicines, but most benefit will follow 
its use when the cough is of a spasmodic character. Take of Bromide of 



CHRONIC BRONCHITIS. 419 

Potassium half an ounce, Chloral Hydrate two drams, Syrup of Tolu two 
ounces, icater to make the mixture six ounces. jSIix. 

Dose: A tablespoonful three or four hours apart. 

HOMCEOPATHIC TREATMENT. Sulphur is, in the majority of 
cases, one of the principal remedies for the treatment of chronic bron- 
chitis. The particular symptoms which serve to indicate its employ- 
ment, are as follows: Dry, racking cough, with spasmodic tightness 
of the chest, sometimes aggravated by the recumbent position, not 
unfrequently attended with nausea, or even vomiting ; accumulation of 
phlegm in the air tubes, and scraping sensation in the throat; sensation 
of soreness at the chest; chronic hoarseness, and even loss of voice; 
aggravation of the generality of the symptoms in raw, d;imp, cold 
weather ; dry cough at night; or cough with considerable expectoration 
of thick, whitish or yellowish phlegm, chiefly in the day time ; attacks of 
suffocative sensation, and oppression of breath ; rattling of phlegm on the 
chest, and occasional, or, even frequent palpitation of the heart ; pains 
in the head and chest, during fits of coughing; mistiness of sight, and 
sensation of darting ; fullness in the head. 

Dose: Six pills in a tablespoonful of water, every morning, the first 
thing (tasting,) for a week, then pause four days, after which the 
course may, if" necessary, be resumed as before, and so on. 

Calcarea-carb, is more distinctly indicated, when the patient is 
subject, from time to time, to depression of spirits, characterized by 
exceeding anxiety respecting his or her health, and attended with great 
languor (often to a distressing degree;) stitches, and occasional pains in 
the chest, and in the sides ; tickling sensation in the throat, accompanied 
or followed by dry, violent cough ; the last-named symptoms occur, espe- 
cially, at night, when in a recumbent position, or even during sleep, or 
in the evening; prolonged and obstinate hoarseness, to which the patient 
is much subject, and which is constantly induced by changes of water; 
accumulation of adhesive phlegm in the air tubes, and rattling of phlegm 
in the chest; sometimes moist cough, with expectoration of ofl'ensive 
phlegm (thick and yellowish). 

Dose: Six pills, as directed for Sulphur. 

Carbo-vcgetabilis is, more particularly, indicated by repeated fits of 
spasmodic cough during the day, and in the evening ; pains, as of sore- 
ness in the upper part of the windpipe, or sensation of tickling and rough- 
ness in the same part; prolonged and intractable hoarseness and rough- 
ness of voice, aggravated by talking, or by raw, cold, damp weather, and 
occurring, more particularly, in the morning or towards night; rheumatic 
pains in the chest and limbs; cough, with considerable expectoration of 
greenish phlegm. 

Dose: Six pills in a teaspoon ful of water, morning and evening. 

Pulsatilla. This medicine is, more particularly, appropriate when 
the following symptoms and conditions occur : Dry cough, which subse- 
quently becomes moist, and is then characterized by very considerable 
expectoration of saltish, or bitterish phlegm, or of phlegm tinged with 
blood, or of a yellowish or whitish appearance, soreness of the palate and 
throat ; frequent attacks of chilliness without thirst ; yellowish, greenish 
or offensive discharge from the nose ; hoarseness, or even loss of voice; 
cough, with much expectoration, and with pain in the chest; racking 



420 DISEASES OF TIIE LUNGS. 

cough, exacerbated at night and in a recumbent position, and accompa- 
nied with rattling of phlegm, nausea (or even vomiting,) and sensation of 
being stifled, feeling of soreness or contusion about the belly in the act of 
coughing. 

Dose: Six pills in a teaspoonful of water, night and morning. 

Sepia is, usually, of eminent service in such inveterate cases of 
chronic bronchitis as are characterized by — cough, attended with or fol- 
lowed by abundant expectoration of greenish-yellow, matter-like, or even 
bloody phlegm of putrid or saltish taste, occurring chiefly in the morning 
and towards night, and accompanied with a sensation of weakness and 
soreness about the chest ; or sometimes dry, spasmodic cough, attended 
with nausea, and resulting in the vomiting of bilious matters — the cough 
occurring, particularly, at night, and being further characterized by dif- 
ficulty of breathing, or shortness of breath. 

Dose: Four pill in a teaspoonful of water, night and morning, for a 
week, then pause four days, resuming the course after this interval, 
if necessary, as before, and so on. 

Causticum is, also, a medicine of much importance in the treatment 
of this disease, and is, more particularly, indicated by aching pains in 
the limbs, bones of the face and jaws, and in the throat and head, associ- 
ated with a violent, racking cough, of which the fits occur, particularly, 
at night ; feebleness of voice; hoarseness, or even loss of voice; lacerated 
and painful sensations in the chest and throat; faltering or feebleness of 
the lower extremities ; rattling of phlegm ; watery discharge from the 
nostrils, accompanied with headache; flushing of heat at night, attended 
with palpitation of the heart; chill during every motion; sometimes 
nausea, and even vomiting of food, with dainty or deficient appetite. 
The open air provokes or aggravates the symptoms. 

Dose; Three pills in a teaspoonful of water, morning and evening. 

Arsenicum is a valuable remedy, in severe cases, characterized by 
great debility and languor, particularly, if the subjoined symptoms occur 
— violent, dry cough, accompanied with shortness of breath, or even with 
attacks of apparent suffocation in the evening, or at night, and provoked 
by cold drinks, or by the least exposure to cold air ; or moist cough, with 
accumulation of very adhesive phlegm in the ramifications of the wind- 
pipe, which is hawked or coughed up with great difficulty ; and general 
aggravation of the symptoms at night, or after eating. 

Dose: Four pills in a teaspoonful of water, three times a day, until 
the symptoms become less violent; and then at night and morn- 
ing. 



INFLUENZA— EPIDEMIC CATARRH. 

We apply the name, influenza, to every bronchitis invading a large 
surface of country, and involving, with marked symptoms of illness, the 
whole organism, more especially, the nervous system, attacking a num- 
ber of individuals, in the same epidemic, with very similar symptoms, 
although these may differ ever so much in different epidemics. 

Influenza is, generally, preceded bj' a preliminary stage where the 
local symptoms of catarrh of the respiratory organs are still wanting, or 
are but imperfectly developed, whereas, the patient complains very much 



INFLUENZA. 421 

of an extreme languor, with nervous excitement, sleeplessness and loss of 
appetite, without or with only slight fever. As the fever increases, the 
local symptoms become, generally, more marked and more intense. At 
times, a coryza is the only prominent symptom, at other times the mucous 
lining, from the nose to the finest bronchial divisions, is inflamed. At the 
same time, a violent and constant headache is complained of, which is 
commonly located in the forehead, and is marked by all the peculiari- 
ties that so commonly characterize the headache in an incipient typhus. 
This headache is accompanied by rheumatic pains in many parts of the 
muscular system, accompanied by a degree of debility that almost amounts 
to paralysis. 

After a gradual, very seldom sudden increase, the disease reaches its 
full hight. The catarrh is, at times, violent; at other times very slight. 
The fever is intense, but so plainly remittent that the remissions some- 
times appear like intermissions. The debility is excessive. The head- 
ache is agonizing, and is either complicated with sopor, or with violent 
delirium. The digestion is entirely prostrated; the tongue is thickly 
coated white or yellow, at times it exhibits a sickly redness, with dispo- 
sition to dryness ; nausea, and even diarrhoea are often present; the bow- 
els are confined, diarrhoea is less frequent. The symptoms exacerbate in 
the evening, and at night, the patient being very much disturbed by the 
cough, which aggravates the headache a great deal. Thus, the more vio- 
lent attacks of influenza simulate an acute typhus, milder cases a so-called 
nervous gastric fever. Death may take place in the second week, amid 
symptoms of general exhaustion ; sometimes it takes place at a later 
period, in consequence of the peculiar secondary diseases which frequently 
break out as sequelae of influenza. 

In the case of sound, robust individuals, the disease mostly termi- 
nates its course in a fortnight, but always leaving an extreme weakness, 
which may last for weeks. 

In the case of old people, the danger is always great, and recovery 
takes place very slowly. An abatement of the fever is always the surest 
sign of an improvement. The disease very often leaves very threatening 
results, such as disease of the lungs, stomach and liver. 

Thus we see that the prognosis in influenza is uncertain, even if the 
disease sets in favorably at first, and the patient had been in the habitual 
enjoyment of good health. If the individual had pulmonary disease, or. 
in the case of old persons, a fatal termination is not uncommon. The 
peculiar nature of the actually existing epidemic may, likewise, exert a 
great influence ; whereas, one epidemic scarcely destroys a single life, 
another epidemic, on the contrary, claims a great many victims. 

ALLOPATHIC TREATMENT. In epidemic bronchitis or influenza 

in addition to the treatment given for ordinary bronchitis, tonic doses of 
Quinine, two or three grains three times a day, should be given. If the 
patient is feeble, Tincture Muriate of Iron is needed, in doses of ten to 
twenty drops in sweetened water, after each meal. 

The writer is of the opinion that Fowler's Solution, in doses of five 
to ten drops, and the Iodide of Potassium, in doses of fifteen or twenty 
grains, three times a day, is beneficial ; they can be given in syrup and 
water, with Sarsaparilla and Peppermint. 



422 DISEASES OF TIIE LUNGS. 

HOMCEOPATHIC TREATMENT. Incipient Stage. Camphor 
(saturated tincture). This medicine, when employed upon the earliest 
manifestation of symptoms of influenza (or of common cold during the 
prevalence of influenza,) characterized by chilliness, shivering, and gen- 
eral sensation of uneasiness, will, frequently, prove effectual in arresting 
the further development of the disease. In a more advanced stage, more- 
over, Camphor is equally indicated, and is often of great service, when 
laborious, asthmatic breathing, accumulation of phlegm in the air tubes, 
and cold, dry skin, occur as predominant symptoms. 

Bone: One drop of the Saturated Tincture on a small lump of fine 
loaf-sugar, repeated at intervals of one hour. 

Ntix-vomica. This remedy has, also, repeatedly proven of great 
emcacyin the first stage of influenza; and, frequently, when timely admin- 
istered, in the cases in which it is indicated, prevents the development of 
the disease. 

The symptoms which point out the fitness of Nux-v. are chiefly as 
follow: obstruction of the nose; hoarse, hollow cough, excited by tickling 
in the throat, and attended with severe headache ; confusion in the head, 
giddiness; want of appetite, disgust at food, acid taste, or vomiting of bit- 
ter or acid matter; thirst; pain, as from a bruise under the short ribs; 
aching pain in the lower part of the back; constipation ; pain in the 
chest, as if from excoriation; alternate heats and chills; general aching 
and prostration ; sleeplessness, nocturnal excitement, and restlessness; 
pains in the face and teeth. 

Dose: Six pills in a teaspoonful of water, three times a day. 

Inflammatory Stage. Aconitam is indicated for children, when 
the disorder assumes an inflammatory character, with quickness, hard- 
ness, and fullness of pulse, dry, hot skin, and short, harsh, shaking 
cough. 

Dose: Of a solution of six pills to two tablespoon fu Is of water, give a 
teaspoonful every three hours, until fever symptoms abate. 

Arsenicum. The following are the characteristic indications for the 
emplo3'ment of this important remedy : Heaviness and rheumatic pain 
in the head; profuse, watery and corrosive discharge from the nose, caus- 
ing a disagreeable, burning sensation in the nostrils; violent sneezing; 
shivering and shudderings, with severe pains in the limbs ; oppression of 
the chest; difficulty of breathing ; thirst; anxiety; restlessness; great 
prostration of strength, with aggravation of sufferings at night, or after 
a meal; inflammation of the eyes, with sensibility to light. These symp- 
toms may be attended with a deep, dry, fatiguing cough, worse in the 
evening, at night, or after drinking; or with sensations of dryness and 
burning, with mucus in the throat, which is difficult to detach. 

Dose: Two pills in a teaspoonful of water, every two hours, until the 
symptoms are moderated, and then every six hours. 

Merciirius. This remedy is indicated by the following symptoms: 
Chilliness, followed by profuse perspiration, unattended by mitigation of 
suffering; severe cold in the head, with copious, acrid, watery discharge; 
fever, with general heat; great weakness, relaxed bowels, headache; pains 
in the head, face, teeth and chest; sore throat; swelling of the glands 
beneath the ear ; violent, shaking cough, at first dry, but, subse- 
quently, moist, with copious secretion of phlegm — the paroxysms of 



WHOOPING-COUGH. 423 

coughing being commonly excited by irritation in the throat and chest; 
aching in the bones, and slimy, bilious, diarrhoea, attended with straining. 

Dose: As for Aconite. 

Phospliorus has been found exceedingly useful when there was 
excessive irritation in the windpipe and its ramifications, bordering on 
inflammation, with alteration of the voice, and pain during speech. 

Dose: Six pills in a teaspoonful of water, every three hours. 

Bryonia has proved of greatservice in relieving the violent, pressivo 
aching, bursting, frontal headache, dry, hot skin, with or without fever, 
and cough, both day and night, with scanty or copious, easily loosened, 
white or yellow colored phlegm ; or when the cough produced pain in the 
upper part of the belly, and caused a pain, as if arising from the effects of 
a blow, beneath the breast-bone or under the short ribs. It has, further, 
been found of great efficacy when the liver was tumefied, painful to the 
touch, or on coughing, or taking a full inspiration; also when vomiting 
was liable to take place after coughing. 

Dose: Of a solution of eight pills to four teaspoonfuls of water, give 
a teaspoonful every four hours. 

Opium has, in some cases, been successfully employed, when other 
remedies had failed, against distressing, dry cough, or cough with diffi- 
culty in expectorating the phlegm which has been detached, the parox- 
ysms of which were always followed by yawning. 

Dose: Six pills in a teaspoonful of water, every four hours. 



WIIOOFIXG-COUGH—TUSSIS COXVULSIVA. PERTUSSIS. 

Whooping-cough is an epidemic disease which sometimes occurs in 
the form of very extensive, and sometimes circumscribed epidemics, in 
which latter case the few cases of whooping-cough might be called local. 
So far the real cause of the epidemic has not yet been determined. A 
connection with other epidemicaffections, especially measles, and, likewise, 
with smallpox and scarlatina cannot well be denied. Whooping-cough 
frequently precedes or succeeds epidemics of the last-named diseases, and 
in rare cases accompanies them. 

In the majority of cases, whooping-cough commences as an ordinary 
catarrh of the nose or of the larynx, trachea and bronchial tubes. This 
introductory catarrh, which does not, properly speaking, form a component 
part of whooping-cough, may break out in all degrees of severity and 
extent, without this circumstance justifying a conclusion regarding the 
approaching attack. Hence the most proper course would be to regard this 
preliminary catarrh, as connected with the epidemic only in so far as it 
furnishes a soil or a susceptible spot upon which the whooping-cough 
miasm can be grafted, and in which it can germinate. This is shown by 
the cases where the whooping-cough breaks out without being ushered in 
by a simply catarrhal stage, or, where a simple catarrh exists for weeks 
before it is converted into whooping-cough. At any one period of 
this first stage, in a few days, or even after the lapse of weeks, either 
a harmlessly-sounding cough sets in, or else an actually existing cough 
becomes more severe, and sooner or later assumes a paroxysmal 
character, which constitutes it whooping-cough. After this form of cough 



424 DISEASES OF THE LUNGS. 

has reached its full development, the simple cough ceases entirely ; only 
in a few instances violent paroxysms and simple turns of cough occur 
mingled together. A single paroxysm has the following characteristic 
symptoms : The children, who had hitherto been bright and cheerful, 
shortly before the setting in of the paroxysm, become restless and anx- 
ious, or, if old enough, they complain of titillation in the larynx or under 
the breast-bone, or of oppression of breathing ; it is very seldom the 
case that a violent cough sets in without any preliminary symptoms, 
which, after a short lapse of time, is succeeded by a wheezing and labored 
inspiration, taking turns with the single paroxysms without admitting of 
a full respiration, for the reason that all the respiratory muscles, and par- 
ticularly the glottis, are affected by the spasm. While the exertion to 
cough is constantly increasing, and the spasm of the glottis is gradually 
abating, the children finally succeed in raising or vomiting up a more or 
less considerable quantity of a tenacious, white mucus, which terminates 
the attack. During the attack the children express ereat anguish and 
restlessness ; in consequence of the impeded breathing, the face and 
tongue become blue-red, the eyes weep, a watery mucus is discharged 
from the nose, even blood is spit up sometimes and flows from the nose 
to the terror of the parents. The vomiting either brings up mere mucus 
or the contents of the stomach. Involuntary discharge of stool and urine 
is a rare occurrence, if the children are otherwise robust. After the ter- 
mination of the paroxysm, the children continue for some time in a state 
of confusion and languor, after which they play again as if nothing had 
happened. Only in the case of feeble or very small children the parox- 
ysms are succeeded by real attacks of eclampsia, or else by a state of sopor, 
or even complete catalepsy. Under such circumstances the intermissions 
are not free from morbid symptoms, whereas vigorous children seem per- 
fectly sound between the paroxysms. 

These paroxysms sometimes set in quite frequently, and at other times 
at more protracted intervals. Generally, their frequency increases up to a 
certain point where the affection remains stationary for some time, after 
which it gradually decreases in violence. In the space of twenty-four 
hours the children may have upwards of thirty paroxysms of cough ; they 
occur more frequently in the night, and at this time likewise last longer 
and are more intense. A paroxysm seldom lasts longer than three min- 
utes; if the parents assert that the paroxysms last longer, they are 
deceived by the anxiety which the mother, particularly, experiences, to 
whom a minute may possibly seem a quarter of an hour. The paroxysm 
is excited by talking, eating, screaming, or by violent exercise, likewise, 
by a violent fit of passion ; the cough may likewise occur without any 
apparent cause, for instance, during sleep. 

The constitutional state of the little patients is variously affected by 
the cough, even if there are no complications. Strong children bear this 
cough for months, without losing flesh, or without their general well- 
being being interfered with. It may, however, be accepted as a rule, that if 
whooping-cough lasts longer than four weeks, children begin to lose their 
strength and flesh, and that this loss goes on increasingly, in propor- 
tion as the cough lasts longer. Sickly, and very small children, are speed- 
ily and threateningly affected by the cough, even if none of the foregoing 



WHOOPING-COUGH. 425 

complications are present. The children grow pale and languid, they lose 
their appetite, but are not often attacked with diarrhoea. 

The course of the disease is, generally, for several months; but when 
we couie to speak of the treatment, we shall show that this period is con- 
siderably abbreviated in skillful hands. 

Of particular importance, are the complications and sequelae of whoop- 
ing-cou ;!i, which alone constitute the dangerous features of this disease. 

Tho most frequent of these complications, are inflammatory affections 
of the lungs. The catarrh of the respiratory passages, which was incon- 
siderable at first, invades the more delicate ramifications of the air-pass- 
ages, more and more, until a more or less intense bronchitis sets in, which 
easily assumes the capillary form, and becomes readily associated with 
pneumonia. The presence of such pneumonia is suspected, if the bron- 
chitis steadily increases in intensity, and the intervals between the parox- 
ysms are no longer free from hacking cough, and a constantly increasing 
shortness of breath, — but the signs of this untoward change do not set in 
until the cough has lasted for days, and even weeks. In such a case, the 
little patient does not entirely recover from the attacks, he grows languid 
and feverish, has a short and dry cough, he does not wish to rise from bed, 
the pulse is hurried, the respiration becomes more and more incomplete, 
more hurried ; he feels drowsy and tosses about. If these symptoms mani- 
fest themselves in the latter course of the disease, they always augur dan- 
ger, and very commonly lead to a fatal termination. 

Brain diseases are scarcely ever caused by the direct action of whoop- 
ing-cough ; existing diseases of this kind may become fatally aggravated 
by the cough. The convulsions, which often attack little children during 
the course of whooping-cough, are more correctly attributed to the influ- 
ence of whooping-cough, over the whole nervous system, and, on this 
account, may become lasting. The apparently violent congestions of the 
head during the paroxysms, are of very little importance to the brain of a 
perfectly healthy child, but they prognosticate trouble, if the brain was 
diseased before the cough set in. 

Acute heart disease is seldom one of the complications of whooping- 
cough. On the other hand, the development of consumptive pulmonary 
affections is a very common thing. Usually, however, the affections exis- 
ted before the cough set in, although many cases occur, where the cough 
occasions the deposition of the tubercular matter in individuals predis- 
posed to this disease. 

Beside the complications, the frequently occurring sequelae may prove 
very dangerous to the patients. Among them, we distinguish chronic 
bronchial catarrh, deterioration of single parts of the lungs, with conse- 
quent malformation of the thorax, pulmonary consumption, heart-disease, 
although the last-named rarely, and then involving mostly the right side of 
the heart; spasms, occasionally mental derangement, and lastly hernia, 
which is of comparatively frequent occurrence. If the disease lasts a long 
time, complete marasmus is not an unfrequent occurrence ; it is not atten- 
ded with other morbid conditions, and seems to result from the exhausted 
condition of the nervous system, caused by the excessive paroxysms of 
cough. 

The prognosis is always uncertain. Although the cough does not 
endanger the lives of healthy children, nevertheless, the supervention of 



42Q DISEASES OF THE LUNGS. 

one of the above mentioned complications at any period during the course 
of the disease, may occasion death, or a life-long infirmity; thus it happens 
that we often see vigorous and healthy children come out of an attack of 
epidemic whooping-cough, like wretched invalids. 

ALLOPATHIC TREATMENT. In the treatment of whooping-cough, 
it is to be borne in mind, that the most careful attention to the hygienic 
management of the case, will save from the complications which constitute 
the chief danger from the disease, but with this attention, many cases 
require no further treatment. The clothing should be warm, and flannel 
should be worn next to the skin all seasons except summer. The child 
must be kept indoors during wet weather. The food should be plain and 
digestible, but nutritious. 

In the beginning of the disease, the treatment should be the same as 
that given for an essential catarrii in the same situation. The same direc- 
tions are appropriate for the continuing catarrh. 

Of the remedies especially appropriate in this disease, is Belladonna. 
It is markedly serviceable in the spasmodic stage, and if there is much 
bronchial secretion, but can be given at any time. The rule I have fol- 
lowed, is the one given by Trosseau, viz: to begin with a single dose at 
night, much smaller than will probably be required, the next night, two 
doses were given, the third night three, and so on, regularly increasing in 
arithmetical progression until the cough and spasm is markedly relieved, 
(or excessive dryness of the throat, and dilation of the pupils from Bella- 
donna, become so severe as to be impossible to continue.) The dose which 
is found to relieve the cough, should be given each night for a week. Then 
the dose may be lessened in the same manner as it was increased, back to 
the first dose, but if the cough increases, the size of the dose is to be 
increased again. The medicine should be given about a week after the 
spasmodic cough has ceased. Trosseau began by giving the young children 
a pill of one-tenth of a grain of Extract of Belladonna, or one-fifth of a 
grain for a child four years old, increased as above directed. As Atrophine 
is the only form which is of uniform strength, it is doubtless the best form 
for this use. 

Take of Sulphate of Atropliine one- fifth of a grain dissolved in an ounce 
of distilled W2ter. The dose is two to four drops, taken at bedtime, and 
gradually increase the dose as directed above. The Tincture is a suitable 
preparation, beginning with three drops for a child of two years. The Mono- 
Bromated Camphor, and the Bromide of Ammonia, probably rank next in 
value. The Mono-Bromated Camphor may be given in doses of three to 
five grains in Syrup of Tolu, and Mucilage four times a day. 

Three to ten grains of the Bromide of Ammonia, or Potassium may be 
given in Syrup of Tolu and Mucilage three or four times a day. 

When the Bromides are given, a dose of Chloral five to ten grains in 
Syrup and water at night will, generally, give a prolonged, and quiet sleep. 
The two may be prescribed in one mixture. 

Take of Bromide of Ammonium two drams, Chloral Hydrate half a 
dram, Syrup of Tolu half an ounce, water an ounce and a half. Mix. 

Dose: A teaspoonful four times a day. 

In case spasm of the glottis (upper opening of the windpipe) occurs, 
the mixture may be given every half hour. 

It is claimed, that the local effect upon the throat, of a solution of 



WHOOPING-COUGH. 427 

Quinine in water acidulated (with Hydrochloric Acid) sufficient to effect 
a complete solution, proves curative. It is used by inhalations of the solu- 
tion in spray, and taken internally in the usual full doses, one to five 
grains every three or four hours. The writer has seen the disease yield 
with wonderful rapidity to this treatment in conjunction with the Bella- 
donna treatment. The inhalation of steam will often be beneficial. The 
vapor of Carbolate of Iodine (Tinct. Iodine, four drams, Iodide, of Potas- 
sium fifteen drams. Carbolic Acid a dram), or Bromine inhaled by dropping 
upon hot water is often beneficial in severe cases. The medicated steam 
may be conducted to the mouth by an inverted glass funnel or one made 
out of stiff paper. 

The inhalation of Oliphiant Gas (burning gas) has proved beneficial. 
In case of excessive long-continued bronchial secretion, the above inhala- 
tions will prove of value. The inhalation recommended for chronic bron- 
chitis may, also, be used. 

Some of the other internal remedies deserve mention, as proving ser- 
viceable in domestic practice, and, in the hands of physicians. Carbonate 
of Potash (Saleratus) one or two grains three times a day to a child a 
year old. It may be given with Cochineal as follows: 

Take of Carbonate of Potash half a dram, Cochineal ten grains, White 
Sugar tw> drams, soft water four ounces. Mix. 

Dose: One or two teaspoonfuls three times a day. 

Alum is often serviceable in doses of one to six grains according to 
age. 

Take of Alum a dram, Syrup of Ginger, Syrup of Acacia, and soft water 
each an ounce. Mix. 

Do*e : One or two teaspoonfuls three times a day or of tener. 

Sulphur is often useful in doses of from two to five grains in milk or 
molasses, two or three times a day. 

Lung Fever (Pneumonia) is the most dangerous complication. Its 
management requires especial care. Stimulant applications to the chest, a 
thin poultice of sixteen parts flaxseed and one part fine mustard, covered 
with an oiled muslin jacket, should be used, or the chest wrapped in flan- 
nel, thoroughly wet with a saturated solution of Camphor Gum in Olive 
Oil. Anodyne and tonic remedies will be required, as in pneumonia occur- 
ring under other circumstances. Especial attention should be given to 
the latter, and to supporting the system with nourishment. 

Spasms will be best met by warm baths and the Bromide and Chloral 
mixture before given. 

HOMOEOPATHIC TREATMENT. First oh Febrile Stage. In the 
incipient, fevery, irritative, or catarrhal stage of the cough, the most 
appropriate remedies are to be found amongst those which we have 
already pointed out in the treatment of common cough, and must be 
selected according to the indications there given, and administered in the 
same manner, unless otherwise specified. By a careful selection of these 
remedies, it is frequently possible to check the disorder in the first stage. 
The following, however, according to the special indications mentioned, 
are particularly appropriate. 

Aconiturtt is appropriate in many instances for initiatory treatment, 
inasmuch as there is, generally, a considerable degree of fever present. 
As soon, however, as the febrile symptoms have somewhat subsided under 



428 DISEASES OF THE LUNGS. 

the employment of Aconite, which, in the generality of cases, will occur 
within a few hours after the first dose or two, and appropriate selection 
should be made from amongst the following medicines. It should not be 
omitted, that Aconite will frequently be required from time to time, as an 
intermediary remedy, whenever marked febrile or inflammatory symp- 
toms are present, always returning to such other medicines as are most 
prominently indicated, as soon as the symptoms which especially indicate 
Aconite have been moderated. 

Dose: Six pills in a teaspoonful of water, repeated, when requisite, at 
intervals of three hours. 

Pulsatilla is appropriate when the symptoms are as follow: cough 
loose, and accompanied with a flow of tears, weakness of the eyes, sneez- 
ing, thick, discolored discharge from the nostrils, slight hoarseness, and 
inclination to vomit after coughing; occasional diarrhoea, especially, at 
night. 

Dose: Six pills as for Aconite. 

Mercurius is indicated by hoarseness, watery discharge from the 
nose, with soreness of the nostrils ; dry fatiguing cough, generally occur- 
ring in two successive fits. 

Dose: Four pills in a teaspoonful of water, immediately after the fits 
of coughing, (but not more frequently than every hour.) 

Belladonna is one of the most important remedies in the catarrhal 
stage of whooping-cough, when there is dry, hollow, or harsh and barking 
nocturnal cough, which becomes materially aggravated at night. This 
medicine is, also, particularly well adapted to the sore throat, which is not 
an unfrequent concomitant, at the commencement of the affection. 

Dose: Three pills as for Mercurius. 

Nnx-vomica is of great service when the cough approaches the 
second stage. It is indicated by the following symptoms: dry, fatiguing 
cough, attended with vomiting, and occurring, particularly, from about 
midnight until morning; the paroxysms so protracted and violent as to 
produce apparent danger of suffocation, with blueness of the face, and, 
occasionally, bleeding from the mouth and nose. 

Dose : As for Mercurius. 

Ipecacuanha is, like Nux-vomica, of great value when the cough is 
attended with danger of suffocation, and each inspiration appears to excite 
a fresh fit of coughing. It is, further, indicated when the fits are attended 
with spasmodic stiffness of the body and blueness of the face, great 
anxiety and accumulation of phlegm in the chest. 

Dose: Of a solution of ten pills to three tablespoonfuls of water, give 
a teaspoonful every three hours. 

Second or Convulsive Stage. Drosera is one of the principal 
remedies in the treatment of the disease, when it has reached this stage ; 
and in cases where the constitution has not been enfeebled by the trans- 
mission of hereditary weakness, or other causes, it will speedily declare its 
beneficial effects, and materially shorten this trying and painful period 
of the disorder. The particular indications for the use of this medicine, 
are: Violent paroxysms of cough, occurring in such rapid succession as 
to threaten suffocation, and attended with the characteristic shrill sound 
during inspiration, and sometimes fever; after each fit of coughing, vom- 
iting of food, or of stringy mucus ; relief on moving about ; no fever ; or, 



WIIOOPING-COUGII. 429 

if there be fever, it consists of regular paroxysms of chilliness and heat ; 
thirst after the cold fit ; warm perspiration, sometimes only at night. 

Dose: Or' a solution of eight pills to two tablespoonfuls of water, give 
a teaspoon ful every severe fit of coughing. 

Verat rum-album- is indicated when the child has become reduced 
in strength and emaciated ; or when it suffers from cold sweats, particu- 
larly, on the forehead, with excessive thirst, involuntary emission of 
urine, vomiting, and other symptoms common to this stage; also, pain in 
the chest and towards the groin ; low fever, with small, weak, and accel- 
erated pulse; much thirst; aversion to conversation. 

Dose: As for Drosera. 

Carbo-vcgctabilis (Charcoal) is frequently useful in bringing this 
stage of the affection to an early and successful termination, after the 
previous use of Veratrum or Drosera, or both of these important reme- 
dies, particular^, when, notwithstanding the decrease of cough, the ten- 
dency to vomit still remains. 

Cuprum-accticum. This remedy is found most useful in the nerv- 
ous stage, particularly, when convulsions, with loss of consciousness 
ensue, after each paroxysm. Also, when we find vomiting after the 
attacks, rattling of mucus in the chest, and wheezing at all times. 

In almost all cases, a marked benefit has followed the employment of 
this remedy ; sometimes it has been found sufficient of itself to cut short 
(he disease, and, in others, has so far modified it, that other remedies, 
which had before seemed to fail, have, after its exhibition, acted with the 
most marked effect, and completed the cure. 

Dose: Of a solution of twelve pills to three tablespoonfuls of water, 
give a teaspoon ful every half hour. 

HOME TREATMENT. A Burgundy plaster, or any other stimulating 
plaster, may be worn between the shoulders and across the breast, with 
advantage. 

After the first stage has passed, the patient should, if convenient, be 
removed to some other place, as a change of air is always beneficial in 
this disease. 

Among the many remedies that have been used with benefit in this 
disease, the following will be found to be some of the best: 

Take of Black Cohosh or Rattleroot, Bloodroot, Skunk Cabbage, each 
in coarse powder, a tablespoonful, add a pint of boiling water ; mix. 
Steep, in a covered vessel, near a fire, for six hours; when cold, strain; 
add thirty drops of Nitric Acid or Aqua Fortis, and sweeten with sugar. 

Dose: From a teaspoonful to a tablespoonful, several times a day, 
whenever the cough is bad. 

Take five to ten drops, each, of Balsam of Sulphur and Oil of Amber, 
rubbed up with sugar, for a dose, repeating it three or four times day. 



PXEUMOXIA—IXFLA3IMATIOX OF THE LUNGS. 

On account of its frequency and the importance of the affected organ 
pneumonia is one of the most important diseases. Pneumonia may occur 
at any age, but attacks, more especially, individuals between the ages of 
twenty and forty years, very rarely children in the first years of infancy. 



430 DISEASES OF THE LUNGS. 

No constitution is exempt from the liability of an attack ; if a robust and 
plethoric constitution is generally regarded as more susceptible, it is, 
most probably, because robust men are more frequently exposed to the 
exciting causes of pneumonia. This circumstance is, most likely, the 
reason why men are so much more frequently attacked than women ; the 
occupations pursued by men expose them more fully and more frequently 
than women to the deleterious influences productive of pneumonia. 

Infants at the breast, and children who have not yet passed through 
the first period of dentition, are seldom attacked with croupous pneumo- 
nia. The nature of the country does not seem to exert any palpable 
influence; for pneumonias occur in level country as well as on moun- 
tains, in sunny districts as well as in exposed places. The seasons, on 
the contrary, exert a decided influence. 

Our statistical tables show, to a demonstration, that the transition 
from cold to warm seasons is the most fruitful source of pneumonia ; the 
transition from warm to cold seasons is less productive of this disease, 
winter still less, and summer least of any. 

Mechanical injuries, more especially a violent blow, or kick, may, 
likewise, give rise to pneumonia ; noxious agents, acting directly upon 
the lungs, such as irritating gases, excessive cold or heat, may, likewise, 
excite the disease. 

Symptoms. As yet we are not acquainted with any disease which, in 
the absence of any particular complications, runs its course in such fixed 
and stable forms as pneumonia, and adheres as fixedly as this disease to 
definite critical days. 

Pneumonia begins, almost without an exception, with a chill which 
is usually very severe, and is, in many respects, of great importance. It 
is from this chill that we date the commencement of the disease, and by 
it we determine the critical days. The chill, which is sometimes of very 
long duration, and is immediately succeeded by, but never alternates 
with fever, is in no other disease of such a peculiar nature. As soon as 
the chill sets in, the muscular strength vanishes, so that the patient finds 
it almost impossible to stand erect. 

As soon as the chill, which almost always lasts several hours, and 
scarcely ever only a few minutes, is over, a violent, dry fever-heat sets in 
and the pulse becomes more or less accelerated, fuller and more tense, but 
very seldom exceeds the number of one hundred beats. The temperature 
is always raised a few degrees. The face, which, during the chill, has an 
almost cadaverous appearance, now becomes flushed, sometimes only on 
one side ; the cheeks are bright red, the eyes injected, and very commonly 
some headache is felt, and the patient, generally, feels thirsty, but is very 
seldom disposed to vomit. The appetite is at once gone, and, owing to 
the intense fever, all the secretions are suspended. The patient feels more 
exhausted than he really is. 

This condition, which is, as yet, free from all local symptoms, may 
last longer than twenty-four hours, but, in such a case, the local symp- 
toms appear at an earlier period ; in rare cases, they precede the chill. 
The patient complains of unceasing stitching pains, which he gener- 
ally points out with tolerable accuracy as existing at the affected spot, 
very seldom far removed from it; they are aggravated by every unus- 



INFLAMMATION OF THE LUNGS. 431 

ual exertion of the respiratory organs, especially, by coughing, and they 
sometimes increase to a high degree of intensity. The pain, usually, 
sets in, associated with a short, and, at first, dry cough, the respiratory 
movements are much less full, and more frequent in number. The 
breathing is not only painful and accelerated on this account, but the 
violent fever, likewise, occasions an increased desire for breath, which 
cannot be gratified, and causes great restlessness and anxiety, and a 
marked activity of all the other respiratory movements. These exertions 
are generally so striking, that pneumonia can be recognized from this very 
fact, more especially, from the flapping of the alse nasi during an inspir- 
ation. Vocalization is of course altered, feebler and shorter, and fre- 
quently interrupted. 

Soon after the cough has begun to set in, the patient begins to expec- 
torate; this expectoration is important as a diagnostic sign. It is scanty, 
very tenacious, and usually intimately mixed with blood from the com- 
mencement, which imparts to it the color of rust, or brick-dust; this color 
is scarcely ever absent in the case of young, robust individuals. At this 
stage, the physical symptoms have so far advanced, that they render the 
diagnosis perfectly certain. During the first days the fever gradually 
increases, showing but slight morning remissions. Considering the high 
degree of temperature, the pulse is not so very frequent, scarcely ever 
exceeding one hundred and twenty beats ; gradually the fullness of the pulse 
decreases considerably. 

The end of the inflammatory stage, generally, designates the period 
when a change takes place in the symptoms. The infiltration is seldom 
completed on the third day, sometimes not till the seventh, even still later. 
After this, the pains almost cease, the breathing becomes more tranquil, 
the fever is apparently less, the pulse remains unchanged, the constitu- 
tional symptoms do not mend very perceptibly. The local, as well as the 
general symptoms, may remain unchanged in intensity, until a change 
takes place in the disease. Such change seldom takes place before the 
fifth day. This critical change is very often preceded by the breaking out 
of herpes labialis (cold blisters) which almost always authorizes the. expec- 
tation of a favorable turn. Previous to the critical change, the intensity of 
the symptoms either rises to a great hight by a gradual increase, or else it 
is often the case, that after two to four quiet days, a violent fever again 
rages for twelve to eighteen hours, after which the disease decreases very 
suddenly. Convalescence takes place so rapidly, that on the fourteenth 
day every trace of the disease has generally disappeared. As we shall see 
presently, the mode of treatment exerts a great influence in this respect. 

Pneumonia does not alter the shape of the thorax, or so little that no 
stress need be laid upon this symptom; nor are the intercostal spaces 
altered any more than the general capacity of the throax. Very com- 
monly, however, a more distinct vibration of the thoracic wall, corres- 
ponding to the diseased portion of the lungs, as perceived when the patient 
is talking. The most important positive signs are yielded by percussion, 
which informs us with tolerable certainty, whether a larger portion of the 
lungs is infiltrated or not. We speak, of course, of croupous pneumonia, 
for it is this alone, that causes the infiltration of a considerable portion of 
the lungs, most commonly of a whole lobe. In the incipient stage of 
pneumonia, the sound either remains unchanged, or is only changed very 



432 DISEASES OF THE LUNGS. 

slightly; hence, immediately after the occurrence of the chill, no changes 
can be discovered. But in proportion as the hypersemia increases, the per- 
cussion-sound becomes more tympanitic, sometimes to such an extent 
that one might be led to believe, a piece of intestine had been struck. 
Hence, the tympanitic sound is really characteristic in pneumonia, and is 
only less marked, if the thoracic walls are very thick, or if the diseased 
portion of the lungs is separated from the thoracic wall by a normal layer 
of pulmonary parenchyma. In croupous pneumonia, this is very seldom 
the case. The more complete the infiltration, the more completely the air 
escapes from the lungs, and the more empty the sound becomes, unless a 
layer, from which the air has not yet escaped, lies over the diseased portion 
of the lungs. On the sides of this normal layer, the dullness often first 
changes to the tympanitic and further on to the normal sound, the tympanitic 
sound is sometimes heard, even in the non-affected portion of the lungs, 
most likely owing to the accompanying hypersemia. A change in the infil- 
tration is revealed by percussion, if resolution takes place, in which case, 
the tympanitic sound most commonly returns for a short time, and soon 
after gives way to the full sound. The results of asculation are equally 
valuable as diagnostic signs. At the commencement of pneumonia, the 
normal respiratory murmur is very often quite feeble, much less frequently 
increased. As soon as the infiltration begins to set in, and the air is still 
able to circulate in the inflamed portion of the lungs, we perceive, espe- 
cially, during an expiration, the crepitation that is so rarely absent, that it 
can almost be regarded as characteristic in pneumonia. 

In the case of children, the invasion of the disease is often marked by 
convulsions, such as may occur in other acute affections ; in the case of 
adults, spasmodic symptoms are seldom witnessed. A very severe intes- 
tinal catarrh sometimes constitutes the stage of invasion. In such a case, 
the vomiting only lasts until the infiltration is completed, whereas, the 
diarrhoea often continues throughout the whole course of the disease. In 
the case of children, as well as of old people, very seldom in the case 
of adults, pneumonia throughout its whole course, is sometimes accom- 
panied by such prominent cerebral symptoms, that a physical exploration 
alone is capable of establishing the diagnosis upon a perfectly reliable 
basis, or even the cough in such cases is often wanting. 

The patients sometimes remain unconscious during the whole course 
of the disease, which need not run a prolonged course on this account. 
Cerebral derangements of a slighter grade, a light delirium, mostly of a 
merry nature, sleeplessness or sopor, are very common occurrences. These 
happen most frequently in the case of drunkards. The tongue does not 
exhibit any regularly-occurring changes ; — at times it is quite clean — 
sometimes very much coated, at times humid, at other times quite dry. 
The last-mentioned appearance is not very promising; it is, especially, 
ominous, if the balance of the symptoms impart to the affection a dubious 
character. The appearance of a 'slight icterus (jaundice) after the comple- 
tion of the infiltration is very common, nor is it of any particular impor- 
tance; but if icterus sets in, together with symptoms of catarrh of the 
stomach and bowels, it always indicates an unwelcome complication, 
which threatens to delay the course of the disease. As a rule, the skin 
remains pretty dry during the whole course of the disease ; prof use or 
exhausting sweats occur much less frequently. 



INFLAMMATION OF THE LUNGS. 433 

The symptoms specially appertaining to the lungs, vary considerably. 
The cough, which is usually not very violent and occurs in single short 
turns, may assume a spasmodic character, when, on account of the increase 
of pain, it becomes a source of great distress to the patient. It rarely is 
entirelj- wanting, or is quite dr}'. It is particularly old people who some- 
times do not cough at all. The frequency of the respirations is sometimes 
but inconsiderably increased, and it is the insufficient depth of the inspir- 
ations that reveals the character of the disease. The pain varies more 
than any other symptom; in the case of old people, it is generally very 
slight ; in their case the admixture of blood in the sputa is generally mis- 
sing. 

In the case of young and vigorous individuals, the resolution of the 
infiltration generally takes place very rapidly, sometimes in a single 
day. Thus we find that the fever decreases on the ninth day, and that 
the patient, generally, feels a little better; but there is no sudden decrease 
of all the abnormal phenomena, no immediate, but a scarcely perceptible, 
dragging commencement of convalescence. We seldom notice this condi- 
tion of things in the case of robust men ; it occurs quite easily among 
weakly persons, and after an exhausting method of treatment. Sometimes 
after convalescence has begun, an exacerbation with progressing infiltra- 
tion sets in, in which case the fever is very apt to assume an asthenic 
character and the appearance of typhus, yet the course of the disease need 
not necessarily be very much protracted or unfavorable. But almost with- 
out an exception, important complications exist in such cases ; such a form 
of pneumonia is very seldom the result of epidemic influences, but most 
generally of an exhausting treatment. 

Experience has shown that the seat of pneumonia is of great impor- 
tance, as regards the probability of a normal termination. As a rule pneu- 
monia of the right'side is much more favorable than that of the left, pneu- 
monia of a lower lobe lighter than that of an upper one, which is apt 
not to terminate in resolution, and to assume a tubercular form. Inflam- 
mations of the left upper lobe are especially obstinate and deviating from 
the normal course; they occur the least frequently. 

ALLOPATHIC TREATMENT. In the beginning of a case of Pneumo- 
nia, a saline purge, as one or two tablespoonfuls of Epsom Salts, (boiled 
for a couple of minutes with one-third its bulk of roasted coffee in an 
earthen dish, and allowed to draw a few minutes to disguise the taste,) 
the same quantity of Citrate of Magnesia, or Rochelle Salts, or a couple of 
Seidlitz Powders, and its operation followed by a full dose of Opium in 
some form, as the quarter grain sugar-coated pills of Morphine, the grain 
pills of Opium or Codia, ten grains of Dover's Powder, or twenty-five or 
thirty drops of Laudanum ; the opiate continued at such intervals as will 
relieve the pain, restlessness or vigilance of the patient, with hot fomen- 
tations, hot poultices, or hot Turpentine stupes applied to the chest, will 
meet the requirements of the case. 

The patient should be kept in a warm room of sixty-five to seventy 
degrees F. 

The air should be moistened with steam. 

There is no better treatment for the control of deep seated inflamma- 
tions, than the use of Opium in the doses above indicated. The writer 

28 



434 DISEASES OF THE LUNGS. 

lias frequently seen a marked decline in the frequency of the pulse and 
breathings, (respirations) with comfort and refreshing sleep follow the use 
of full doses of Opium, not only in the early stage of the disease, but to 
accompany its continued use to the extent of relieving pain or restlessness 
throughout the course of the disease. The writer very seldom sees the 
need of any further sedative treatment. This treatment has the advan- 
tage of not being harmful. It in no way delays resolution. If the patient 
does not expectorate thoroughly, and mucus accumulates in the bronchial 
tubes Opium ought not to be given in full doses. Doses about half the size 
of those named above, are appropriate, under such circumstances. 

From the beginning to the end of the disease, great benefit will be 
derived from hot fomentations. The hot wet pack is one of the most ser- 
viceable. A large towel, wrung out of hot water, is folded and laid on the 
affected side; the whole chest is then wrapped in a large towel or bandage. 
The covering should be thick, to retain the heat. Previous to applying 
the hot pack, it is doubtless advantageous to apply a hot Turpentine 
stupe. A flannel is wrung out of hot water, dipped in hot turpentine, 
applied to the chest, and thickly covered to retain the heat. When con- 
siderable smarting has been produced, the stupe may be replaced by a hot 
wet pack, or a hot poultice. Lay hot poultices, covering the affected side 
and front part of the chest, or the whole chest. They should be frequent- 
ly repeated- Linseed meal is the best substance from which to make a 
poultice. The stupe may be used twice a day. In case a poultice is used, 
sufficient mustard may be mixed with the flaxseed meal, (one or two 
ounces to the pound,) to make the poultice sufficiently irritating, without 
the use of the stupes. 

The amount of blood drawn to the surface from the internal organs, 
by these hot dressings, is simply immense. One of the best, and most 
easily managed dressings for the chest is a flannel jacket, covered with an 
oiled muslin one. This is the dressing used in Bellevue Hospital, N. Y. 
This protects against cold, and secures all the benefits of a poultice. The 
repeated application of the Tincture of Iodine, is an effectual application. 
Blisters are harmful in the first stage, and after the fever subsides, when 
absorption has begun, they have no advantage over the application of the 
Tincture of Iodine. 

If the fever and pulse continue to run high, either the Tincture of 
Aconite or Veratrum Viride may be given, according to the following 
directions: 

Many physicians place great esteem upon the use of Veratrum Viride 
in the treatment of pneumonia. This opinion was extravagantly expressed 
by the gentleman with whom the writer first read medicine, Dr. A. K. 
Fifield, of Canneaut, Ohio : " Veratrum Viride is the sheet anchor with 
me in the treatment of pneumonia." There is no doubt of its power to so 
reduce the force of the current of blood that in the early (beginning) stage 
of the disease, in strong subjects in full health, and so lessening the 
amount of blood circulating in the lung, that important service may be 
rendered. But as soon as the lobe of the lung affected becomes solidified 
its usefulness must cease. It is too powerful a remedy to be given with- 
out the guidance of a physician. The dose of the Fluid Extract is one to 
three drops, and of the Tincture, (U. S. P.) is from two to six drops. If 



INFLAMMATION OF THE LUNGS. 435 

used, the dose should be small, at first, and frequently repeated, one to 
two hours apart. The dose can be increased until the rapidity of the 
pulse and night of fever are materially lessened. 

The Tincture of Aconite is serviceable in the same way, and is pre- 
fered by many practitioners. It is, more especially, useful in the incip- 
iency of the disease, but can be continued, with greater advantage, until 
the fever ceases to rise, when the remedy is omitted. It may be given in 
doses of a half drop to a drop, every half hour, until an impression is 
made on the fever movement, and then continued in doses of a drop 
every hour or two. This, in itself, is very effectual treatment. Some 
physicians are so confident in its efficacy as to assert that no other treat- 
ment is required up to the period of crisis, but other measures of treat- 
ment are not incompatible with it. 

There is no doubt, in some cases of very strong, vigorous patients, 
when the constitutional symptoms are very violent, of the benefit of 
bleeding, if practiced during the stage of congestion ; this is within the 
first twenty-four hours, generally. Many circumstances prevent its prac- 
tice then, as a rule. Only the most robust can be benefited even then. 

After the disease is fairly established, in any case, bleeding can only 
weaken. All the sedative and revulsive effect required, can be secured 
by the cathartic, Opium and hot applications, with, perhaps, the use of 
Aconite, or Veratrum Viride. 

The use of Mercury or Tartar Emetic, according to the plan of some, 
is not called for, <»s they have no special influence over the disease. 

One of the principal objects in treatment, after exudation has taken 
place, is to support the strength of the patient, by means of nourishment, 
tonic remedies, and stimulants. The majority of cases which prove fatal, 
do so from failure of the powers of life before resolution can take place. 
It is, therefore, important that the supporting measures should not be 
delayed beyond the time when it is evident that the patient has pneu- 
monia. 

In patients who are feeble to begin with, this supporting treatment 
is all the more necessary early in the disease. It is just as important to 
support the strength of the patient in this disease, as it is with contin- 
ued fever, or any other disease. In warm climates, this part of the treat- 
ment is even more important than in cold or temperate climates, as, in 
them, patients are less able to sustain the disease. 

Animal essences (consisting of the juice of finely-chopped lean meat, 
extracted by heating in a loosely-corked bottle set in a kettle of water.) 
strong beef tea, made by taking a pound of finely-minced lean beef in a 
pint of cold water, gradually raised to a temperature of one hundred and 
sixty degrees, and maintained at that point for four hours, when it is to 
be strained and seasoned for use. During the steeping, a little water can 
be added, from time to time, to supply the loss by evaporation. 

Milk, eggs beaten with a teaspoonful of sugar, and mixed with a little 
water, or milk, and starchy articles of food, as bread, rice, gruel, etc., will 
form a suitable variety. The taste of the patient can be, generally, fol- 
lowed with safety. 

Tender beefsteak, broiled rare, is not inadmissible in many instances; 
tender fowl and game may, often, be allowed. 



436 DISEASES OF THE LUNGS. 

Nourisfi^^ c should be given four times in the twenty-four hours, in 
all cases. 

The patient ought to have nourishment in the night, and. if very ill, 
it should be given from two to four hours apart, night and day. 

Of tonic remedies, Quinine is to be preferred. It is not needed in 
mild cases, but should be given in doses of one to three grains three or 
four times in the twenty-four hours, when prostration of the vital powers 
is likely to occur. It may be given throughout the course of the disease. 

In cases occurring with intermittent fever, Quinine should be given 
in large doses, as directed for intermittent or remittent fever, until the 
periodical paroxysms are arrested. The high fever is not an objection to 
its immediate use. 

In malarious localities, it is possible to prevent the development of 
these malarial complications by the use of tonic doses of Quinine. 

Alcoholic stimulants are often a necessary part of the supporting treat- 
ment of this disease, as an aid to digestion. Two or three tablespoonfuls 
of Brandy or Whisky, may be given with the milk, beef tea or essence, or 
gruel, every time it is given. Their use should be resorted to whenever 
any degree of prostration occurs, or insufficient nourishment is taken. 

The late Prof. Hughes Bennett, of Edinburg, directed the use of stim- 
ulants, as soon as the pulse became soft, to the amount of from four to 
eight ounces of wine a day. Out of one hundred and twenty-nine cases 
treated in the Royal Infirmary, of Edinburg, treated by Prof. Bennett, 
one hundred and twenty-five recovered, and of these, eighty-five took 
wine, or spirits, in quantities varying from three ounces upward to, in 
one case, twelve ounces. Sometimes very large quantities of spirits are 
required. After convalescence is well established, their use should be 
discontinued. 

In chronic pneumonia, tonics of Quinine and Iron, as three grains 
of the Citrate of Iron and Quinine, in Syrup, three times a day. Cream 
or Cod Liver Oil may be required. 

Anodynes should be given to palliate the cough and distress. The 
cough mixture of Paregoric, Hyoscyamusand Wild Cherry Bark, directed 
in the treatment of acute bronchitis, is often sufficient, but stronger pre- 
parations may be used. if necessary. 

Counter-irritation, by applying Tincture of Iodine over the affected 
side, is useful. Supporting measures comprise all that can be done to 
prolong life. 

In the Treatment of Pneumonia in Young Children, the same 
principles prevail as are given for adults. A teaspoonful of Rochelle Salts 
or Citrate of Magnesia, should be given, to move the bowels. They 
should be kept open by the occasional use of the same remedy. 

For the relief of pain, cough and restlessness, Opium should be given 
in just sufficient amount to relieve these symptoms. The most eligible 
are: Paregoric, Laudanum, particularly the Deodorized Laudanum, and 
Dover's Powders in doses suitable to the age. Under six months, five to 
ten drops of Paregoric ; half a drop, to a drop of Laudanum ; one-fourth 
to half a grain of Dover's Powder, given from two to four times in the 
twenty-four hours. Over the age of six months, up to two years, these 
doses may be doubled. A somewhat larger dose may be given to a child 



INFLAMMATION OF THE LUNGS. 437 

of three or four, and for one five or six years old the dose may be three 
times as large as for six months. 

The opiate is often more serviceable if Tincture of Hyoscyamus, in 
doses the same as of Paregoric; or Tincture of Belladonna, in the same 
doses as of Laudanum, is given with it. 

In older children, with excessive fever, and a bounding pulse, the 
Tincture of Aconite may be given in doses of half a drop two or three 
hours apart. Its continued use will depend on the amount of impression 
on the fever and pulse. It should not be continued after the fever is down, 
or the pulse down to one hundred per minute, or if given in only half the 
former doses. Then, if the fever rises again, it can be given more fre- 
quently. The following is a suitable mixture: 

Take of Tincture of Aconite Root sixteen drops. Syrup of Ipecac two 
drams, Syrup of Tola to make four ounces. Mix. 

Dose: Half a teaspoonful can be given every two or three hours to a 
child five years old. 

From one to three grains of Citrate of Potash may be given about 
four hours apart, in syrup or in other mixtures, to stimulate the kidneys 
and skin. Spirits Mendireus in doses of half a teaspoonful to a teaspoon- 
ful and a half, given in the same way, is suitable for the same purpose. 

The supporting treatment should be the sameas for adults, and should 
be begun early. Strict attention to nourishment should be given from 
the beginning, from two to four hours apart. The dose of Quinine for a 
tonic is from half a grain to a grain. The dose of Brandy or Whisky, 
given in the food, is from half a teaspoonful to a teaspoonful every two or 
three hours. Infants at the breast will be sufficiently nourished by breast 
milk. With them the stimulant should be given in sweetened water. 

The same plan of counter-irritation as with adults should be followed 
— giving preference to a thin poultice made of Flaxseed meal, with one- 
sixteenth part of mustard, kept constantly on the chest, covered with a 
jacket of oiled muslin. Flannel wet with Olive Oil, containing as much 
Camphor as it will dissolve, wrapped about the chest and covered with 
oiled muslin, is a convenient and suitable application. The Oil can be 
made more irritating, if it does not redden the skin, by the addition of a 
little Turpentine. 

Turpentine, Tincture of Iodine, or Mustard poultices, may be used, 
if preferred, but the chest should be covered by oiled muslin, whatever 
plan of counter-irritation is followed. 

H0M(E0PATH1C TREATMENT. Complicated Cases. Symptoms. 
In severe cases, inflammation of the lungs is often found combined with 
pleurisy, in which cases the pains of the chest are intense, and mostly of 
an acute, shooting character. Another and still more frequent complica- 
tion is formed with bronchitis. 

Issue and Results. When the disease comes rapidly to a favorable 
termination, some striking evacuation generally attends it, such as a very 
free and abundant expectoration of thick, white or yellow matter, often 
slightly streaked with blood ; or a profuse and general sweat ; diarrhoea; 
a profuse discharge of urine, with a copious sediment ; or a flow of blood 
from the nose. 

If inflammation of the lungs be not checked in the earlier stages, the 
lung is altered in structure ; and the fac* 1 becomes patched with red, and 



438 DISEASES OF THE LUNGS. 

sometimes livid, the vessels of the neck swollen and turgid, and the pulse 
weak and irregular. 

In the advanced or suppurative stage of the disorder, the expectora- 
tion becomes purulent or converted into a brown, serous fluid, and slight 
shiverings generally supervene; the pain or sense of fullness and tight- 
ness becomes abated, and the patient is commonly enabled to lie on the 
affected side without much inconvenience; but the pulse becomes weak 
and thready, and the strength commonly sinks rapidly; a fatal result is, 
however, sometimes even then, avoided by proper homoeopathic treat- 
ment. 

The great danger attendant upon this disease renders the assistance of 
professional experience, when that can be obtained, absolutely indispen- 
sable. But to provide, in some measure, for the contingencies in which 
such aid cannot be secured, the following directions are subjoined, to ena- 
ble even unprofessional persons to entertain some hope of insuring a suc- 
cessful issue. 

Aconitum. In the stage of simple inflammatory congestion, with 
severe inflammatory fever, whether or not accompanied or followed by 
violent shooting pains in the chest, this remedy is unquestionably of great 
service. 

Dose: If singly, of a solution of six globules to two tablespoonfuls of 
water, give a teaspoonful every hour, until the pulse becomes reduced 
in volume and frequency, or the skin moist, or covered with profuse 
perspiration — upon which the intervals may be extended to two 
hours, and the administration thus continued. 

Bryonia is frequently the best remedy to follow Aconite, when the 
more severe febrile symptoms have been lowered by the medicine, or, 
more especially, when such symptoms as the following predominate: 
cough with expectoration of stringy or tenacious phlegm of a brick-dust 
color, oppression and acute shooting pains in the chest; or rheumatic 
pains in the chest and extremities, with aggravation on movement; foul, 
dry tongue, constipation, and other indications of derangement of the 
stomach. When the pain in the chest is excessive, and of a shooting, cut- 
ting or pricking character, the membrane which invests the lungs is 
generally involved, and the case thereby complicated with pleurisy. In 
such cases the alternate use of Bryonia, with such other medicine as may 
further embrace some of the symptoms, is sometimes necessary, or, at all 
events, conducive to more speedy recovery. 

Dose : In every respect as directed for Aconitum. 

Belladonna is, generally, required before (or even after) Bryonia, 
when the fever returns, after having been apparently subdued by Acon- 
itum, and the difficulty of breathing, and pain, or feeling of uneasiness in 
the chest, continue; the expectoration tinged with blood, and difficult to 
bring up; the cheeks flushed, lips and tongue dry and parched, the skin 
hot, and the thirst incessant; the pulse hard, quick, and full; the sleep dis- 
turbed by frightful dreams and delirium. In young, robust subjects, Acon- 
itum and Belladonna may be exhibited in rapid alternation, with the most 
satisfactory results during the first stage. 

In such cases, indeed, the further progress of the disease is not unfre- 
quently arrested, or at all events, such a degree of improvement is effected 
that any remaining symptoms, such as some degree of oppression, and 



INFLAMMATION OF THE LUNGS. 439 

expectoration of viscid phlegm, readily yield to the administration of 
Bryonia. 

Do.se : As for Aconite. 

Phosphorus. This remedy has been employed with striking suc- 
cess in almost every stage of the disease in question, under whatever form 
it presented itself, and even when the disease had already attained a some- 
what advanced stage. Much fever, with hard, full pulse, cough, and blood- 
stained expectoration, are the salient general indications for Phosphorus. 
It is. also, more or less necessary in all cases occurring in consumptive 
habits. 

Done: If singly, of a solution of six pills to two teaspoonfuls of water, 

give a teaspoonful every three hours. 
Additional Particulars.— Serious Cases. Antimonium-tar- 
taricum is frequently of service when the oppression at the chest, and 
anxiety continue to increase, and the pulse becomes small, weak, and 
irregular; or, moreover, either when there is no expectoration, or when 
the expectoration is not tinged with blood, and occurs chiefly at night; or, 
again, when difficulty of breathing, anxiety, and other dependent symptoms 
are always temporarily relieved after expectorating. 

Dose: Of a solution of six pills to two tablespoonfuls of water, give a 
teaspoonful, first at intervals of a quarter of an hour, and then of 
half an hour, and so on, extending the intervals to three hours, as 
improvement gradually ensues. When the urgent symptoms have 
subsided, consider the general aspect of the symptoms, and suspend 
or continue treatment accordingly. 
Sulphur is a medicine of great service when a relapse threatens to 
succeed the improvement previously effected by other treatment; and in 
repeated courses, upon the accession of convalescence, to restore the vigor 
and equilibrium of the system, and to neutralize the remaining suscepti- 
bility to affections of the same organs. 

Dose: If against an impending relapse, three pills in a teaspoonful of 
water every three hours, until the progressive improvement, previ- 
ously manifested, becomes apparent. If as an after-remedy, against 
the remaining susceptibility of the lungs, give six pills in a table- 
spoonful of water, every morning, the first thing (fasting) for a 
week. 

HOME TREATMENT. From the beginning to the end of the disease, 
great benefit will be derived from hot fomentation. The hot, wet pack 
is one of the most serviceable. A large towel, wrung out of hot water, is 
folded and laid on the affected side; the whole chest is then wrapped in a 
large towel or bandage (dry). The covering should be thick, to retain the 
heat. 

Hot poultices are of great benefit. Linseed meal is one of the best 
substances from which to make a poultice. Sacks of hot ashes applied to 
the affected side is, also, of great benefit. If poultices are used, sufficient 
mustard may be mixed with the meal to excite a little irritation. 



ASTHMA. 

A disease characterized by an extreme difficulty of respiration (breath- 
ing) which is worse at certain seasons of the year, and particular periods 
of the day, being generally worse at night. The difficulty of breathing is 



440 DISEASES OF THE LUNGS. 

increased by violent emotions, damp atmosphere, excess of any kind, 
strong exercise, running, walking briskly, or ascending a flight of stairs. 
It is, also, more laborious in a horizontal position, and hence more distress 
is felt at night when in bed. The warmth of the bed, also, has a strong 
influence on the disease, by assisting in the causes that fill up the air-pass- 
ages, and hence causing paroxysms to be more frequent during the night 
than the day. 

The patient seeks relief by sitting upright in bed, or bending the body 
forward, and endeavoring to expand the chest mechanically by every pos- 
sible means. Old persons are more liable to the disease than young. 

It is now believed that spasmodic asthma is caused by a spasm of the 
muscular fibres encircling the bronchial tubes, especially, the small 
branches. The existence of these fibres is placed, beyond a doubt, by 
microscopic examinations. In common asthma, the lining membrane of 
the air passages is more or less affected, as in chronic bronchitis, but the 
affection of the mucous membrane extends further down into the lungs, 
the air cells are more obstructed, and the conformation of the chest itself, 
is often somewhat contracted and defective. The action of the diaphragm 
is imperfect, as well as that of the walls of the chest, and hence it is, that 
from want or inervation, and free action of these parts, the disease is com- 
monly deemed nervous, as distinguished from chronic bronchitis which 
affects the bronchial mucous membrane chiefly. In spasmodic asthma, the 
nerves are still more deeply implicated; their action seems defective in the 
respiratory organs, as stammering shows imperfect nervous action in the 
organs of speech; and in both cases, the difficulty is increased by physical 
or moral excitement. Chronic asthma seldom shortens life where patients 
carefully avoid all violent emotions, exercise, and excess, although spas- 
modic paroxysms may endanger life at any time, if these precautions are 
neglected. Attacks of spasmodic asthma generally occur during the first 
sleep, soon after midnight when sleep is most sound, or early in the 
morning. 

The patient suddenly awakes with a sense of suffocation, tightness 
of the chest and difficulty of breathing; the respiration is wheezing and 
laborious, the shoulders are raised and every effort made to enlarge the 
chest. The pulse is usually quick, weak, and irregular, the lower extrem- 
ities cold. When cough and expectoration come on, or can be brought on 
the patient is relieved. The spasm may continue half an hour or more, 
and even three or four hours. Asthma is often complicated with diseases 
of the heart, or with chronic bronchitis, acting as a source of permanent 
congestion, predisposing the parts to be more easily thrown into a state 
of spasm. 

The most common consequences or concomitants of the disease are, 
chronic inflammation and dilation of the bronchia. Emphysema (a swel- 
ling produced by air or gas) oedema (tumefaction) of the lungs, spitting of 
blood, tubercular deposits, larger girth and widening of the cavities of the 
heart, collection of liquid into the sack containing the heart, into the 
pleura, and sometimes congestions and effusions in the head causing 
apoplexy. 

ALLOPATHIC TREATMENT. For the relief from a paroxysm of 
Asthma, a great variety of remedies have been tried by the patient and 



ASTHMA. 441 

frequently he knows what will succeed most promptly, so that often his 
experience is the best guide. 

The narcotics which are best adapted for immediate relief are Mor- 
phine and Belladonna. A hypodermic injection of a quarter to a third of 
a grain of Morphine (always by a physician) is one of the surest known 
means for cutting short a paroxysm. 

Atrophine may be injected in doses of a sixtieth of a grain, and is, 
probably, the next best method for procuring relief. 

These two remedies may be combined with advantage. A slower, 
and unsatisfactory way, is to give these remedies by the mouth. A third 
to half a grain of Morphine, and twenty to thirty drops of the Tincture 
of Belladonna, are the doses. 

Inhalations resorted to, are Stramonium, Belladonna, Tobacco, Opium, 
Nitrate of Potash (Saltpetre,) Arsenic and anaesthetics. Stramonium or 
Belladonna leaves are smoked, from a common pipe, with benefit, or 
dipped in a strong solution of Saltpetre and dried, they may be burned 
iu a close room, and the fumes breathed until relief is obtained. 

Cigarettes, made by the following formula (of Trousseau) are excel- 
lent, the patient smoking them when the paroxysm occurs, and breath- 
ing the fumes until relief follows : Take of Belladonna five grains, Stra- 
monium and Hyoscyamus each three grains, Extract of Opium one-third of 
a grain, Clierry -Laurel Water sufficient quantity to moisten the leaves. 
Moisten tlie leaves of Belladonna, Stramonium and Hyoscyamus in the Cher- 
ry-Laurel Water, having dissolved in it the Extract of Opium, dry and make 
into cigarettes. 

Two to four of these cigarettes may be smoked during the day. To 
persons who do not smoke, the smoking of one or two cigars will fre- 
quently bring relief. 

The following formula is a tried and useful one, and has been long 
and successfully employed in the Pennsylvania Hospital. Paper, pre- 
pared as follows and rolled into cigarettes, can be smoked two or three 
times a day, until relief is afforded or giddiness follows. (It is called 
compound Arsenical Paper): 

Take of Belladonna leaves ninety-six grains, Hyoscyamus and Stramo- 
nium leaves each forty-eight grains, Extract of Opium four grains, Tobacco 
eighty grains, Water one pint. Mix; and make a solution; then add Nitrate 
of Potash (Saltpetre) one hundred and forty grains, Arsenite of Potash three 
hundred and twenty grains. Saturate white, thin, blotting paper with 
this solution, and when dry, it is ready for use. It can then be rolled 
into cigarettes and smoked. 

Ether, Chloroform and Nitrite of Amyl, given by inhalation, by a 
phy.-ician, will frequently arrest a paroxysm. 

Burning Xitre paper in the room, and allowing the patient to inhale 
the fumes, is frequently successful in arresting the paroxysms or pro- 
ducing relief. The paper is made by dipping white blotting paper in a 
saturated solution of Saltpetre, and drying 

Certain remedies which produce nausea will arrest a paroxysm. One 
of the best of these is Lobelia, one or two teaspoonfuls of the Tincture 
may be given every half hour, until nausea is produced. Other Emetics 
may be used ; in this way the sickness of the stomach relaxes the spasm, 
and the patient breathes freely. 



442 DISEASES OF THE LUNGS. 

Anti-spasmodics, such as Asafoetida, Skunk Cabbage, and Skull Cap, 
will sometimes relieve the spasm causing the difficult breathing. Brom- 
ide of Potassium in doses of fifteen or twenty grains, with half as much 
Iodide of Potassium, given every half hour or hour, will sometimes cut 
the attack short. 

In the interval between the attacks, attention should be given to the 
general health: by the use of tonics, as may be required, regular habits of 
life, the regular use of sponge or shower bath, regulating the diet to over- 
come dyspepsia, relieving constipation. 

When digestion is poor, one or two teaspoonful doses of Liquid 
Pepsin, prepared by Sheffer's formula, taken at meal times, will be ben- 
eficial. Sometimes five or ten drops of Dilute Hydrochloric Acid, may 
be added to each dose, with benefit. 

Nearly all cases of asthma depend upon co-existing bronchitis, and 
upon the cure of that depends the cure of the asthma. The most effect- 
ual measure to produce this, is a change of climate, (even changing the 
sleeping apartment, from one room to another, has been known to accom- 
plish it.) 

The most popular climate now, for asthmatic patients to resort to, is 
that of the Rocky Mountains— especially Colorado. This climate proves 
beneficial in a large number of instances. 

Commencing to change the residence, a locality chosen should, in the 
first place, be one which possessed just the characters opposite to the 
former one, as from the city to country, or from country to the city. 

If the patient lived in a moist air, a locality with a dry one should be 
first tried— and vice versa; from a low region to a high one, or the oppo- 
site, etc. Sufficient has been said to guide in the selection of a change of 
residence. If the patient does not improve under the treatment resorted 
to, a change of climate should be insisted on. 

A remedy which proves successful, in a large number of instances, is 
Iodide of Potassium. It should be continued for a long time, in doses of 
five, ten, fifteen or twenty grains, three times a day. The smallest dose 
should be commenced with. It can be given with tonic remedies, should 
they be needed. This is one of the remedies which is sometimes given to 
relieve an attack or asthma. For this purpose, it should be given in 
doses of fifteen, twenty or thirty grains, every two, three or four hours, 
according to the severity of the seizure. It is one of the most reliable 
remedies. 

In the so-called " hay asthma," or summer catarrh, the Iodide of 
Potassium, combined with Arsenic, gives good results : Take of Iodide of 
Potassium an ounce, Fowler* s Solution a dram, Water four ounces. Mix. 

.Dose: A teaspoonful every four hours. 

When Arsenical Cigarettes are not smoked, Arsenic may be given in 
doses of one to three drops, after eating. The two remedies, Iodide of 
Potassium and Arsenic, have accomplished the greatest number of cures. 

For the relief of asthma, the various means recommended for 
bronchitis may be resorted to. 

HOMCEOPATHIC TREATMENT. The treatment has to aim at the 
relief of the present paroxysm, and at the curing of the disease. When 
the attack is accompanied by congestion of the head, in fleshy individu- 



hiccups. 4 A3 

als, and in women and children of a peevish, ill-natured tendency, 
where the attack usually occurs in the evening, sensation of dust in the 
lungs, better when bending the head back and when holding the breath. 
Face and eyes red, head hot, sleepiness — but cannot sleep, Belladonna 
will prove itself a good remedy. 

If the attack was brought on by mental excitement: Aconite. If 
children are troubled with asthmatic breathing while teething, and at the 
same time are very peevish, nothing pleasing them, want to be carried all 
the time: Chamomilla. * 

If the breathing is anxious, short and oppressed, with much labor and 
greatly increased difficulty on assending a flight of stairs, attacks of suffo- 
cation, especially in the evening, at night, or in bed, attended with great 
restlessness and fear of death, extreme thirst, drinking often, but little 
at a time; cannot lie for fear of suffocation, and wants to be in a warm 
room, you will find Arsenicum the best remedy. 

Ipecac for spasmodic asthma, with violent contractions in the throat 
and chest. Rattling noise in the bronchial tubes during an inspiration. 
Suffocation threatens from contraction in the throat and chest, worse 
from the least motion. Nausea with feeling of emptiness about the 
stomach. 

HOME TREATMENT. In most cases, persons can almost immediately 
relieve themselves of an asthmatic attack, by smoking in a pipe, Stra- 
monium or Jimson Weed leaves soaked in a solution of Saltpetre; at the 
same time, heating their feet thoroughly near a fire. If it should be dis- 
agreeable to use the pipe, the leaves may be pulverized and placed in a 
saucer, then drop some bright coals of fire in the saucer, and hold the face 
over it so as to inhale the smoke or vapor as it arises from it. This will 
frequently relieve a very severe attack. 

Deadly Nightshade (Belladonna) leaves may be prepared the same 
way, and will often prove of great benefit. Every person who is subject to 
this disease, should keep these articles prepared, on hand in readiness to 
use; it is easily made by carefully drying the Stramonium or Belladonna 
leaves, and then placing them in a solution of Saltpetre, made as strong as 
the water will take up of Saltpetre; then dry the leaves and keen them in 
a tin or other vessel well closed. 



SING ULTUS-IIICC UP. 

This is owing to a spasmodic contraction of the diaphragm, during 
which, the air is drawn in through the contracted glottis with a shrill and 
short sound. 

The hiccup either originates in the nervous centers, as during a gen- 
erally increased irritability or neuralgia, especially, in the case of hysteric 
and hyphchondriac patients; or when accompanying cerebral (brain) dis- 
eases, such as cerebral anaemia, consequent upon long-lasting, exhausting 
diseases, or upon considerable losses of blood and other animal fluids, 



444 DISEASES OF THE LUNGS. 

as well as upon violent psychical (mental) impressions, such as fright, 
anger, etc. 

Or else, it is simply a reflex-phenomenon, as during diseases of the 
pleura and pericardium. 

Consensual singultus may occur during diseases of the stomach, liver, 
pharynx, intestinal canal, etc. 

En the case of children, it often occurs in consequence of a cold, or acid 
stomach . 

Singultus, occurring during cerebral arlsemia (bloodlessness of the 
brain) consequent upon chronic diseases, such as cancer, Blight's disease, 
tuberculosis (consumption,) etc., or upon exhausting diseases, such as 
typhus, cholera, or upon pleuritis with profuse exudation ; likewise, upon 
exhausting diarrhoea, is always a very dangerous symptom, that may con- 
tinue for days, and finally increase to convulsions. 

ALLOPATHIC TREATMENT. The best remedy is Musk, in doses of 
five to fifteen grains suspended in Mucilage. It can be repeated at inter- 
vals of two to four hours. Oil of Amber is, probably, next to Musk, the 
most effectual remedy; the dose is ten to twenty drops in emulsion 
with Syrup or Mucilage of Gum Arabic, repeated two to four hours apart. 
Tincture of Belladonna, in doses of ten drops, repeated every hour until 
relieved, or dryness of the throat is produced, is generally effectual. 
Ether or Hoffman's Anodyne may be given in doses of a teaspoonful every 
half hour. A quarter of a grain of Morphine, or twenty grains of Chloral 
in water, will generally cut short a severe attack. 

The use of any anti-spasmodic remedy is appropriate. A glass of cold 
water, or a sharp word from a superior, will often succeed in relieving 
this cough. 

HOMCEOPATHIC TREATMENT. A passing hiccup is scarcely noticed ; 
only if it lasts too long and becomes too severe, medical treatment may 
have to be resorted to. 

In case of simple hiccup, it may be arrested by stopping the breathing 
for some time, or by drinking a little cold water, by fixing one's attention 
upon a certain object, such as: holding a key in one's hand, by a system- 
atic crossing of the fingers of both hands ; by a sudden surprise, or such 
domestic remedies as eating a little sugar, magnesia, ice, etc. 

Infants who have taken cold, have to be warmed, after which they 
should be put to the breast; if their stomachs are acid, we give them Cal- 
carb 6, or Nux-vom. 6; if they are affected with intestinal catarrh, we give 
them Chamomilla 3, or Rheum 3. A domestic remedy that is frequently 
made use of, is calcined Magnesia, as much as will cover the point of a 
knife, morning and evening. In one case, where not one of these remedies 
would help, a teaspoonful of recently prepared lime-water, removed the 
spasm. 

As external remedies, practitioners recommend, laying grated horse- 
radish upon the epigastrium, dropping Ether upon the pit of the stomach, 
painting this region with the Oil of Chloroform, one dram to two 
drams of Almond-oil; and in desperate cases the inhalation of Ether or 
Chloroform. 




THE THORAX. 



THE THORAX. 



445 







IIISB!,,! 



., |iiHii,i;ilii:ffl 



An aged and close-observing physician recently said to an old and dear 
friend of his : " Yes, my friend, your lungs are not sound. And my advice 
to you and all who are of the nervous temperament like you is, live in Cen- 
tral Florida, and you will fully recover. Lymphatic people will do well in 
high altitudes and should not go south." 

THE THORAX. 

The opposite illustration shows the Thorax with ribs and sternum— breast- 
bone — removed, and also part of the pleura from the left side, exposing to 
view the lobes of the lungs, of which there are two in the left and three in 
the right side ; on the right side the pleura and the blood-vessels just under 
the ribs are left. It is an inflammation of this lining membrane of the 
lung cavity Y V that is known as Pleuritis— Pleurisy ; and inflammation 
and swelling of the small air-cells that look in the illustration like sealed-up 
cells in a honey-comb (II, II,) that is known as Pneumonia ; this swelling 
becomes so great at times as to exclude the air, and thus, by preventing the 
oxidation of the blood by contact with the air, causing death from the af- 
fected portion of the lung. A deposit of little white particles in the lungs, 
usually at first either at the top or bottom of the lung, and an inflammation 
and suppuration of the lung tissue about them, is what is known as Phthisis 
pulfrwnalis or Consumption. E and F are portions of the breast-bone, and 
the point where the clavicle— coilar-bone G— joins the breast-bone is at Q. 
The diseases affecting the parts here shown are the cause of death of three- 
sevenths of the human family. 



446 INFLAMMATION OF THE PLEURA. 

CHAPTER XXI. 



DISEASES OF THE PLEURA. 



PLEURITIS, PLEURISY— INFLAMMATION OF THE 

PLEURA. 

Inflammatory affections of the pleura are not by any means rare 
occurrences; yea, the frequent adhesions of the lungs to the thorax, 
revealed by post-mortem examinations, show that pleuritic affections are 
not only very frequent, but that they run their course unobserved. The 
more trifling inflammatory phenomena are without any practical value, 
nor do they ever constitute an object of treatment ; for this reason, we here 
treat only of the more acute forms of pleurisy with copious exudation. 

Pleurisies of this character are scarcely ever really primary diseases; 
in the majority of cases, they are of a secondary nature. The history of 
primary pleuritis is somewhat obscure, unless the disease is caused by 
some direct and mechanically acting agency. A most frequent cause is 
said to be a violent cold ; but the case is here, as in pneumonia, the con- 
nection is taken for granted, rather than proven. The more frequent 
occurrence of pleuritis, during peculiar states of the weather, justifies the 
conclusion, that atmospheric conditions exert a decided influence upon the 
origin of this disease. To designate such inflammations as rheumatic, is 
in so far justifiable to some extent, at least, as acute rheumatisms occur 
epidemically at the same time. 

On the other hand, pleuritis as a complication or secondary affection, 
is exceedingly frequent. All inflammatory pulmonary affections, even 
hypersemia of more than ordinary extent, if occurring near the surface of 
the lungs, develop pleuritis, which is, generally, confined to a very limited 
space, but may, likewise, be very extensive and violent. Inflammatory 
affections of the heart may lead to pleuritis. Acute rheumatism and peri- 
tonitis, and likewise, acute exanthemata, easily result in the development 
of pleuritis. Among chronic affections, the following may occasion the 
disease: Pulmonary consumption, pulmonary abscess, suppuration of the 
vertebra and ribs, Bright's disease. The occurrence of pleuritis during 
the stage of convalescence in severe acute affections, pj'semia and gen- 
erally, in diseases characterized by marked signs of a septic condition of 
the blood, is a remarkable fact which does not admit of any further expla- 
nation. Like peritonitis, so pleuritis is superinduced in its worst and 
most extensive form by the intrusion of foreign substances into the pleu- 
ral cavity, most commonly by the effusion of pus from a superficial cavern, 
or from a suppurating bone. 

Symptoms. It is absolutely impossible to draw a permanently and 
universally true picture of pleuritis; the symptoms characterizing an 
attack of pleuritis vary greatly, in intensity as well as extent; many symp- 
toms are sometimes entirely wanting, whereas, in other cases they are 
most prominently present. However, inasmuch as the symptomatic dif- 
ferences of pleuritis are mostly depending upon the quality of the exuda- 



DISEASES OK THE LUNGS. 447 

tion, we subjoin a superficial sketch of these differences, and shall discuss 
essential details in subsequent paragraphs. 

The plastic exudation exists seldom as an idiopathic affection; it gen- 
erally accompanies other diseases, more particularly pneumonia. Inas- 
much, however, as it is scarcely ever, even when existing as an idiopathic 
disease, accompanied by violent fever, we may suppose, that even where 
it exists as a complication, it does not contribute much to an increase of 
the fever. On the other hand, it is precisely this form that causes the 
most violent pain, which is very much increased by every somewhat more 
expansive movement of the thorax and of the body generally, more partic- 
ularly by coughing, and which very frequently renders even percussion 
painful. After the lapse of at most a week, the pain disappears again 
entirely ; but the physical signs, of which we shall treat by and by, some- 
times remain for some time after. 

Like all other more extensive inflammatory processes, it almost always 
sets in with a severe chill, followed by considerable increase of the pulse 
and temperature, attended with headache, intense thirst, loss of appetite, 
and almost immediately an intense pain in the inflamed region of the 
pleura. The pain, generally, decreases in proportion as the effusion 
increases in quantity. As the exudation increases the breathing of course 
becomes shorter, and a distressing cough sometimes sets in, with a thin 
expectoration, which is tinged with blood, but is not to be regarded as a 
sign that pneumonia or bronchitis has supervened, but most commonly 
depends upon no other cause than the congestion of the non-affected part, 
which congestion is a necessary consequence of the pressure caused by the 
exudation, and for this reason, does not show itself at the outset of the 
disease, but only in its subsequent course. In favorable cases, the termi- 
nation in recovery may commence with the second week, and may lead to 
a complete restoration of health ; or else, the process of reabsorption takes 
place very slowly, imperfectly, and the patients remain for a long time in 
a sickly, lentescent condition, where they are threatened with renewed 
attacks and exacerbations. 

The third form, empyema, often develops itself, as was stated above, 
from the second form. That pus is forming, may be inferred from the cir- 
cumstance that the fever does not abate; on the contrary, that in the sub- 
sequent course of the disease, and without any increase of the exudation, 
the fever increases in violence, mingled with chills, or assuming the char- 
acter of a hectic fever, with a constantly increasing prostration of 
strength. If the purulent exudation is a consequence of pyaemia, of a sep- 
tic state, or a general dissolution of the blood the exudation may originate 
and run its course without pain ; it only aggravates the previously excit- 
ing morbid phenomena. The course of the disease depends essentially 
upon the fact, whether the exudation is re-absorbed or enclosed within a 
sack, or finally, whether it escapes from the cavity, and in v/hat direction. 

The fourth form, where the exudation is chiefly serous, usually 
imparts to pleuritis a sub-acute or even chronic character. This form is 
very insidious, because it so often develops itself very gradually and with- 
out pain, and even commences without fever, which does not generally 
supervene until at a later period. At first, the patients only complain of 
lassitude, they lose their appetite, have a sickly appearance. Gradually the 



448 INFLAMMATION OF THE PLEURA. 

respiration becomes more oppressed and labored, but not by any means to 
a degree that might lead the patients to suspect the presence of a pulmon- 
ary disease. The quantity of the exudation occasions a displacement of 
the thoracic and abdominal organs. Recovery from such attacks always 
takes place slowly; it is only exceptionally that absorption takes place 
very rapidly amid a profuse flow of urine. 

Among the symptoms of pleuritis, there is not one that could be 
pointed out as characteristic of the disease. It is true, that in most cases 
of acute pleuritis we have the peculiar pain, but it varies exceedingly in 
character and intensity. At times the pain is simply a sensation of tense- 
ness and constriction; at other times the pain is a seated, localized 
stitching pain; at other times again, the pain is spread over the whole 
side of the thorax, and is of a tearing or burning kind. Not unfrequently 
there is no pain at all; this happens more particularly in most insidious 
cases. In genuine pleurisy there is very seldom any cough, especially, 
at the commencement of the disease ; if cough sets in at a later period, it 
may be occasioned by simple hyperemia or by pneumonic infiltration. 
At all events, it causes the patient a good deal of distress, increases his 
pain to an extraordinary degree, and complicates the course of the disease, 
since every additional obstacle must necessarily, in view of the existing 
shortness of breath, imply an additional amount of danger. The symp- 
toms presented by other organs cannot be determined beforehand. Most 
generally, it is the action of the heart, especially that of the right heart, 
which is altered; if any considerable amount of exudation is present, the 
beats of the heart become irregular, stronger and more rapid, the more so 
the more the heart is pushed out of its place by the effused fluid. A dis- 
placement of the liver is attended with pressure in the right side, and 
slight symptoms of jaundice. Neither the intestinal canal nor the kid- 
neys are involved in all cases. The brain becomes slightly engorged, if 
the effusion is copious, and the circulation is interfered with. The posi- 
tion of the patients deserves particular notice, more especially, as con- 
trasted with their position in pneumonia. Pleuritic patients, almost 
always, lie on the painless and unaffected side, whereas, if the effu- 
sion is not attended with pain, they prefer lying on the diseased side. 
Very seldom, the patient wants to lie on his back; if he does, the trunk 
has to be elevated a good deal. 

All these objective, as well as subjective symptoms, which we have 
described, are not sufficient to establish a reliable diagnosis. If a reliable 
diagnosis is at all possible, it will have to be based upon the results of a 
physical exploration, which is even more important in this disease 
than in pneumonia, for the reason that pleurisy often remains such a 
latent disease, that the objective phenomena alone can shed light upon 
its existence and true character. This examination can only be made by 
a physician. 

ALLOPATHIC TREATMENT. The indications for treatment, in the 
first place, are to subdue the inflammation and to relieve the pain. For 
this purpose, full doses of Opium is the most useful and effective treat- 
ment, which not only relieves the pain completely, but lessens the con- 
gestion very materially. 

The hypodermic injection of Morphine in doses sufficient to pro- 



DISEASES OF THE LUNGS. 449 

dace its sedative influence, a third to half a grain, by the physician, is 
the best method for its administration. If given by the mouth, from a 
grain and a half to two grains of Opium, thirty to forty drops of Lauda- 
num, fifteen or twenty grains of Dover's Powder, may be given every 
two hours, until the paiu is relieved, *and repeated at intervals sufficiently 
often to relieve the pain. After the pain is relieved, doses half the size 
above named, will probably be sufficient, but the pain must be relieved. 

Morphine may be given, by the mouth, in doses of a third to half a 
grain, and repeated every hour, until the pain is relieved, after which the 
dose should not exceed a fourth of a grain, repeated often eough to relieve 
the paiu. 

For continued use, if the preparations of Opium produce unpleasant 
symptoms, probably Atropine in doses of one-sixtieth of a grain, given 
with the Opium, will obviate the difficulty ; or Codia may be used instead 
of Opium or Morphine, in the same doses as that of Opium. 

A full dose of Quinine (fifteen or twenty grains) at the very begin- 
ning, is said to suppress the inflammation. It is more effectual if Opium 
be given with it as above directed. 

The cold, wet pack, applied to the side, diminishes inflammation and 
relieves the pain. A large towel is wrung out of cold water, folded and 
placed over the affected side. Then wrap the chest tightly with a long, 
broad bandage, or towel, which was previously had in readiness, and 
fastened. 

Oftentimes the hot, wet pack is more serviceable, and is to be pre- 
ferred, the feelings of the patient being a safe and reliable guide. It is 
applied in the same way, the towel being wrung out of water as hot as 
can be borne. 

Hot Linseed meal poultices applied to the affected side, will answer 
the same purpose. 

Some physicians prefer a large mustard plaster over the affected side, 
or Turpentine stupes, in the method described in the treatment of pneu- 
monia. 

The application of Tincture of Iodine maybe made to the affected 
side, and is a serviceable form of counter-irritation. 

A large blister, over the affected side, is always applied by some good 
practitioners, but they do not seem to possess any advantage over the 
use of heat either by the pack or poultices, and appear to be harmful, by 
adding to the irritation from which the nervous and circulatory systems 
are suiTering. When the disease has begun to decline, a blister is useful, 
1 y assisting in the removal of the products of inflammation, but then 
has no advantage over the repeated applications of Tincture of Iodine. 

Like pneumonia, in cases of robust persons with high fever and a 
strong, incompressible pulse, and the pain is very severe, a blood-letting, 
in the very beginning of the disease, will prove serviceable, and often be 
followed by quick relief. The amount of blood taken should be from 
twelve to sixteen ounces. A feeble, or only moderately strong person, 
ought not to be bled. 

After the pain has been relieved for several hours, by the use of Opi- 
um, the revulsive effect of a free saline cathartic is required. For this 
purpose, one or two tablespoonfuls of Epsom Salts is the most efficient. 

29 



450 INFLAMMATION OF THE PLEUKA. 

If boiled with one-third its bulk of roasted coffee for a couple of min- 
utes, in an earthen vessel, and then allowed to draw for a few minutes, 
the taste will be covered. Other salines may be given, but with less 
effect, as the Solution of the Citrate of Magnesia, Rochelle Salts or Seid- 
litz Powders. 

The bowels should be kept open by the use of moderate doses of the 
saline cathartics. For this purpose, the latter ones are as appropriate. 

If the fever and pulse continue to run high, after the influence of the 
Opium is produced, a drop of the Tincture of Aconite should be given 
every half hour, until an impression is made on the fever movement, and 
then continued in one-drop doses of one hour to two hours apart, accord- 
ing to the degree of fever and the force of the pulse. The Opium should 
be continued, in doses of sufficient size, and with such frequency as would 
relieve the pain. 

The use of Veratrum Viride is preferred, by some practitioners, as a 
sedative for the pulse and fever. While it is very powerful, it seems to 
the writer that the Aconite is to be preferred. Neither of them should 
be prescribed, except by a physician, and then they are only called for, as 
a rule, in persons of robust constitution. 

In giving Yeratrum Viride, the Fluid Extract should be used, in doses 
of one to three drops, or the Tincture in doses of two to six drops, repeated 
every hour, until the pulse is slowed, and then repeated two hours apart, 
to continue the required impression upon the pulse. 

This treatment should continue as long as there is pain and fever, 
and should be maintained just in proportion to the prominence of these 
symptoms, but should be discontinued when they disappear. Counter- 
irritation will be appropriate, as will be shown. 

Great reliance is placed upon the use of Mercury by some practition- 
ers, as having a specific effect upon this and other inflammations of 
serous membrane, and by these is generally given with the Opium in doses 
of from one-half to one grain. The writer believes it is powerless in the 
way claimed. The use of the remedy as a cathartic, in doses of ten grains 
is admissible, if the patient is not especially susceptible to the influence of 
the drug. If the bowels do not move, it should be followed by a Seidlitz 
Powder, or one of the other saline cathartics mentioned above. 

The nutrition of the patient should be maintained by allowing such 
food, from the very beginning of the disease, in patients not strong, as 
will be retained and is digestible ; as a rule milk, eggs, animal essences or 
strong beef tea, and bread, rice, and other farinaceous articles are to be 
chiefly used, but in the latter part of the disease, the food should be more 
solid and meat may be allowed. In a very robust patient, feeding is not 
required to be followed as persistently until a few days have elapsed, but 
with feeble patients, the best results depend upon immediate and system- 
atic feeding from the beginning of the disease. The principles for nour- 
ishment given in the treatment of Pneumonia will apply here with only 
little less force. 

Measures to promote the absorption of the liquid thrown out into the 
pleural cavity (dropsy of the chest,) are hydrogogue cathartics (producing 
watery stools,) diuretics (medicines increasing the flow of urine,) counter- 
irritation, and such remedies as may, especially, promote absorption. 



DISEASES OF THE LUNGS. 451 

It is generally not well to resort to these cathartics until late in the dis- 
ease, on account of their extreme depressing influence. Themost powerful 
should be given, only when the greatest urgency exists, as extreme diffi- 
culty of breathing, from the great amount of liquid in the pleural cavity, 
or where other means have proved unavailing. They are Elaterium, 
Croton Oil, and Gamboge. They ought, if used, to be prescribed by a 
physician. The dose of Elaterium is one-eighth to one-fourth of a grain; 
it should be combined with half a grain or a grain of Extract of Hyoscya- 
mus. The dose of Croton Oil is one drop in mucilage or syrup. The dose 
of Gamboge is three to five grains in pill form, or rubbed up with sugar. 

Cathartics which are less severe, and very effective and can be relied 
on, are the Saline Cathartics mentioned on the preceding page. Diuretics 
may be given without reducing the system, and they often act with effi- 
ciency. Mustard Whey is resorted to as a domestic remedy, and is often 
sufficient. It may be taken almost at will. Water Melon or Pumpkin 
Seed tea can be given, with the addition of fifteen or twenty grain doses 
of the Citrate, Bitartrate,or Acetate of Potash. Squill, Digitalis and Broom 
are the most efficient remedies for this purpose. They may be combined 
in an Infusion of Digitalis (made from one dram of Digitalis to a half 
pint of water,) four ounces, Yinegar of Squill half an ounce, Fluid Extract 
of Broom half an ounce. Mix, and giveatablespoonful three times a day 
or oftener. The Potash Salts just mentioned may also be given with this 
mixture, or the Iodide of Potassium in doses of twenty grains. 

When giving cathartics or diuretics for removing the dropsy, the 
amount of drink should be limited as much as possible. Blisters no doubt 
hasten the absorption of the fluid, but it is probable that as much good 
will be done by the repeated applications of Tincture of Iodine to the 
side. 

If the strength of the patient should begin to fail, cathartics and diu- 
retics are out of place, especially the former, and Tonics and stimulants 
should be given as directed for Pneumonia. 

If the liquid accumulates in the chest to such a degree as to endanger 
life, the surgeon should remove it by tapping, as will be described for 
Chronic Pleurisy, and Dropsy of the Chest, further on in this article. 

The treatment of chronic pleurisy calls for the same treatment as the 
latter stage of acute pleurisy, consisting of the same cathartics and diu- 
retics, and for the same purpose. Small blisters may be repeatedly applied 
over the side, or preferably the Tincture of Iodine may be applied from 
time to time. 

The strength of the system requires support by the use of tonics, 
nourishment, and in extreme cases, alcoholic stimulants and out of door 
exercise. In many cases supporting measures are the chief means of cure. 
The Citrate of Iron and Quinine is as good a tonic as any, given in doses 
of two to five grains three times a day. It should be given in solution. 
The diet should be the most nutritious possible, but simple and digestible. 
If alcoholic stimulants are used at all, it should be a glass of wine or table- 
spoonful of whisky or brandy at meal times, and is doing good if it causes 
the patient to eat and digest more food. 

If the fluid persists in the chest, it can be effectually removed by tap- 
ping by means of a small trocar and canula attached to a Davidson's 



452 INFLAMMATION OF THE PLEURA. 

syringe. The liquid is removed in the same way as it is drawn from a 
vessel, during the process of an inj ection. When the fluid returns after its 
removal a half ounce of the Compound Solution of Iodine (Iodine a dram, 
Iodide of Potassium two drams, water twenty-one drams,) should be 
injected into the pleural sac. This is especially serviceable if the sac con- 
tains pus. Then the sac may be washed out with an ounce of this solution 
to a pint of water. 

The use of Iodide of Potassium, in doses of ten to twenty grains three 
times a day for a long time, is useful in promoting absorption. The treat- 
ment of dropsy of the chest is the same as that for chronic pleurisy. 

The Principles of Treatment for Pleurisy in Young Chil- 
dren are essentially the same as for the disease in the adult. The doses 
of Opium admissible are proportionately much smaller than are directed 
for an adult. It cannot, with safety, be used so heroically. For a child six 
months old, or less, five to ten drops of Paregoric, and half a drop to a drop 
of Laudanum. Above this age, and under two years, ten to twenty drops 
of Paregoric, two or three drops of Laudanum, or a grain of Dover's 
Powder; at the age of three or four, twenty to thirty drops of Paregoric, 
three to five drops of Laudanum or two grains of Dover's Powder may be 
given. The effect should be watched with a great deal of care. The doses 
should be repeated only sufficiently often to relieve pain, which will vary 
in frequency from two hours apart to two or three times a day. When the 
opiate is given every two hours until positive drowsiness is produced, it 
should be given at longer intervals, or its administration discontinued 
altogether for a time. 

Hot applications, poultices or the hot wet pack, are the preferable 
means for local treatment. 

Hot Turpentine stupes, or the application of the Tincture of Iodine, 
or Mustard plaster, may be resorted to. These are fully described in the 
treatment of pneumonia. 

After the pain is relieved, the bowels ought to be moved by the use of 
a saline* purgative, as directed for adults, in doses of half a teaspoon ful to 
a teaspoonful of Rochelle Salts; or Castor Oil may be given in doses of a 
teaspoonful mixed with an equal quantity of Glycerine, and a drop or 
two of Oil of Gauletina or Cinnamon, to disguise the taste. The bowels 
should be kept soluble by full or half doses of the same cathartics. 

Jf the pulse and fever continue high, after the pain is relieved, and 
the warm applications to the side have been made, if the patient is over 
three years old, the Tincture of Aconite in small doses frequently repeated, 
until an impression is made on the fever, and the pulse reduced to ninety 
or a hundred. It can be given with syrup, as follows: Take of Tincture 
of Aconite half a dram, of Syrup Tolu three and a half drams. Mix. 

Dose : From one to six drops every one or two hours. 

If the disease is secondary, or the patient feeble, Aconite or other 
depressing measures ought not to be used. 

Opiates to relieve pain, stimulant and warm applications as above 
directed, tonics and nourishment, will constitute the treatment. 

Except the child takes freely from the breast, nourishment consisting 
largely of milk, eggs, animal essences, and strong beef tea should be given 
through the length of the disease. 



DISEASES OF THE LTJXGS. 



453 



To promote absorption, the use of Tincture of Iodine for a counter- 
irritant is preferable. Small blisters, made with the Blistering Collodion, 
are admissible. 

The diuretic effect of Iodide of Potassium is very useful. It should 
be given in doses of two to five grains three or four hours apart : Take of 
Iodide of Potassium two scruples, Syrup of Peppei'mint and Water each an 
ounce. Mix. 

Dose : Twenty drops to a teaspoonful. 

If the child's blood is much impoverished, a scruple of the Pyrophos- 
phate of Iron may be added to the above formula. This prescription is 
very useful in preventing the disease passing into the chronic state. 

Other diuretics may be given in connection with the Iodide of Potas- 
sium. The following is a suitable formula: Take of Vinegar of Squills 
two drams, Tincture of Digitalis thirty drops, Water four ounces. Mix. 

Dose: A teaspoonful for a child two years old, or a dessertspoonful 
for a child four or five years old, three or four times a day. 

Purgatives should be limited as above stated, to keeping the bowels 
open. 

In case the treatment failed to produce the absorption of the fluid, the 
surgical procedures recommended for chronic pleurisy of the adult should 
be resorted to by the physician. 

HOMOEOPATHIC TKEaTMEIYT. Aconitum is an indispensable remedy 
in allaying the intense fever (with quick and full pulse) which is often 
attendant upon pleurisy ; and is in many cases, indeed, when timely 
administered, alone sufficient to cure the disease. It completely supplies 
the place of the lancet in such cases, and rarely fails to effect improve- 
ment in from six to eight hours ; should it not do so in that space of time, 
another remedy must be selected. 

Dose : Of a solution of ten pills to two tablespoonfuls of water, give a 
teaspoonful every hour, until the pulse becomes more healthy, the 
skin moist, and the breathing less painful and impeded. 

Bryonia-alba should, in general cases, follow Aconitum, when the 
fever has been somewhat allayed by that remedy. It is, more particularly, 
indicated, either in simple or complicated pleurisy, when the following 
symptoms are encountered, at an early stage of the disease : Aching, burn- 
ing, but, more especially, acute shooting or cutting pains in the chest, 
much increased during inspiration or on movement ; oppression and 
anxious respiration; palpitation of the heart; dry, cracked, brown, or 
yellow-coated tongue; bitter taste, nausea, and occasionally vomiting of 
mucus, or of a bitter, bilious-looking fluid ; aching or painful pressure at 
the pit of the stomach and under the false ribs ; intense thirst, especially 
at night ; constipation ; head confused and giddy ; giddiness on sitting up 
in bed ; aching and shooting pains in the head, or pain as if the head 
would burst, particularly, at the temples, with exacerbation on coughing, 
or moving; fiery, or bluish redness, and puffiness of the face; restless, dis- 
turbed sleep, frequent startings ; nocturnal- delirium, with alternations of 
lethargic sleep; burning heat of skin ; occasionally partial, clammy per- 
spiration ; pulse generally frequent, hard and small, but sometimes full, 
unequal, intermittent and weak; aching in the limbs. Lastly, when, in 
connection with many of the above, the following symptoms are met * 
with : Cough on lying on the side, or impossibility of lying otherwise 



454 INFLAMMATION OF THE PLEURA. 

than on the hack; dry cough, or cough with expectoration of dirty, yellow 
colored phlegm, streaked or tinted with blood, and attended with great 
exacerbation of pain, Bryonia will rarely fail to render much service, and 
can, indeed, with difficulty, be dispensed with. 

Dose : Of a solution of six pills to two tablespoonfuls of water, give a 
teaspoonful every four hours (or, in very severe cases, every two 
hours). 
Sulphur may, with advantage, follow Bryonia, when the pain men- 
tioned has been removed by that medicine, and often completes the cure, 
when Aconite or Bryonia, or both of these, have been insufficient. This 
remedy is, however, not uncommonly of essential service as an interme- 
diary resource, administered from time to time, to awaken the suscepti- 
bility in the system to the action of others — in such cases (associated with 
constitutional taint) as are not adequately influenced by either of the fore- 
going. 

Dose: If as an intermediary medicine, two globules in a teaspoonful 
of water, four hours after the last dose of any other medicine, fol- 
lowed, in six hours, by such treatment as may be particularly indi- 
cated. If as a conclusive resource to perfect the cure (already 
advanced) three globules in a teaspoonful of water every six hours, 
until four doses have been given, and then six globules the first 
thing in the morning (fasting) for four days; then pause two days, 
resuming the course as before, if necessary, and so on, until all traces 
of the disease have been removed. 



THE HEART AND PART OF THE ARTERIES. 

3. The right auricle receives the blood from all the veins in the body by 
the superior and inferior vena cava and corinary sinus, and passes it to the 
right ventricle. 

1. The right ventricle receives the venous blood from the right auricle, 
and forces it through the pulmonary arteries to the lungs to be changed by 
contact with the air. 

5. Pulmonary artery. 

4. Left auricle receives the blood from the lungs by the pulmonary 
veins, and passes it on to the left ventricle. 

2. The left ventricle receives the arterialized blood from the right ven- 
tricle, and forces it through the aorta (6) and its branches to every part oi 
the body. 

6. Aorta. 

7. 8. Eight and left coronary arteries respectively. 

9. Inominate artery. 

10. Left common carotid. 
. 11. Left sub-clavicle. 

12. Superior vena cava. 

13. Inferior vena cava. 




THE HEART AND THE COMMENCEMENT OF THE ARTEU1E 



PART TEPfTO. 

-~-~~ — .«. „ 

DISEASES OF THE ORGANS OF CIRCULATION. 



CHAPTER XXII 



DISEASES OF THE HEART. INFLAMMATION OF THE 

HEART. 

Under this head, we will have reference to inflammation of the mus- 
cular structure of the heart, carditis, inflammation of the lining mem- 
brane of the heart, endocarditis, and inflammation of the membranous 
sac which envelopes the heart, pericarditis. These are generally, treated 
upon as separate and distinct diseases, but as their symptoms are very 
similar, as well as the treatment recommended for them, we have judged 
it best to embrace them under one head. 

Symptoms. Inflammation of the heart, or its membranes, usually 
commences with the symptoms common to most inflammatory attacks, 
as chills, heat and dryness of the skin, thirst, flushed face, full pulse, etc. 
These are succeeded by rapid, imperfect and often unequal breathing and 
an acute lancinating pain about the region of the heart, which may extend 
to the shoulder. This pain, especially in pericarditis, is aggravated by 
pressure over the heart, as well as by a full inspiration. There will, also, 
be a dry, harrassing cough, which augments the patient's sufferings, and 
generally a sense of suffocation will be experienced. Motion or exercise 
will increase the pain and difficulty of breathing to a greater or less extent. 
The features are haggard and expressive of much suffering, with a degree 
of anxiety, the heart beats violently and irregularly ; a sensation of faint- 
ing is present, more or less constantly; at first the pulse is full, hard, and 
bounding, but speedily becomes small, frequent, and unequal, and fre- 
quently cannot be observed at the wrist; the appetite is deficient; the 
tongue coated white; the bowels constipated ; the urine insufficient and 
high-colored; the skin is often bathed in sweat, as in acute rheumatism; 
and when the diaphragm or midriffis involved, there will be a distressing 
and painful hiccup. 

Causes. These affections are, most commonly, owing to the presence 
of acute rheumatism, the disease either attacking the heart primarily, or 
being translated to it from some other part of the system. They may, 
likewise, occur from other causes, and are sometimes met with in combi- 
nation with pleurisy, Bright's disease of the kidneys, etc. 

45o 



4£tf INFLAMMATION OF THE HEAIIT. 

Prognosis. These attacks are of a very serious character, and may 
terminate fatally in a very short time; though it is said that even when 
left entirely to themselves without any care or treatment, not more than 
one in six cases is wont to prove fatal. The principal evils to fear are the 
secondary or chronic affections resulting from the acute attack. 

ALLOPATHIC TREATMENT. Inflammation of the substance of the 
heart is so rare and so completely impossible to determine during life, 
that a discussion of means of treatment is not called for. 

The most frequent form of inflammation is that of the lining mem- 
brane of the heart (endocardium) and is called endocarditis. It produces 
the great majority of diseases of the heart by causing permanent changes 
in its valves. This form of inflammation of the heart (endocarditis) most 
frequently occurs with inflammatory rheumatism (of the joints) and 
appears to depend on the same morbid cause. When rheumatism exists, 
therefore, the treatment required for it will have the most favorable influ- 
ence on the endocarditis and should be employed. If promptly resorted 
to, it will prove protective against this disease. 

Remedies addressed directly to this inflammation may be briefly sum- 
marized as follows : It is appropriate to use saline laxatives, provided the 
patient is not weak or reduced. The articles most appropriate are a table- 
spoonful doses of Rochelle Salts, and Seidlitz Powders. Pain over the 
region of the heart should be met by hot poultices, the hot wet pack, as 
described for pleurisy, or Turpentine stupes. Opium in doses of half a 
grain to a grain, fifteen to twenty-five drops of Deodorized Laudanum, or 
appropriate doses of other preparations of Opium, may be given to relieve 
the pain, and sufficiently often to procure this effect. 

The subsequent ill-effects of the disease are due to the products of the 
inflammation, either the deposit of lymph beneath or upon that portion 
of the membrane covering the valves. Remedies which will reduce the 
fibrin in the blood or retain it in a fluid state, are called for. The alkalies 
called for by the rheumatism are appropriate. Ammonia has a direct 
influence to this end; the Aromatic Spirits of Ammonia (Hartshorn) 
may be given through the course of the disease. The dose is a teaspoon 
half full to a teaspoonful in water or syrup, and may be repeated from two 
to six hours apart, according to the severity of the disease. 

To promote the absorption of the lymph Iodide of Potassium may be 
given in doses often to fifteen grains, three times a day, and the Tincture 
of Iodine may be applied, daily or less often, over the region of the heart. 
The discrimination of this affection requires the skill of a physician. 

The more immediately and exceedingly dangerous inflammation to 
which the appendages of the heart is subject is pericarditis (inflammation 
of the serous membrane covering the heart). When the disease occurs in 
the course of acute articular rheumatism the remedies appropriate to 
that affection are urgently called for. The use of the saline cathartics, 
Rochelle Salts in doses of one to two tablespoonfuls or one or two Seidlitz 
Powders, are useful by way of revulsion. They should be repeated in four 
hours, if the bowels have not moved. 

Opium in some of its forms is invaluable given to the extent of reliev- 
ing pain. The best manner of using it is the hypodermic injection of 



DISEASES OF THE ORGANS OF CIRCULATION. 457 

Morphine in doses of a quarter to a third of a grain, by a physician . They 
may be repeated every half hour, until pain is overcome. 

A third of a grain of Morphine, thirty drops of Laudanum, or a grain 
and a half of Opium may be given every hour, until pain is relieved. 
Afterwards, repeated at such longer intervals as will maintain the effect. 

If, after the pain is relieved, the pulse continues strong and very 
rapid, Tincture of Aconite may be given in doses of a drop every hour, 
until an impression is made on the fever and pulse, and then every two 
hours, to maintain its effect. 

Tincture of Veratrum Viride is used instead, by some practitioners, 
for this purpose. The dose is two to five drops of the Tincture, or one to 
three drops of the Fluid Extract every two hours. 

Mercury is thought, by some practitioners, to exercise a controlling 
power over this and other inflammations of serous membranes. If used, 
it may be given in doses of a sixth to a third of a grain of Calomel every 
two hours to impress the system quickly. Its beneficial action is, to say 
the least, doubtful. 

Counter-irritation, such as Mustard plasters, Turpentine stupes as 
directed for pneumonia, the applications of Tincture of Iodine, the hot 
wet pack may be useful. A warm poultice may be kept over the region 
of the heart. 

After the acute symptoms have subsided, to promote the absorption 
of fluid from the pericardial (upon the heart) sac, the region over the 
heart may be painted every day with Tincture of Iodine, and small blis- 
ters may be applied by using the Blistering Collodion with a camel's hair 
brush. When a blister is made, it should be allowed to immediately 
dry up. 

The use of cathartics is admissible, as far as the strength of the patient 
permits, to promote absorption. 

Epsom Salts, or Citrate of Magnesia, or Bitartrate of Potash may be 
made to produce one or more water stools a day. 

Diuretics, as Squills and Digitalis, may be given, in equal parts, three 
or four times a day, in doses of a teaspoonful. 

It is during this stage that the strength of the system needs support- 
ing with nutritious food, as strong beef tea, or essence, milk, raw eggs 
beat up with sugar and water or milk, or poached, and such farinacious 
articles as the patient desires; steak, broiled rare, may be eaten, if rel- 
ished. 

Quinine, in doses of one to three grains, three times a day, may be 
given for a tonic. 

If the circulation is weak, stimulants are called for. A tablespoonful 
of Brandy or Whisky may then be given in milk or with the raw egg, 
as often as two hours apart, if required. Its beneficial effect will be 
shown by producing a fuller, softer, and more regular pulse. 

During convalescence, the diet should be good and nutritious, but 
simple. Much exercise should be avoided, though part of the time spent 
in the open air is beneficial. 

Treatment appropriate to other diseases when pericarditis occurs as a 
complication, must be continued. 

Pericarditis from wounds can have little else done for it, except to 
relieve the pain with Opium. 



458 INFLAMMATION OF THE HEART. 

Should the disease become chronic, the treatment given for the acute 
disease, after the early symptoms, is appropriate. Iodide of Potassium 
may be given, in doses often to twenty grains, three times a day. If the 
blood is much impoverished, one or two grains of the Pyrophosphate of 
Iron may be given with the Iodide of Potassium. In cases in which the 
use of these means with cathartics, diuretics, etc., fail to remove the 
liquid, it has been successfully done by tapping, and in some instances 
the Compound Solution of Iodide of Potassium has been injected into 
the sac. 

So serious a disease, and one involving such difficulty in its manage- 
ment, requires, invariably, the services of a physician. 

HOM<EOPATHIC TREATMENT. The diseases of the heart are all 
so difficult to understand, and a proper understanding of the case is so 
important that, although I very much desire to bring their treatment 
within the comprehension of the masses, I am unable, thus far, to do so, 
fully. Appended are many of our most approved remedies, with their 
particular indications, by Lillienthal. 

The dose should be varied and repeated in proportion to the urgency of 
the case. From four to eight pills in a little water, repeated at intervals 
of from one to twelve hours, may be given. 

Aconite, Oppression about the heart, burning flushes along the 
back; palpitation, with feeling as if boiling water was poured in the 
chest; anxiety, difficulty of breathing, flying heat in the face, sensation 
of something rushing into the head ; fainting with tingling. 

Amon. carb. Audible palpitation, with attacks of great anxiety, as 
if dying; cold sweat, involuntary flow of tears; unable to speak ; loud, 
difficult breathing and trembling of hand ; debility and soreness of the 
whole body; pulse hard, tense, frequent. 

Apis?nel. Sudden attack of acute pain just below the heart, soon 
extending diagonally toward the right chest; blowing sound with the 
diastole; sensation as if he would not be able to breathe again; great 
prostration ; pulse accelerated, full and strong, or feeble and imper- 
ceptible. 

Argentum met. Full feeling in region of heart; frequent spas- 
modic, though painless, twitcbings of the whole cardiac muscle, espe- 
cially on lying on back ; fears apoplexy ; lame, weakness with all pains. 

Arnica. Sensation as if heart were grasped by an iron band; stitches 
in cardiac region; region of base of the heart feels as if bruised; sudden 
pain, as if the heart got a shock ; intermittent, feeble, hurried, irregular 
pulse; hypertrophy of heart, induced by over-exertion, especially, in 
young men, as from rowing; the fatty heart. 

Arsenicum. Palpitation, after suppressed herpes or footsweat, with 
feeble, irregular pulse; the heart beats strong, visible, and audible at 
night, more rapidly when lying on back ; pericarditis in consequence of 
suppressed measles, or scarlet fever, with inexpressible anguish and rest- 
lessness, worse at night, flushed face, paralytic feeling in the upper extrem- 
ities; tingling in fingers, cold perspiration. 

Assafmtida. Nervous palpitations ; with small pulse, breathing not 
oppressed, in women after suppressed discharges, or bodily exertions; 



DISEASES OF THE ORGANS OF CIRCULATION. 459 

pressure in cardiac region, as if heart were too full and expanded; pulse 
small. 

Aurum Met, Frequent attacks of anguish about the heart, with 
tremulous fearfulness ; violent beating of the heart after exertions, with 
great agony ; strong beating of heart, with anxiety and congestion to head, 
after metorrhagia; when riding or walking, palpitation compels one to 
stop ; palpitation, with irregular intermittent pulse, and short breathing. 

Belladonna, Nervous palpitations, with congestion to head; pres- 
sure in cardiac region, which arrests the breathing, and causes a sense of 
anxiety ; gurgling at the heart, a kind of palpitation when going upstairs; 
throbbing of carotid and temporal arteries. 

Benzoic Acid, Benzoate of Ammonia. Kheumatism of heart; 
pains change place incessantly, but are not constant around the heart ; 
awakens after midnight, with violent palpitations of the heart and tem- 
poral arteries ; internal, but not external heat; at times, tearing pains in 
the extremities, relieving the heart; urine high-colored, offensive, hot, 
scalding, ammoniacal, high specific gravity. 

Bryonia, Pericarditis, with stitching pain in cardiac region, pre- 
venting motion, and even breathing, wants to lie perfectly quiet; heart 
beats violently, and rapidly, strong orgasm of blood ; from re-percussion of 
measles. 

Cactus Ch*and. Pericarditis and endocarditis ; sensation of con- 
striction of the heart, as if an iron band prevented its normal movement; 
acute pains and stitches in the heart; difficulty of breathing; attacks of 
suffocation, with fainting ; cold perspiration on face, and loss of pulse ; 
palpitation when walking, and at night when lying on left side. Nervous 
palpitations; easily frightened, often awakes in a fright; numbness of 
left arm, annoying, creeping sensation from before backwards, in cardiac 
region, oedema of the hands, especially, of left one; endocardial murmurs, 
excessive impulse, increased prsecordial dullness; enlarged right ventri- 
cle ; irregularity of the heart's action, at times frequent, at others slow ; 
great irritation of the cardiac nerves; enlarged left ventricle; pains in the 
apex of the heart, shooting down the left arm to the ends of the fingers ; 
feeble pulse, dyspnoea; general weakness, prostration, great depression, 
sleeplessness, fainting. 

Cimicifuga. Excessive impulse of the heart over an extensive por- 
tion of the left side, with dullness on percussion ; heart's action ceases 
suddenly, impending suffocation ; pains from the region of heart, all over 
the chest and down left arm, palpitation, unconsciousness, cerebral con- 
gestion, dyspnoea, face livid, cold sweat on the hands, numbness of the 
body, the left arm numb, and as if bound to the side; pulse weak, irregu- 
lar, trembling; chorea of heart, tumultuous, irregular, unexpected, 
and strange motions of the heart ; cardiac debility ; rheumatic endo, and 
pericarditis. 

Colchicum, Heart disease, following acute rheumatism, dropsy of 
heart (hydro-pericardium;) pressure and anxiety in precordial region ; 
fullness and oppression, as from stagnation of blood in the heart at night, 
while lying on left side, he is obliged to turn to the right side ; dull, irreg- 
ular, seemingly suppressed beats of the heart, with a peculiar sensation in 
chest ; pulse small, slow, and weak. 



460 INFLAMMATION OF THE HEART. 

Digitalis, Pericarditis, with copious serous exudation ; violent, but 
not very rapid beating of the heart, irregular, intermittent pulse, brick- 
dust sediment in urine, during or after rheumatism. Very feeble irregu- 
lar action of the heart, with feeble, small, intermittent pulse; great 
prostration, fainting on the least movement, even lifting the arms, with 
palpitations, coldness of limbs and body, and dreadful weak feeling in pit 
of stomach, with or without convulsions, of syncope; profuse expector- 
ation of bloody mucus, and vomiting of food ; sensation as if the heart 
would stop beating if she moved, with fear of impending death ; hydro- 
pericardium (dropsy of the heart). 

Ferrum. Consecutive heart disease, especially from chlorosis and 
onanism ; congestion to head, spitting of blood ; palpitations, better 
from moving slowly about; pseudo-plethora, with hard, strong, beat- 
ing of the heart and throbbing in all bloodvessels; pulse full, hard, 
increased by exertion; soft bellows sound at apex; nervous restlessness, 
must walk slowly about. 

Gclsewiinum. Cardiac neurosis. Feeling as if the heart would stop 
beating, if she did not move about ; a sensible motion of the heart, as 
though it had attempted to beat, which it failed fully to accomplish, and 
the pulse then each time intermitted, worse when lying down in bed, 
especially when lying: on left side; excessive action of heart; stitching 
sensation in cardiac region, heart's action slow and feeble, the beats of 
heart cannot be felt, chills and pains in head ; nervous chills, yet skin is 
warm, wants to be held that she may not shake so. 

lodwm. Pericarditis in complication with croupous pneumonia purr- 
ing feeling in the region of the heart, violent palpitation, increased from 
the slightest motion, better while tying perfectly quiet on the back ; faint- 
ing spells ; sensation as if the heart were squeezed together; fluttering 
sensation in heart ; constant, heavy, oppressive pain in cardiac region. 

Lilium Tigrin. Cardiac irritability, nervous palpitation ; pains dull, 
pressing and heavy, as if the heart were grasped and released alternately ; 
sensation as if the heart contained too much blood, which might be re- 
lieved by throwing up blood ; pain, pressure, and fullness about the heart 
with a feeling of coldness about the heart, but no indication of any organic 
lesion ; trembling feeling about the apex of the heart, worse on talk- 
ing; frequent sensation as if the heart stopped, followed by a rush of the 
blood to the heart and violent palpitations ; amelioration by lying on left 
side. 

Lycopodiiini. Hydro-pericardium ; trembling palpitation, pulsating 
tearing in the region of heart; sensation as if the circulation would stand 
still, or ebullition of blood ; palpitation of heart nearly every evening in 
bed ; marked palpitation, with flatulence ; acceleration of pulse, with 
coldness of the face and feet ; neck drawn towards right side, stitches in 
left side of chest ; typhoid symptoms. 

Nux moschata. Hysteria cardis ; violent action of heart ; feels as if 
her head would burst, and her heart be squeezed off; trembling flutter- 
ing of heart, as from fright ; palpitation and fainting, followed by sleep; 
irregularity in heart's beat, pulse intermits sometimes so long that it ex- 
cites fear of death ; murmur in carotids ; frequent trembling pulse, accel- 
erated after wine; disposition to faint even from slight pains. 



DISEASES OF THE ORGANS OF CIRCULATION. 461 

Nux-vomica. Hypertrophy of heart from portal obstruction; palpi- 
tation in frequent short paroxysms, with pulsating throbs in the direction 
of the heart, especially, from mental emotions, protracted study, after 
eating highly-seasoned food ; tired sensation of the heart, with palpitation 
when lying down, frequent belching; dilation of heart (weakened heart) 
with nervous palpitation, with nausea, inclination to vomit, and heaviness 
of the chest. 

Phosphorus. Disease of right heart, with consequent stagnation; 
dilation of the heart following endocarditis; fatty degeneration of heart; 
dyspnoea, tightness across the chest; great weakness, with inability to 
exert himself; palpitation from every emotion, with rush of blood to the 
chest, especially, in rapidly-growing youths; over-sensitiveness to external 
impressions ; congestion to lungs, tightness across chest, and tight cough; 
painless diarrhoea. 

Phytolacca. Chronic rheumatic endocarditis ; shocks of pain in car- 
diac region, pain goes into right arm; awakens with lameness near heart, 
worse during expiration, cannot get to sleep again; heart's action weak 
(fatty heart), with constipation; great exhaustion. 

Podophyllum. Nervous palpitation, in consequence of excessive 
hepatic action ; sensation in chest, as if heart were ascending to throat; 
palpitation, with a clucking sensation rising up the throat, obstructing res- 
piration ; palpitation from mental emotion or exertion, with rumbling in 
ascending colon ; heavy sleep, fatigue on waking in morning. 

Pulsatilla. Nervous palpitation in young girls during the time of 
puberty, or from amenorrhcea; catching pam in cardiac region ; better for 
a time from pressure of hand ; rheumatic irritation of heart, the pains 
shifting rapidly from one part of body to another ; constant chilliness ; 
worse nights, especially after getting feet wet ; burning in cardiac region ; 
violent fits of palpitation, often with anguish and obscuration of sight. 

Rhus-tox. Uncomplicated hypertrophy, from violent exercise ; 
organic heart disease, with sticking pain and soreness ; numbness and 
lameness of the left arm ; chest and heart feel weak after a walk ; violent 
palpitations when sitting still ; pulse sometimes quicker than the heart's 
beat, irregular; restlessness, must change position; always worse when 
keeping quiet. 

Scutellaria. Irregular action of the heart, from derangement of the 
cardiac nerves; tremulousness and twitching of cardiac muscles; oppres- 
sion of the chest, with a sticking pain in cardiac region; sensation of 
throbbing about the heart, with flushed face ; nervous disorders of heart, 
as palpitation, tremor, and strange sensations, from emotional excite- 
ment; hysteria; reflex nervous irritation, from ovarian or uterine dis- 
orders. 

Sepia. Suppressed menses ; congestion of blood to the chest, with 
violent palpitations; an occasional hard thump of the heart; palpitations, 
with anxiety about things which happened years ago ; palpitation after 
mental emotion ; interruption of the beating of the heart, most after din- 
ner; alarming, quivering motion; restless, fidgety; sensation of ball in 
inner parts. 

Spigelia. Kheumatic pericarditis. Undulating motion of the heart; 
indistinct beats of the heart, running one into another; tumultuous beat- 



462 INFLAMMATION OF THE HEART. 

ing of the heart, in recumbent as well as sitting positions, not synchronous 
with the radial pulse; spasms of the chest; suffocative complaints ; trem- 
ulous sensation in chest and temples, increased by motion ; tearing sensation 
in chest when raising the arms overhead, and when touching pit of stomach ; 
purring murmur during the beats of the heart; stitches in cardiac region; 
pulsations of carotids, with tremulous motion ; great dyspnoea at every 
change of position ; bright redness of lips and cheeks, changing to pallor 
during every motion ; audible beating of the heart,causing a pain that is 
felt through the back ; cutting pains from the heart to shoulders, as far as 
the head and arms; arthritic pain and stiffness in joints; dull stitches 
where the beats of heart are felt, and recurring with the measured regu- 
larity of the pulse ; scraping in throat , affection of the tracheal and 
bronchial mucous membranes ; systolic blowing at the apex; pulse irregu- 
lar, strong, but slow. 

Spongia. Aneurism a aortas; dry paroxysmal cough; worse lying 
down; rheumatic endocarditis; loud blowing with each heart-beat ; attack 
of oppression and cardiac pain; worse when lying with the head low; 
stinging-pressing pain in precordial region ; violent palpitation; awakens 
at night with a sense of suffocation ; violent gasping respiration ; loud 
cough; great alarm; agitation and anxiety; valvular insufficiency; feel- 
ing of numbness of lower part of the body; trembling in all the limbs. 

Veratrum-album,. Tumultuous, irregular contractions of heart, 
forerunners of paralysis ; intermittent action of heart in feeble persons, 
with some obstruction to heptic circulation ; violent, visible, anxious pal- 
pitation, with fainting; pulse sometimes slower than heart-beat. 

Veratrum-viride. Idiopathic and rheumatic peri- and endocarditis ; 
violent fever; full, hard, bounding pulse; congestion to the head, without 
delirium ; throbbing carotids ; constant burning pain, with oppression of 
the chest; sensation as of a heavy load on the chest; heart's action violent 
and tumultuous ; respiration rapid, labored, and sighing ; faintness and blind- 
ness when rising from lying, from sudden motions ; patient feels best 
when lying quietly. 



PALPITATION OF THE HEART. 

Palpitation of the heart is symptomatic of some other disease, but is 
often so severe as to require a distinct consideration. There is a rapid 
beating or fluttering motion of the heart, which may be felt very plainly 
when the hand is placed upon the chest over this organ. Various other 
symptoms may accompany it, as a shortness of respiration, a sense of pain 
in the neighborhood of the heart, a feeling of constriction across the chest, 
inability to lie down, pale countenance, swollen feet, a real debility, irreg- 
ular or intermittent pulse, much distress on slight exertion, etc. The 
palpitation may vary from a simple, full, uniform, powerful beating of the 
heart to a rapid, violent, confused and irregular action, shaking the whole 
system, and producing very disagreeable sensations. 

Causes. Palpitation of the heart is, generally, owing to dyspepsia, 
or some derangement of the digestive functions; occasionally, it occurs as 
a symptom of some nervous disorders, and it frequently accompanies 



DISEASES OF THE ORGANS OF CIRCULATION. 463 

enlargement of the heart, dropsy of the heart, and other diseases of this 
organ and its arteries. It may, also, be brought on by great mental excite- 
ment, intemperance, masturbation, excess in venery, etc. 

ALLOPATHIC TREATMENT. Many cases of palpitation of the heart 
depend on an impoverished condition of the blood (anaemia,) in which 
case the remedy is to restore the blood to its natural richness by the use 
of Iron and Quinine, good food and hygiene. 

The Citrate of Iron and Quinine is one of the suitable remedies, given 
in doses of two to five grains in solution three times a day ; other tasteless 
forms of Iron may be used, as the Pyrophosphate, or the Soluble Citrate, 
and the Quinine may be taken in pills of one or two grains. 

Many cases of feeble heart, rapid in its action, are greatly relieved by 
five to twenty drops of Tincture of Digitalis, three or four times a day. 

If the patient is strong and robust, and the action of the heart vigor- 
ous, and the arterial action high, the physician would be justified in 
resorting to the use of such arterial sedatives, as Tincture of Aconite in 
doses of two or three drops, or Tincture of Veratrum-viride in doses of 
two to five drops, sufficiently often to produce a sedative effect on the 
action of the heart, one, two, or three hours apart. 

The Bromides are suited to cases of irregular action of the heart, and 
in cases having an irregular circulation in one extremity, while it is reg- 
ular in the other, and various other irregular symptoms referable to the 
circulation. The Bromide of Potassium may be given in doses of ten to 
thirty grains, three or four times a day. For feeble patients, the Bro- 
mide of Iron, in one or two grain doses, may be given at the same time, 
or other tonics may be taken. 

A Belladonna plaster over the region of the heart, will sometimes 
give relief, especially, if there is pain. 

Prolonged attacks of palpitation are often speedily relieved by half 
teaspoon ful doses of Chloric Ether, or Hoffman's Anodyne every fifteen 
or twenty minutes, until relief is obtained. 

If valvular disease, or dilatation of the heart exist, exercise should be 
of the most moderate kind, and all excitement, of every kind, avoided. 

This trouble may be caused by tobacco, coffee, tea, stimulants, narcot- 
ics, mental depression, or excessive venery. Such causes are to be sought 
for, and, if discovered, they are to be removed. 

HOMEOPATHIC TREATMENT. When the palpitation is owing to 
disease of the heart, relief is all that can be expected, unless the disease 
be cured, and the same may be said when it is owing to the dyspepsia or 
other affections; but diseases of the heart are not so readily cured as 
many other maladies. Whatever may be the disease occasioning the 
palpitation, it should be treated and removed, if possible. 

Aconitum may be recommended for palpitation of the heart, attended 
with a sensation of anguish and intense oppression at the chest, and, 
generally, with weight and weariness of the extremities, flushing of heat, 
especially in the face, short, painful and anxious respiration, or short- 
ness of breath, particularly during sleep; sometimes pricking sensations 
in the chest, or sensation of compression, or as if bruised in the left 
side, or, again, shooting pains in the left side, particularly during mo- 
tion, and on going up stairs ; palpitation caused by fright. 



464 PALPITATION OF THE HEART. 

Dose : Six pills in a teaspoonful of water, repeated at intervals of an 
hour, until the particularly indicative symptoms are moderated ; or 
afterwards again, from time to time, should those indications occur. 

Belladonna, when there are violent pulsations of the heart, reverb- 
erated, as it were, through the whole chest, and sometimes to the extrem- 
ities and head; sensation as of a heavy weight on, or firm band about 
the chest, with pains in the shoulder-blades; irregular, and sometimes 
interrupted breathing, with an occasional effort to expand the chest for 
breath, or short, anxious, and very accelerated respiration ; palpitation, 
sometimes attended with intense anxiety, particularly in the evening in 
bed ; tremulous palpitation of the heart, with anguish ; or palpitation 
generally on going up stairs. 

Dose: Six pills in a teaspoonful of water, as directed for Aconitwn. 

Nuoc-vomica is more particularly of service for palpitation of the 
heart, occurring in persons of dry, meager habit ; but, also, in persons of 
robust constitution and sanguine or bilious temperament, and, particu- 
larly, when the paroxysms are liable to come on either in the morning — 
sometimes attended with nausea, and even inclination to vomit, or with 
pressure at the chest — or, more especially, upon first lying down or after 
eating (sometimes after every meal,) heat, or even burning sensation in 
the chest, occasionally occurring at night, and attended with great anx- 
iety, sleeplessness, and agitation ; or if coming on after the use of coffee or 
liquors. 

Dose: Six pills, as directed for Aconitum. 

Sulphur is, generally, of service after one or more of the foregoing 
medicines, in completing the cure, but, particularly, when the attacks are 
provoked by ascending stairs, etc., and are accompanied by a feeling of 
anxiety or dread. This remedy is, also, very serviceable when the affec- 
tion has ensued after the suppression of an eruption, or the sudden healing 
of an old sore. 

Dose : Six pills, as directed for Aconitum. 

Arsenicum may sometimes be required after the previous adminis- 
tration of Sulphur, in cases in which the symptoms have not yielded to a 
second course of the last named medicine, and when the affection has 
ensued as the consequence of a suppressed eruption, or of the sudden heal- 
ing of an old sore. 

Dose: Six pills, as directed for Aconitum. 

Lachesis is indicated when there is frequent desire to draw a long or 
deep breath, or shortness of breath, chiefly prevalent after eating or after 
any exertion of the limbs (particularly of the arms,) generally attended 
with deep despondency ; also, by suffocative attacks at night; or spasmodic 
affections of the heart, attended with a peculiar pulsative sensation, deep 
(as if on the drum) in the ear, which make it appear as if the membrane 
would burst — or, again, in very severe cases, and when fainting-fits and 
cold sweats attend upon spasmodic attacks of the heart, and there is 
extreme shortness of breath. 

Dose : Six pills, as directed for Aconitum, 

Pulsatilla is a remedy of great value in the generality of cases, in 
which palpitation of the heart occurs as a nervous or hysterical symptom, 
or in young girls during the time of puberty, or from suppressed men- 
struation. 



DISEASES OF THE ORGANS OF CIRCULATION. 465 

Dose: Six pills, as directed for Aconitum. 

Codtidus is more particularly required when there is a suffocative 
palpitation of the heart associated with- weakness, trembling of the limbs 
and extreme languor, dizziness and faintishness, and when the attacks 
are aggravated or excited by talking, eating, or drinking. 

Dose: Six pills, as directed for Aconitum. 

Cactus is indicated in palpitation occurring in persons who are usu- 
ally low-spirited or hypochondriacal; palpitation worse when walking, 
and at night, when lying on the leftside; general prostration of strength, 
and sleeplessness. 

Dose: Six pills, as directed for Aconitum. 

Coffea is more especially required, in recent cases, particularly when 
the palpitation is attended with excessive nervous excitement, with suffo- 
cative attacks and excessive anxiety, attended with groundless apprehen- 
sions, torture of conscience, great despondency, restlessness, and some- 
times complaints ; or again, when sudden emotions of joy have induced 
the attack. 

Dose: Six pills, as directed for Aconitum. 



FATTY DEGENERATION OF THE HEART. 

Fatty degeneration either consists in an abnormal increase of the 
normal quantity of fat about the heart, or in the adventitious formation 
of fat within the muscular tissue of the heart. . 

In the former case, the fatty heart proper, the disease can be traced to 
all those causes that determine a general increase of fat; hence fatty heart 
is generally met with among persons inclined to grow fat; fatty heart is 
likewise the result of an excessive use of ardent spirits. On the contrary, 
and in defiance of all physiological explanations, a fatty heart is some- 
times, although rarely, met with in spare individuals or in persons tainted 
with a constitutional dyscrasia. 

The second kind, fatty degeneration of the muscular tissue, not unfre* 
quently results from the former. 

In fatty heart, the normal quantity of fat covering the heart, etc., is 
sometimes increased to such a degree, that the whole heart seems 
surrounded by a thick cushion of fat. The layer of fat deposited on the 
right side of the heart is always more considerable, and is formed sooner 
than on the other side. Not unfrequently the fat dips into the interstices 
of the muscular fibres, impairs their nutrition, and either results in atro- 
phy or a fatty degeneration of the muscular tissue. 

Symptoms AND COURSE. The lesser grades of fatty heart and fatty 
degeneration of the heart may run their course without any morbid phe- 
nomena; there may even exist a considerable deposit of fat, and yet the 
general health of the patient may be perfectly sound. Morbid symptoms 
may not take place until the pressure of the fat causes atrophy or fatty 
degeneration of the muscular tissue. The first symptoms of this disease 
consist in functional deficiency of the action of the heart; peculiar feel- 
ings of weakness and short breath from the least exertion. In addition to 
this, we have disposition to vertigo, fainting-fits or paroxysms resembling 
syncope, and sometimes even apoplexy. Except a distressing sensation of 

30 



466 FATTY DEGENERATION OP THE HEART. 

pressure, the patient does not experience any pain. In the higher grades 
of this disease the skin becomes cool, disposed to perspire promsely; it 
assumes a pale and sickly appearance, oedema sets in, and the excessive 
weakness of the circulation may result in dropsy. The physical signs 
are the following: Increasing weakness of the impulse of the heart; 
feeblenessof thesoundsof the heart; easily compressible, soft, unresisting 
pulse, which may show every possible irregularity and is often extremely 
slow. 

This affection only runs an acute course if the fatty degeneration seta 
in rapidly and very extensively in consequence of inflammatory processes; 
otherwise the disease runs a very chronic course and depending upon the 
following conditions: If the fatty degeneration affects an hypertrophied 
heart with valvular disease, dilatation and finally paralysis of the heart 
result, or else rupture of the heart takes place. This may likewise result 
from a less extensive fatty degeneration, after partial dilatation has 
occurred. The disease is very commonly characterized by marked remis- 
sions or even complete intermissions. Death takes place, although not in 
a majority of cases, either by general wasting away with dropsy, or by 
dropsy of the lungs, or paralysis of the brain, or, which is most commonly 
the case, very suddenly by acute anaemia of the brain, rupture or paralysis 
of the heart. 

HOME TREATMENT. In treating this disease, we have to aim in the 
first place, at arresting its progress by the avoidance of every hurtful influ- 
ence generally, and every dietetic indiscretion in particular; next, at 
stopping the paroxysms of distress as soon as possible ; and finally, at 
effecting a retrograde change of the disorganization. 

We should be led too far, if we were to go into full particulars regard- 
ing the diet; all we shall do is to present the following general proposi- 
tions to the reader's attentive regard : The production of fat is owing to 
an excessive supply of food, the supply considerably exceeding the waste. 
The quantity of fat produced will be so much greater the more the supply 
consists of substances that are known to make fat, principally animal and 
vegetable fats and starch-containing food. Beer generally promotes the 
formation of fat, either directly or indirectly. Meat, if constituting the 
chief article of diet, scarcely ever makes fat. These few points suffice as 
general dietetic directions. Let the supply and waste be properly bal- 
anced by bodily and mental occupation, and let whatever excess remains 
be done away with. The patients should principally use lean meat, no 
starch-containing vegetables or fruit, and but little bread and wine ; and 
they should never overload their stomachs, as so many people do from 
mere habit, not from necessity. By pursuing such a system of diet and 
hygiene, the patient will be able, as a rule, to do without a resort to any 
remedial agents. Starvation-cures are the more condemnable in the case 
of such patients, the more the heart has already become diseased. At the 
same time, it must be admitted, that there are many persons who, most 
generally, in consequence of abnormal changes in the functions of the 
liver, deposit such quantities of fat, even under the simplest and most cau- 
tious diet, that it seems impossible to suggest any further changes in this 
respect. 

Fatty degeneration may sometimes, but assuredly, only in rare 
instances, have its primary origin in a constitutional tendency to fatness ; 



DISEASES OF THE ORGANS OF CIRCULATION. 467 

otherwise, we are unacquainted with any other cause of this disease, that 
might suggest special dietetic preventive rules. 

If the presence of cardiac disease is substantiated beyond any doubt, 
the patient's mode of living has to be regulated with a view of preserving his 
strength as much as possible. Substantial nourishment, so far from being 
forbidden, should be recommended; the moderate use of wine is generally 
attended with the happiest results. In the case of drunkards, spirits 
should be withdrawn gradually, not all at once. A sudden and complete 
abstemiousness might lead to dropsy; indeed the frequent occurrence of 
such an event should be a warning to us. The prostration which follows 
every considerable exertion, admonishes the patient never to use his 
strength to the point of exhaustion. This precaution, likewise, applies to 
mental efforts. The frequent paroxysms resembling syncope or simulat- 
ing apoplexy, are very apt to lead to the adoption of measures which, by 
depressing the strength, are at the same time calculated to aggravate the 
patient's condition, for the reason, that these cerebral phenomena do not 
depend upon anaemia, but hyperemia. 



HYPERTROPHY OF THE HEART— ENLARGEMENT OF 

THE HEART. 

By this name we mean a condition of the heart, where its volume is 
considerably enlarged by the increased thickness of its muscular tissue, 
and by a more or less considerable distention of its cavities. 

Primary hypertrophy arises in consequence of hereditary disposition 
without any apparent cause ; or it may develop itself in cases where a pe- 
culiar mode of living stimulates the heart to a constant and severe action, 
as may take place in consequence of severe manual labor, continued run- 
ning, excessive gymnastic exercises, fencing, abuse of strong coffee, wine, 
beer, spirits ; or, finally, hypertrophy may arise if the heart is kept in a 
constant state of tumultuous action by strong mental impressions, hence 
in the case of individuals with intensely sanguine temperaments. 

Hypertrophy of the heart may occur at any age between the years of 
fifteen and forty. Males are decidedly more liable to it than females; 
this, however, is probably owing to the circumstance that men are more 
frequently exposed to the causes giving rise to such structural changes. 

Symptoms. While in a state of rest, the patients generally feel well; 
they complain at most of a slight feeling of pressure in the prsecordial 
region. Every rather violent and continued motion, every mental excite- 
ment not only causes a troublesome and even distressing palpitation of 
the heart, but along with it, an oppression and feeling of anxiety in the 
chest, a sensation as if the clothes were too tight, dyspnoea. The increased 
excitement in the arterial circulation gives rise to congestion of the head, 
the face looks flushed, the eyes glisten and are injected, the margin of 
the lids often looks as if inflamed, there is buzzing in the ears, vertigo, etc. 

The Home * and dietetic management has to aim at two objects, in 
the first place, the avoidance of everything in the patient's mode of liv- 



* This disease ought, by all means, to bo treated only by a physician of large experience, and for 
that reason we omit other treatments. 



468 ANGINA PECTORIS. 

ing that might aggravate the disorder ; and, secondly, to surround the 
patient with influences that will have a direct tendency to ameliorate his 
condition. As regards the first point, spirits, coffee, strong spices, the 
excessive use of salt, very substantial and more particularly fat food will 
have to be avoided. The patient should be governed by the nature of 
his business in the quantity of food he consumes. Overloading the stomach 
is very hurtful; frequent and small meals are preferable. A person 
afflicted with cardiac disease should never go to sleep immediately after 
dinner, or go to bed with a full stomach. Every bodily motion occasion- 
ing a sensation of increased action of the heart, is too great a tax on this 
organ; all mental excitement is, likewise, strictly to be avoided. As 
regards the second point, we would call attention to the fact, that we very 
often succeed by changing the patient's mode of living, in avoiding or 
diminishing the violent congestions of the head. A business that corn- 
pels the patient to lead a sedentary mode of life, or exposes him to much 
excitement, should be abandoned. If icy coldness of the lower extremi- 
ties is accompanied by heat of the head and a flushed face, this trouble 
might, perhaps, be remedied by rapid walking, which, by exciting the 
action of the heart, would, on the other hand, prove a source of mischief; 
whereas, gymnastic exercises, with the feet alone, might often render the 
best service, without causing palpitation of the heart. An exhaustive 
development of these rules would occupy too much space in a work of 
this size. What we have said will suffice to show in how many ways a 
patient with heart disease claims our attention. 



ANGINA JPECTOBIS-STENOCABDIA. 

The history and causes of this disease are obscure and vague ; we 
only know from statistical data that males are infinitely more subject to 
this disease than females, and that fat individuals, or such as incline to 
make fat, are principally attacked. Persons beyond the age of forty are 
mostly liable to the disease, and they generally belong to the higher 
classes. All exciting causes are very often entirely absent; but the attacks 
are usually provoked by a bodily effort giving rise to an augmentation of 
the heart's activity. 

It is only exceptionally that a paroxysm does not set in suddenly; 
generally it takes place after very short and altogether vague preliminary 
symptoms. The patients suddenly experience a peculiar pain in the 
region of the heart, which is sometimes extremely severe and at other 
times dull, yet of such a peculiar kind that the sufferer is scarcely ever 
able to describe it, either according to its quality or extent. With the pain 
a sensation of prostration and fainting sets in; all patients agree in 
describing this sensation, as if death were at hand. What is remarkable 
is, that not a sound of pain escapes the lips of the sufferers, probably, 
however, owing to their dread of increasing the distress by the least exer- 
tion. They carry this precaution so far as to arrest the breathing, which 
gives them the appearance of great difficulty of breathing, although they 
are perfectly able to take a long breath, if they choose. Generally the 
patients remain immovably erect or in a sitting posture, a recumbent pos- 



DISEASES OF THE ORGANS OF CIRCULATION. 469 

ture suits them very seldom. The action of the heart is at times normal, 
at other times slower than usual, and again hurried and irregular, espe- 
cially if the patient is afflicted with heart disease. Very seldom the pain 
remains confined to the region of the heart; most commonly the pain 
radiates to the left shoulder and arm, less frequently to the neck and nape 
of the neck, or to the lower extremities, or even the right side. The pain 
very seldom increases gradually ; it mostly sets in immediately in its 
greatest intensity. 

A single paroxysm generally lasts only a minute or two; it scarcely 
ever exceeds one hour. As the paroxysm generally sets in in all its inten- 
sity, so it generally ends all at once. It is only if the paroxysms are slight, 
that the patient's health is at once completely restored, or at least very 
soon after the cessation of the paroxysm ; whereas, in this as in most other 
paroxysmal nervous affections, great lassitude and sleeplessness remain 
for some time. 

The Course of this whole disorder varies greatly. Very seldom a 
paroxysm is succeeded by a complete feeling of health. It more commonly 
happens that the paroxysms commence slightly and increase in intensity 
with every succeeding attack. Except in cases of heart disease, the inter- 
vals are quite free from all morbid symptoms, the patients do not show a 
single trace of the insidious disease; they often have even a very florid 
appearance. The single paroxysms, as well as the whole disease, are of 
an indefinite duration ; a paroxysm seldom occurs more than once on the 
same day; ordinarily they are separated by clays, months and even years. 
Many doubt the possibility of curing this disease; we, however, believe 
in the absolute possibility of the contrary, although a violent paroxysm 
may suddenly terminate in death. It is questionable whether the disease 
ever changes to some other form of heart disease, for the reason that the 
heart-disease, most likely, was already in existence when the angina first 
broke out. 

The prognosis is decidedly bad, if the angina is associated with or- 
ganic heart disease, and likewise in the case of older individuals, whereas 
the purely nervous form in the case of young persons very possibly admits 
of a cure. We must always keep in mind, that this insidious disease 
sometimes remains quiescent for a long time before it suddenly breaks 
out again in all its former, or with increased, violence. 

ALLOPATHIC TREATMENT. Attacks of Angina Pectoris are most 
speedily relieved by the inhalation of five or six drops of Nitrite of Amyl. 
If the circulation is feeble a teaspoonful of Brandy, or one or two tea- 
spoonfuls of Ether or Hoffman's Anodyne may be given. The hypodermic 
injection of Morphine in doses of a third to half a grain is another effect- 
ual method. Mustard may be applied over the chest, and Mustard drafts 
to the extremities. 

During the interval between the attacks, excitement of all kinds, 
active exercise, immoderate eating, and the use of alcoholic liquors are to 
be avoided. The general health requires attention. 

Arsenic appears to have the power of preventing the attacks, or less- 
ening their severity. It may be given in the form of Fowler's Solution 
in doses of three to five drops, three times a day in water, after meals. Its 
use should be directed by a physician. During its administration, if puffy- 



470 INFLAMMATION OF THE VEINS. 

ness of the eyelids, or pain in the bowels occur, it should not be taken 
until these symptoms disappear. 

HOME TREATMENT. A treatment for a single paroxysm cannot well 
be arranged; we might even inflict injury if we would violently interfere 
with the position the patient may have selected instinctively for his 
relief. Even the use of local applications, especially severe cutaneous 
irritants, to which we might feel tempted, may prove dangerous; in no 
case is the people's rule, not to touch an individual seized with a nervous 
spasm, more appropriate than in angina pectoris. Such precepts as may 
be found in every therapeutic treatise, are unpractical, for the reason that 
the attack does not last long enough to test their clinical vaiue. This 
remark likewise applies to the use of remedial agents, which we might not 
even be afforded sufficient time to procure before the attack is ended. 



CHAPTER XXIII. 

DISEASES OF THE ARTERIES AND VEINS. 



DISEASES OF THE ARTERIES. 

The various diseases of the arteries are of very little importance in a 
book like this, for the simple reason that they cannot be treated medicin- 
ally. 

Arterial inflammation, mostly only a symptom of other diseases, is 
scarcely recognizable with positive certainty, even in the case of larger 
arterial trunks. Of course, an inflammation of the larger arteries is 
highly interesting, because the closure of an arterial trunk near the heart 
may give rise to cardiac hypertrophy. 

Aneurisms (dilatation of an artery with rupture of one or more of its 
coats,) are not exactly diseases, but consequences of other influences. We 
do not see how medicines are to accomplish anything in such cases. It is 
only the disturbances which such arterial lesions cause in the heart, that 
suggest the propriety of medicinal interference, and we regard it as down- 
right absurdity to recommend medicines for the cure of aneurisms, as has 
indeed been done. 



DISEASES OF THE VEINS. PHLEBITIS— INFLAMMATION 
OF THE VEINS. 

Phlebitis, the correct diagnosis of which is a recent triumph, is, so far 
as its consequences are concerned, one of the most important of all known 
morbid processes. The veins of the lower extremities and of the cavity 
of the skull are particularly liable to inflammation, besides all the veins 
whose sides do not collapse, such as, above all other veins, those of the 
gravid uterus. 

The causes of Phlebitis are : Direct injuries of the vessel ; coagula 
arising from impediments to the circulation occasioned by dilatation of 
the vessel; introduction of foreign substances resulting iss -a. Hec-nvnosi- 



DISEASES OF THE ORGANS OF CIRCULATION. 471 

tion of the blood. This last-named explanation is applicable to phlebitis 
which sets in in an epidemic form in limited localities; or else the disease 
may arise secondarily from inflammatory affections of neighboring parts, 
or of remote parts, but lying in the tract of the vein ; or from puerperal 
conditions, suppurations of bones, especially caries of the bones of the ear. 

The symptoms of phlebitis vary according to its extent and intensity. 
The most intense forms of phlebitis originate in suppuration, to which we 
therefore refer; in this category belongs, especially epidemic phlebitis, 
where the local process is rapidly extended through the whole organism. 
The less intense cases very usually set in with a chill, recurring either 
irregularly with more or less frequency or otherwise, or else setting 
in typically, like an intermittent paroxysm. The diseased vein is 
often indicated by a seated, circumscribed, burning pain, but is quite 
often altogether painless. The chill is succeeded by a feeling of illness, 
usually, so severe that it is entirely out of all proportion to the objective 
symptoms. The pulse is accelerated, and very much reduced in volume, 
the digestion is interfered with, a tendency to perspire sets in, the tract of 
the vein becomes cedematous. If the circulation in the vein is restored, 
all these symptoms may disappear as rapidly as they came. If the vein 
remains closed, oedema develops itself beyond the closure, and, if a collat- 
eral circulation can be established, may last only a short while, or else 
remain permanent. In such a case, lassitude, chills at irregular intervals, 
irregular flashes of heat, sometimes continue for weeks. 

The terminations of phlebitis depend upon the changes going on in the 
inflammatory exudation. If no purulent decomposition takes place, life is 
not exactly in danger; if pus forms, it may be carried along with the 
current of blood, and a most malignant phlebitis may suddenly arise, not- 
withstanding the trifling character of the symptoms at the outset of the 
inflammation. It is, in this manner, that lying-in women and persons that 
had been operated upon, often perish quite suddenty, although not a single 
symptom existed at first that could have given rise to the least apprehen- 
sions of danger. 

The prognosis is uncertain. If the chills recur but seldom, and with 
increasing weakness, the danger is less; whereas, frequent chills, prostra- 
tion and sopor are decidedly ominous signs. The treatment should only be 
in the hands of the best physician you can possibly obtain. 

The subsequently remaining and very prominent oedema of the parts 
which lose their normal circulation, in consequence of the obstruction of 
the vein, cannot be removed by treatment. It does not disappear until the 
collateral circulation is restored, which it sometimes takes years to accom- 
plish ; the uniform pressure of a bandage, if it can be applied, may, if it 
does not affect a cure, afford at least a good deal of relief. 



VARICOSE VEINS— rilLEBECT ASIA— VARICES- DIL A- 
TION OF VEINS. 

In most cases, the causes of these very frequent dilations can be deter- 
mined with perfect certainty; in other cases, however, they are involved 
in obscurity. These are the cases where the disease cannot well be traced 



472 VAKICOSE VEINS. 

to some mechanical obstruction in the circulation of the blood. At all 
events, these cases are the least frequent. 

The existence of a peculiar predisposition in the walls of the veins, or 
else the subsequent supervention of a morbid change in those walls, will 
have to be taken for granted. The most frequent causes are : obliteration 
of the vein, owing to which the portion beyond the obliterated vein dilates 
in its whole extent ; dilation or contraction of the venous trunk, which 
has the same effect as obliterations, only in a less degree ; every change 
that interferes with the flow of blood to the heart, such as dilation of the 
right heart, affections of the liver, tumors compressing the vein, tight 
clothing. In all such cases, varicose veins are of a secondary character; 
it may, likewise, occur as a primary disease in the case of men who have 
to be continually in a position that interferes with the reflux of the blood, 
persons for instance who have to be continually in a sitting or standing 
posture. In a sitting posture, the dilation of the vessels can often be 
accounted for by the pressure exerted upon the abdominal organs in the 
stooping posture; in the standing posture, on the contrary, the dilation is 
entirely owing to the circumstance that the vertical position of the body 
embarrasses the course of the blood onward through the veins. 

Every vein in the body may become dilated; dilations occur most fre- 
quently in the veins of the rectum, (then called piles,) lower extremities 
and spermatic cord. We will briefly dwell here upon varices of the lower 
extremities. They occur more frequently among women in whom the 
cause of the dilation is traceable to the impregnated uterus, whereas, pri- 
mary dilations are decidedly of more frequent occurrence among men. 
What we have said just now concerning the originating causes of dilation 
is particularly applicable to this form. At first one of the larger cutaneous 
veins of the leg is most commonly affected, whence it does not usually 
extend to the thigh, but involves very regularly the larger as well as the 
more minute veins of the foot, especially, of the veins situated around the 
ankles where they give rise to a considerable swelling, covered with a blu- 
ish net of both delicate and coarser vessels. In most cases these varicose 
veins are painless. In other cases the leg pains for a short time, after 
which the pain again disappears. Very often the pain is felt while a par 
tion of the skin assumes a bluish redness, swells and becomes quite hard ; 
the pain increases continually, finally the skin suddenly breaks at the 
place of infiltration, without being caused by mechanical injury as most of 
these patients fancy, and an ulcer of the size of a pea forms, which is at 
first round and provided with thin, somewhat undermined edges. Without 
proper management and hygienic precautions, the pains increase all the 
time; the ulcer spreads, its edges gradually swell, the surrounding skin 
becomes hypertrophied, (thickened) the ulcer secretes a watery and some- 
times exceedingly fetid fluid, and its base has a sickly color. If the same 
mode of living is continued, during which walking hurts only a little, but 
standing hurts a great deal, the ulcer may spread over the whole surface 
of the leg from the ankle to the calf, and may even penetrate to the bone. 
Ulcers below the ankle and on the front portion of the foot are of rare 
occurrence. The fetor of the ulcer increases in proportion as the ulcer 
spreads over a larger surface. Persons go about with such ulcers for 
years, and it is inconceivable that the constant drain of their vital fluids 
does not result in speedy emaciation. If a fever or some other constitu- 



DISEASES OF THE ORGANS OF CIRCULATION. 473 

tional disease breaks out during the existence of the ulcer, it seems to heal 
spontaneously, in which case the disease is very commonly, but improp- 
erly, regarded as the consequence of the healing. 

If the patients are so situated as to be able to remain at once in a 
recumbent posture, the little sores heal very speedily, but break open 
again very easily, if the person has to stand a great deal, so that the exist- 
ence of such ulcers at any previous period leaves a constant liability to 
their returning again at a subsequent time. 

In the higher walks of life, where every measure is taken from the 
start to prevent the formation of ulcers, a peculiar cutaneous affection is 
witnessed in their stead. The skin assumes a very dark and bluish color, 
and scattered and violently itching pustules form, very frequently, or 
else the skin peels off in scales, leaving the surface moist. This form of 
the varicose affection is, by far, the most malignant and distressing. 

With an entire change in the mode of living, the varicose ulcers may 
heal of themselves, but this is, undoubtedly, a very rare occurrence. 

ALLOPATHIC TREATMENT. The radical cure of varicose veins is 
purely surgical, and consists in obliterating the veins. The means for 
this purpose will be enumerated, but not described. The large trunk 
above the dilated veins is occluded to prevent the return flow of blood 
through it, and, consequently, through the dilated veins leading to it, 
by pressure from metallic clamps, by cauterizing, by incision, by ligature 
by electrolj-sis, by injection of the Sulphate of Iron. These operations 
are effectual, but owing to occasional accidents, resulting from the attempt 
to thus obliterate the veins, it is not attempted, except there is urgent 
necessity. 

Palliative treatment requires an artificial support to the column of 
blood in the veins. In the lower extremities, this is done by an elastic 
stocking, a band stocking, or a well adapted bandage. They may be 
removed at night, but re-applied before the patient rises in the morning. 
In other situations than this most common one, the same principle will 
govern the treatment, and the ingenuity of the physician will meet the 
required indication, as in varicocele (varicose veins of the spermatic cord) 
a well adjusted suspensory bandage of silk or muslin, will be constantly 
worn. 

Varicose veins are subject to inflammation (phlebitis). If this condi- 
tion occurs, whether the veins are varicose or not, the patient should 
remain in bed. If there are wounds or ulcers, they should be poulticed ; 
if there is suppuration, the surface of the wound or poultice should be 
lightly covered with Carbolic Acid in Glycerine, one or two drams to the 
ounce. Generally, without the temperature is too low, cool evaporating 
lotions over the inflamed veins will be most useful. A piece of muslin 
wet in a solution of forty grains of Sugar of Lead, and a scruple of Ace- 
tate of Morphine, in a quart of water, may be laid over the inflamed 
region, (two to four ounces of Laudanum may be used instead of Mor- 
phine,) the cloth should be kept constantly wet. In other cases, hot 
fomentations are moresuitable, towels or flannels may be wrung out of hot 
water, spread over the inflamed surface, and covered to retain the heat, 
or hot poultices may be applied, Hops, or Laudanum, Stramonium, 
(Jamestown Weed,) Tobacco, or Belladonna. A brisk cathartic should be 



474 VARICOSE VEINS. 

given. One or two tablespoonfuls of Epsom Salts, (Sulphate of Magne- 
sia,) is a suitable one. Steeping the Saltc with a third its bulk of coffee, 
covers the taste. Pain should be relieved with Opium, in doses of a grain, 
a quarter of a grain of Morphine, or twenty-five drops of Laudanum. If 
the blood should become poisoned, 3 from the products of inflammation, 
Quinine in large doses, ten or fifteen grains four times a day, for two or 
three days. Stimulants will be required. 

Tonics, as two grains of Quinine four times a day, are needed, if the 
disease continues long. The patient should, also, be well nourished. 

HOMOEOPATHIC TREATMENT. Painless varices, without ulceration 
cannot be regarded as an object of treatment, nor do we believe that any- 
body can imagine the feasibility of removing them by means of medi- 
cines. If pains are felt, and the subcutaneous cellular tissue become 
infiltrated, it would seem as though medicines might be useful ; at any 
rate, we have seen a rapid improvement take place after the use of Sta- 
physagria, Lycopodium and Graphites. These are the only remedies 
which we can recommend, as long as the ulcers are painful. If the ulcer 
has become old, even the three first-named remedies are no longer of any 
use, and a mechanical treatment is the only treatment that can prove of 
any use. These three remedies are, likewise, the only ones that we can 
recommend for the peculiar cutaneous affection, but we must confess that 
they, too, will often leave us in the lurch. Our main resource in treating 
these varicose disorders, are external or mechanical means. The dilation 
of the veins being chiefly a passively mechanical change, it is evident 
that moderate compression, by means of a good bandage, will moderate, 
and, finally, remove the varicose dilation altogether. If individuals with 
marked varicose dilations constantly wear a bandage, or silk elastic 
stocking, they will never be troubled with ulcers, nor with any other cuta- 
neous affection. Existing ulcers heal very rapidly under a carefully- 
applied bandage, so much more rapidly if we first cover them with strips 
of adhesive plaster and a layer of cotton wadding over these, so as to pro- 
tect them from all contact with atmospheric air. By pursuing this course, 
we have never known ulcers of any size, or of upwards of twenty years 
standing, to remain uncured ; but we have never shunned the trouble of 
applying the bandage ourselves. The longest time it has taken us to heal 
these ulcers, is six months. If the excessive sensitiveness does not admit 
of the immediate application of a bandage, the patient must be kept, for a 
short time, in a recumbent position, with his leg raised; in such a case, 
warm poultices afford a good deal of relief. 



THE HUMAN SKELETON. 

The letters of reference appear the same in both views as far as the 
same bones can be seen from both points of vision. 
a. Bones of the cranium. 
h. Bones of the face. 

c. The 7 cervical vertebrae. 

d. 12 dorsal vertebras. 

e. 5 lumbar vertebae. 



THE HUMAN SKELETON, 



475 



/. Bones of Sacrum. 

h. Bones of the pelvis— basin. 

Jc. Ribs. 

m. Scapula— shoulder-blade. 

o. Radius. 



g. Coccyx. 

i. Sternum— Breast-bone. 

I. Clavicle— collar-bone. 

n. Humerus. 

p. Ulna. 




HUMAN SKELETON— FRONT AND BACK. 



q. Carpus and Metacarpus. 

s. Femur. 

u. Tibia. 

to. Tarsi and metatarsi. 



r. Phalanges— fingers. 
t. Patella— knee-cap. 
v. Fibula, 
x. Os calcis— thr n^el-bone. 



z. Phalanges— toes. 



PART ELEVENTH. 

DISEASES OF SINGLE SYSTEMS. 



CHAPTER XXIV. 

DISEASES OF THE BONES, MUSCLES, AND JOINTS. 



OSTITIS, PERIOSTITIS— POTT'S DISEASE. INFAMMA- 
TION OF THE BONES AJSD PERIOSTEUM. 

Inflammations of the bones occur in every age, less frequently, how- 
ever, before the second, and after the fiftieth or sixtieth year. In most 
cases, they originate in mechanical injuries, or mechanically-acting influ- 
ences ; they are less frequently owing to the extension of inflammation 
from the soft parts. In the great majority of cases, the mechanical is 
associated with a constitutional cause, very frequently the latter existing 
alone. Among the constitutional diseases, it is, more particularly, scrof- 
ula, consumption, syphilis, and calomel, that give rise to ostitis. Very 
often, it is very difficult to trace the cause with anything like certainty, 
especially, so far as the inflammation of the substance of the bones is con- 
cerned, because it generally developes itself with scarcely perceptible 
symptoms, and in a very insidious manner, hence too long a period of 
time may have elapsed since the cause first began to act, to permit of the 
disease being traced to a definite origin. 

Bones that are but thinly covered by soft parts, are particularly 
exposed to inflammation from mechanical causes; inflammation arising 
from more dynamic or constitutional causes, may attack any bone ; nev- 
ertheless, inflammations of the lower jaw, of the vertebrae (backbone,) 
the bones of the hands and feet, and of the ribs, occur most frequently, 
and are of particular importance. 

Periostitis (inflammation of the membrane covering the bones) occurs 
more particularly on the fingers, on the bones of the lower extremities, 
and on the skull-bones. 

The symptoms and course of ostitis differ very remarkably in extent 
as well as intensity. It is very often found that at the outset the disease 
is entirely without any symptoms, until the disease is finally revealed by 
the process of suppuration . It very seldom runs an acute and rapid 
course; this is, generally, the case, if the inflammation attacks the outei 
surface of the bone. In such a case, the intensity of the pain depends 
upon the extent of the inflammation ; the fever is high, delirium some- 

476 



INFLAMMATION OF THE BONES. 477 

times sets in, slight chills are common, and the patient very soon begins 
to lose his strength. Cases of this kind, which run a rapid course, always 
terminate in suppuration, and the artificial removal of pus is, in most 
cases, a matter of absolute necessity. After the pus is evacuated, a cure 
does not always take place immediately; the bone, divested of its perios- 
teum, becomes more or less careous before a cicatrix has time to form. 

If the periostitis runs a slow and somewhat chronic course, the inflam- 
mation, of itself, is not very painful ; but very violent pains can be excited 
by contact; here, too, the exudation may be transformed into pus, but is, 
likewise, apt to result in bony growths, and to form extensive flat, or 
tuberous, bony indurations. 

If the inflammation is located in the interior of the bone, the latter is 
generally distended in its whole length, is not very sensitive to pressure, 
but the patient is tormented by paroxysms of peculiar, dull, boring pains, 
which, even in the absence of any specific cause, are, particularly, apt to 
set in, and to become aggravated at night. These pains are usually felt 
for some time before the bone commences to swell ; they interfere with 
the mobility of the limb more or less, generally the less, the more remotely 
they are felt from the joint. 

Ostitis of this central character always runs a chronic course. Its 
terminations are suppuration or ossification of the exudation. If one of 
the large bones is invaded by the suppurative process, death almost 
always results, although in some cases, not till the patient has lived 
through years of suffering. An important diagnostic symptom is the 
presence of albumen in the urine ; it almost always occurs, if the suppur- 
ation is extensive, and augurs very badly for the final result. 

The importance of inflammations of bones varies a good deal. Age 
exerts a characteristic influence; children and young people generally 
recover from such inflammations, even if these should last a long while, 
unless they originate in inveterate, constitutional maladies; older per- 
sons, especially, when on the other side of forty, generally fall victims to 
such inflammations. Children very often recover when the second period 
of dentition sets in, or when they enter upon the period of pubescence. 
The seat of ostitis is of no small importance; inflammation of the bones 
in the upper part of the body is less dangerous than inflammation of the 
pelvic bones, or the bones of the lower extremities. It is, likewise, impor- 
tant to determine whether the inflammation is so located that vital 
organs may become involved; on this account, inflammations of the skull 
bones and ribs are more threatening on account of the danger to important 
organs resulting from them. 

Sometimes the inflammatory symptoms disappear entirely for a time, 
and then suddenly reappear again from some cause or other, or without 
any cause; or else, in one portion of the bone, the inflammation runs a 
favorable course, and then all at once takes a new start, either continu- 
ously in the tissue of the bone, or in separate portions. Every inflamma- 
tion involving more than one bone, renders the prognosis so much more 
unfavorable. 

ALLOPATHIC TREATMENT. Inflammation of bone can scarcely, 
in any case, be treated intelligently, except by a skillful surgeon. Rest 
and cold or cooling applications are the most important means of local 



478 DISEASES OF THE BOXES, MUSCLES AND JOINTS. 

treatment. If cold is not aggreeable, it should be replaced by hot fomen- 
tations—a flannel, wrung out of hot water, and applied to the part, then 
covered well to retain the heat. 

In Chronic Ostitis (inflammation of bone,) counter-irritation by means 
of blisters, or the frequent (daily) application of Tincture of Iodine should 
be resorted to. Sometimes deep incisions into the periosteum (the mem- 
brane covering the bone) afford relief in both the acute and chronic forms 
of the disease. 

Pus should be evacuated by the trephine (an instrument for taking out 
a disc of bone.) If the inflammation has continued long, especially, at the 
end of a bone, it is, probable, pus has formed and the trephine should be 
used. 

When the Medullary Tissue (Marrow) of the bone is inflamed 
(myelitis) the bone as well as its medulla is, generally, involved, in which 
case the condition is called osteo-myelitis. When the disease is the result of 
wounds, the dressings must often be changed, and the wound disinfected 
with a solution of Carbolic Acid in water, one dram to the pint, or Chlor- 
ine water, or the solution of Chlorinated Soda (Labarrague's Solution) 
diluted until they are unirritating. Absolute cleanliness and fresh air 
must be secured. The diet should be good. Tonics may be necessary, two 
or three grains of Quinine three times a day seems the most suitable. 
Both tonics and stimulants may be employed. 

Cold is often the most useful, and may be applied by means of bags of 
ice. If cold causes pain or chills, hot applications should be used instead, 
as directed for ostitis. Free incisions through the periosteum (membrane 
covering the bone) and superficial tissues give some relief. If there is no 
opening into the cavity of the bone, and from the amount of inflammation 
and the length o£ time which has elapsed, there is reason to suspect pus 
has formed, the trephine should be used, and the pus let out. As a rule, 
amputation is inadmissible, but if resorted to, it must be at the nearest 
joint towards the direction of the body or above it. 

In chronic osteo-myelitis counter-irritation with Tincture of Iodine or 
blisters and the internal use of Iodide'of Potassium in doses of ten grains 
or more, three times a day, should be resorted to. Where matter forms, it 
should be let out with the trephine. Excision (taking out a piece) may be 
resorted to in the chronic affection, but not in the acute. When amputa- 
tion is called for, it may often be performed through the shaft of the 
affected bone, if the point of amputation is well above the diseased por- 
tion. 

Periostitis (Inflammation of the Periosteum-Membrane Cov- 
ering the Bone.) in acute cases, requires perfect rest. Cold should be 
applied, either of cold water or bags of ice. If these cause pain, hot 
fomentations should be applied, or hot poultices used. Pain must be re- 
lieved by Opium in doses of a grain, a quarter of a grain of Morphine, or 
thirty drops of Laudanum given one, two, or more hours apart, as may be 
required. If these means do not succeed, free incisions must be made 
through the periosteum. If the disease is primary, and necrosis (death of 
bone) follow, it is generally confined to the outer lamina (layer). If the dis- 
ease is secondary, resulting from ostitis or osteo-myelitis, and necrosis 
occurs, it is much more extensive, which will be considered under necrosis. 



INFLAMMATION OF THE BONES. 479 

Specific forms of this disease (periostitis) from syphilis, scrofula, etc., gen- 
erally yield to appropriate constitutional treatment. 

One of the results of inflammed bone is caries— a kind of surface soft- 
ening and disintegration of the bone tissue. The constitutional treatment 
relates to the cause of the inflammation, whether specific or scrofulous, 
and the appropriate constitutional remedies should be taken. In the for- 
mer case Iodide of Potassium, or Mercury, or both and Iron. In the latter, 
Iodide of Potassium, Iron and other Tonics. 

The local treatment consists in the complete removal of all the dis- 
eased portion. First, by excision with instruments; second, by the appli- 
cation of Acids. "When a joint is carious, amputation is, generally 
required, though sometimes excision may be practiced. 

Another of the results of inflammation of bone, and its membranes is 
necrosis (death of bone). The treatment required is its removal. While 
it remains, it is only a source of irritation; but its removal must not be 
attempted before complete separation has taken place. The suppuration 
which has gone on during the process of separation, generally requires 
supporting treatment — Tonics of Iron, Quinine, nutritious food, and in 
some instances, Cod Liver Oil. 

HOMEOPATHIC TREATMENT. The frequent occurrence of ostitis 
in individuals whose constitutions are tainted with some constitutional 
disease, invites a careful inquiry into the presence of such a constitutional 
taint, even though not manifested by any outward signs; and, in the 
second place, to employ such remedies as not only correspond with the 
constitutional affection, but likewise, aim at remedying the local disease. 
A mere comparison of symptoms will scarcely ever answer the purpose, 
for the reason that the localities may differ too much; it is only for a few 
definite localizations of ostitis, that we possess real remedies. In general, 
we advise, therefore, that the general, not the local symptoms, be taken as 
our guide; on this account we mention the following remedies, with a few 
short comments: 

3Iercurius is a medicine of whose specific and almost constantly defi- 
nite relation to the osseous tissue we may always rest satisfied. It is 
indeed suitable in most cases of ostitis and periostitis, provided they do 
not originate in calomel poisoning. It is particularly indicated by: Vio- 
lent bone-pains, distention, swelling, redness of the skin, and, in general, 
by the more acute symptoms of the disease. The infantile organism is 
more rapidly and certainly affected by Mercurius. The dose had better be 
as small as possible ; the slow course of the disease would seem to point to 
small doses, and given at comparatively long intervals, as preferable to large 
doses of this agent. 

Dj.se : Four pills daily. 

Mcrzereinn antidotes Calomel in the bone-range. Merzereum is par- 
ticularly adapted to periostitis; less to ostitis, and is particularly appro- 
priate at a period of the disease when no complete suppuration has yet 
set in. 

Dose: Four pills daily. 

Phosphoric Acid is generally preferred to Nitric Acid in non- 
mercurial ostitis; it is indicated in the inflammatory bone-affections of 
children, especially, in inflammations of the vertebrse, (back-bone) if there 
is an evident disposition to caries. In fully developed caries, with symp- 



480 DISEASES OF THE BONES. MUSCLES AND JOINTS. 

toms of slow hectic fever, Phosphoric Acid is one of the most important 
remedies. 

Dose : Four pills daily. 

Phosphorus is inferior to Phosphoric Acid, for the reason that the 
latter acts more specifically and more penetratingly in chron.c affections. 
In other respects, the curative action of both remedies is very similar; we 
would accord the preference to Phosphorus, if consumption, with unceas- 
ing diarrhoea, has set in. 

Dose: As for 3£ ercurius. 

Staphysagria is indicated, if the ostitis runs its course with severe 
pains, and the bone and its coverings are affected at the same time; in the 
case of scrofulous individuals ; if the facial bones, or those of the legs and 
feet are involved. 

Dose: Same as for Mercurius. 

Baryta-carhonica is eminently adapted to a slow and almost pain- 
less scrofulous inflammation of the bones of the extremities, after suppu- 
ration has begun to set in. 

Dose: As for Mercurius. 

Aurum is, like Nitric Acid, an exquisitely anti-Calomel medicine, and 
hence, deserves special attention in cases of mercurial ostitis. It has, like- 
wise, an excellent effect in. non-mercurial ostitis with caries, and violent 
pains, especially at night. Aurum is a specific remedy for inflammatory 
ulceration of the nasal bones, and facial bones generally. In affection of 
this kind, we prefer Aurum muriaticum to the cammon gold. 

Dose : As for Mercurius. 

Silicea is one of the most important remedies in caries from any cause, 
and at my age, as soon as the inflammatory stage has run its course: it is 
adapted to every constitution, but may not have a very favorable effect in 
acute ichorous suppuration. We must not forget that Silicea acts very 
slowly ; we recommend small doses at long intervals. 

Dose : Same as above. 

Calcarea. This agent is not so much indicated in uncomplicated 
ostitis, as in ostitis depending upon scrofula; it does not act directly as a 
curative, but by virtue of the favorable change it effects in the scrofulous 
disease. On this account, its use should be deferred until the suppurative 
process is fully established. 

Dose : Same as for Mercurius. 



RICKETS. 

Eauly Signs. This distressing disease commonly begins to show 
itself about the tender age of from one to two years. It is, generally, pre- 
ceded, for a longer or a shorter period, by derangement of the general 
health, before any of its well-known characteristic features become 
developed. 

Pale and sickly countenance ; dry, harsh skin ; soft and flabby flesh ; 
irregular appetite, sometimes with desire for indigestible or unnatural 
food ; constipation or diarrhoea; general febrile excitement, fretf ulness, and 
languor. 

General Symptoms. After which, the head is observed to become 



RICKETS. 481 

preternaturally enlarged, and the forehead unusually prominent. The 
breast-bone projects; the ribs appear flattened; the belly is much dis- 
tended; while the rest of the body, and the limbs in particular, are greatly 
emaciated, and the debility is extreme. As the disease advances, the 
muscles become more flaccid, the wrists and ankles become swollen, the 
legs, thighs, and arms distorted, and the spine partakes in the general 
deformity, by becoming shorter, and curved in various directions. 

When the disease is early attended to, and the more general exciting 
causes,— such as defective nursing, damp or wet, ill-ventilated dwellings, 
insufficient exercise out of doors, improper food, and uncleanliness — are 
capable of being removed— -the chances of recovery are much increased, 
and the deformity is frequently materially, if not wholly diminished as 
the patient grows up. Otherwise, if life be spared, it is liable to be ren 
dered miserable by a state of almost continuous suffering. 

HOME AND MECHANICAL MEASURES. At the head of the arti- 
ficial contrivances for counteracting deformity, may be placed the gentle 
and cautious use of gymnastic exercises, as soon as the child is old enough 
to undergo them ; and it is surprising how early they may be advanta- 
geously resorted to. Without these, all instruments are often futile, not 
to say hurtful. But in combination with them, the objection to the tempo- 
rary employment of an appropriate apparatus for the purpose of exercising 
compression, is, I believe, in certain cases, removed. I allude, more espe- 
cially, to the instance in which the legs have become very much bent, 
either in consequence of neglect, or from its having been found imprac- 
ticable to prevent a high-spirited child from constantly getting on his feet 
before his delicate frame had become sufficiently invigorated by suitable 
treatment. I am free to admit, however, that instruments should always 
be rejected whenever and wherever they can possibly be dispensed with. 

ALLOPATHIC TREATMENT. This is a disease which almost, with- 
out exception, depends on poor feeding and hygiene, during the first year 
of the child's life. Children of unhealthy parents are more liable to the 
disease, but if the child is well fed, has plenty of fresh air, is kept clean, 
and is warmly clad it will not have rickets. If the child is not thriv- 
ing on its mother's milk, it ought to be fed artificially, or, what is bet- 
ter, a vigorous wet nurse procured. In the absence of a wet-nurse, rich, 
fresh cow's or goat's milk may be given. For the first month the milk 
should b^ half water, enriched a little with cream, and sweetened with su- 
gar of milk or loaf sugar. At two months old only a quarter part of water 
need be added ; after three or four months genuine milk may be given pure. 
Eggs beaten up raw, with a little sugar, and diluted with water, may be 
given if the child likes it. The juice of lean meat may, also, be given. 
Strong beef tea, made from finely chopped lean meat and cold water, grad- 
ually raised to the temperature of one hundred and sixty degrees, and main- 
taining it at that temperature for four hours, may be employed for nour- 
ishment. Underdone lean beef, finely ground in a mortar, a teaspoonful 
at a time may be given. A pound of finely chopped lean meat, with eight 
ounces of distilled water and eight to ten drops of Hydrochloric Acid, and 
a third to half a teaspoonful of common salt, allowed to macerate for three 
hours, and then strained through a hair sieve, then pour on the meat a 
couple of ounces more of distilled water, and squeeze it through. The res- 

3] 



482 DISEASES OF THE BONES, MUSCLES AND JOINTS. 

idue makes a nourishing and valuable food in cases of debility. Milk, how- 
ever, is the food for babies, and the other articles of food may be resorted 
to only when the baby does not thrive sufficiently on the milk. 

From the age of six months to a year, farinaceous food may be given, 
in restricted quantities. One of the best forms is Liebig's food. Take a 
heaping tablespoonful of wheat flour (middlings is better,) a heaping des- 
sertspoonful of malt flour, seven and a quarter grains of Carbonate of 
Potash, and an ounce of water. Mix well. Add five ounces of cow's 
milk and heat gently. When the mixture begins to thicken, remove from 
the fire and stir for five minutes, heat, and stir again until it becomes 
quite fluid, then boil and strain through a sieve, when it is ready for use. 
In the absence of malt flour, barley may be ground in a coffee mill and 
sifted to remove the husk. This food is a little laxative, so it cannot be 
given more than three times a day. If there is diarrhoea, twenty or thirty 
grains of prepared chalk may be used instead of the Bicarbonate of Potash. 

For older children the diet must be good, containing such articles as 
meat, eggs, and milk. 

Nothing must be done to weaken, but everything to strengthen the 
patient. The child should have such exercise as is consistent with the 
weakened condition of the bones, such as rolling and tumbling on a hard 
matress. Older children may walk about some, if provided with proper 
artificial support, such as a wheel crutch. They should be taken out into 
the open air every day, or two or three times a day for a ride, or carried out. 
Bending of the limbs may be overcome by applying a light splint of paste- 
board or leather, but the limbs must not be so encumbered as to prevent 
their pretty free use. A light apparatus may be worn when the child 
walks, to prevent the curvature of the spine. The child should lie upon 
a flat matress without a pillow. 

The principal treatment is dietary and hygienic, as given above. 

For medicinal treatment the Compound Syrup of the Lacto-Phosphates 
gives the most promise of all medicines of being useful, excepting Cod Liver 
Oil. It may be given in doses of from ten or fifteen drops to a teaspoonful 
according to the age of the child, three or four times a day. The dose of 
Cod Liver Oil may be begun at fifteen to twenty drops and increased to a 
teaspoonful or a dessertspoonful, according to the age of the child and 
given four times a day. If the oil deranges the digestion, it should not be 
given, otherwise it should be given continuously. Other tonics may be 
given instead of the Lacto-Phosphates, as the Syrups of the Phosphates or 
Hjpophosphites, in the same doses as the Lacto-Phosphates. The Citrate of 
Quinine and Iron, in doses of half a grain to two grains, three times a day. 

Complications (other diseases) which may occur will require the appro- 
priate treatment, keeping this in view, that all treatment must be sus- 
taining. 

HOMOEOPATHIC TREATMENT. Calcarea is a medicine of the most 
essential importance in all cases of rickety disease, and is more particu- 
larly required when the fontanels remain open too long, and when the 
process of teething is unduly protracted, or the teeth that are protruding 
have a tendency to premature decay; or, again, when there is curvature of 
the spine and of the limbs, with enlargement of the joints, and very undue 
dimensions of the skull. Calcarea, again, is yet more especially indicated. 



RICKETS. 483 

if, in addition to these manifestations, there be incrustations on the facc j , 
or if the belly be enlarged and hard, and whilst rapid or gradual loss of 
flesh takes place, the appetite is morbidly voracious; the skin is commonly 
dry and flaccid, and the child wears the appearance of being much older 
than it really is, although it be commonly diminutive and fragile; the 
bowels are habitually costive, or are frequently affected with excessive 
and protracted relaxation. 

Dose: Four pills in a teaspoonful of water, the first thing every morn- 
ing, for a week (unless decided change should sooner occur;) then 
pause ten days; after which the course should be repeated as before, 
and so on. until some distinct signs of general improvement follow. 

Baryta Carbonica will be found adapted to some cases, particu- 
larly of dwarfish children, where there appears to be a general arrest and 
suspension of development, particularly if there be a tendency to gland- 
ular enlargements in the neck and elsewhere. 

Dose: As directed for Calcarea. 

Mercurius should be employed if the following symptoms should en- 
sue:— Pains in the bones, as if from soreness, or as if bruised, with extreme 
tenderness of the shin bone and knee-joints to pressure, with or without 
pressure of the limbs; dandruff, and other obstinate affections of the 
scalp and face; incrustations on the face; extreme susceptibility to take 
cold, with constant or very frequent prevalence of cold in the head or on 
the chest, and tendency to excessive perspiration, whether offensive or not; 
and often a chronic, slimy, or clay-colored diarrhoea. 

Dose : As directed for Calcarea. 

Silicea is appropriate to the treatment of almost all cases of disease 
of the bones; and is more particularly and decisively indicated by a pecu- 
liar tendency to ulceration manifested by the skin upon the least abrasion, 
—that is, when it "heals badly" as it is popularly termed; or when there 
are scabby eruptions on the scalp, the glands being disposed to suppurate, 
the complexion pallid but puffy, and the ears being constantly or fre- 
quently affected with discharges of matter. Silicea may be required after 
Calcarea, to complete the cure. 

Dose : As directed for Calcarea. 

SulpJiur should be employed after Calcarea or Silicea, if these medi- 
cines, having previously been productive of decided good effect, should 
cease to operate so beneficially, or if the following symptoms should pre- 
vail (which, if predominant, however, might more distinctly indicate the 
employment of Sulphur at the onset:) — Extreme susceptibility to take 
cold, and to protracted discharges from the nose or from the wind-pipe, 
or to excessive or continued relaxation of the bowels ; but still more espe- 
cially by obstinate and intractable constipation, with flabbiness of the flesh 
or skin, pallor or pufnness of the face; protracted inability to use the legs 
or to maintain the erect position; tendency to be easily thrown into a vio- 
lent perspiration by any exertion; the skin being otherwise dry, and even 
harsh, and the eyes and eyelids appearing to be habitually more or less 
inflamed, and both mind and body languid, and unfit for exertion of any 
kind. 

Dose: The same, and at same intervals, as directed for Calcarea. 

When there is an hereditary predisposition to this disease, too great 
attention cannot be paid to the first manifestations of ill-health. Great 



484 DISEASES OF THE BONES, MUSCLES AND JOINTS. 

care should, at the same time, be taken to avoid undue pressure upon the 
chest and other parts. The bones of a rickety child are wanting in the 
natural and requisite strength, or firmness, to support the weight of the 
frame. Consequently, when every precaution is not adopted, and the child 
is allowed, or rather compelled, by its heedless or culpable parents, or oth- 
ers, to use muscular exertion, deformity invariably results. It will, there- 
fore, be necessary to deal gently and cautiously with the child, from the 
first day of its early existence. And while every care is observed, to escape 
the mischief alluded to, other means, having for their object the improve- 
ment of health, must be strictly followed. The child should be regularly 
in the open air, when the weather permits ; its apartments ought to be 
well ventilated; its personal cleanliness should be constantly ensured; and 
wholesome and appropriate nourishment provided. When the health and 
strength are improving, but the limbs and other parts have become 
deformed, to a greater or less extent, in defiance of every solicitude— or, as 
more frequently happens, from oft-repeated infractions of the rules laid 
down— considerable benefit may yet be accomplished by judiciously applied 
mechanical aid. 



LUMBAGO— CHICK IN THE BACK. 

Diagnosis. Violent pain, of a rheumatic character, in the lumbar 
region, either periodical or permanent, frequently accompanied with a 
considerable degree of fever. 

ALLOPATHIC TREATMENT. In acute lumbago, the employment 
of strong mustard plasters or repeated hot wet packs, with a hypodermic 
injection of a quarter of a grain of Morphine over the seat of pain, 
repeated sufficiently often to subdue the pains, is generally effectual treat- 
ment. A cathartic should be given to move the bowels. 

If the disease does not subside after the pain is relieved and the bow- 
els moved, the treatment by mustard plasters or hot wet packs and Opium 
should be tried to relieve pain (a quarter of a grain of Morphine, a grain 
of Opium, or twenty-five drops of Laudanum, may be given by the mouth ) 
and should be continued. 

The effect of Salicylic Acid, given in doses of ten grains every four 
hours, should be tried. It can be given in capsules, or mixed with Starch. 

Chronic lumbago is most frequently cured by Iodide of Potassium, 
given in doses of from ten to twenty grains, three times a day. It may 
be given in Peppermint Water, after meals. 

Much relief may be obtained by wearing a Belladonna plaster across 
the loin. 

Other remedies are the same as those recommended for chronic mus- 
cular rheumatism. 

HOMCEOPATHIC TREATMENT. Aconite may be given at the com- 
mencement, if much fever declare itself. 

Bryonia when the pains in the back are of a severe aching or lancin- 
ating description, constraining the individual to walk in a stooping pos- 
ture; aggravated by the slightest motion, or draught of cold air, and 
attended with a general sensation of chilliness. 



INFLAMMATION OF THE JOINTS. 485 

Nux-vomica is particularly indicated when the pains resemble those 
produced by a bruise, or by excessive fatigue; also when they are much 
increased by motion and by turning in bed at night, and are attended 
with considerable weakness; and moreover, when irritability of temper 
and constipation are present. Nux-vomica is often of great service after 
Bryonia in acute lumbago. In chronic cases it is a remedy of no mean 
importance. 

RJius-toxicodendron is almost specific. It should be preferred to 
any remedy when the symptoms are as follows : Dragging or shooting 
pains in the back and small of back; severe aching or pain, as if from 
the effects of a bruise or a sprain in the loins; a feeling of stiffness or ten- 
sion in the affected parts on attempting to move, but aggravation of the 
pains when in a state of rest, or when pressure is made on the seat of the 
sufferings. It is also a useful remedy in chronic cases. 

Belladonna, where the pains are deeply seated, causing a sensation 
of heaviness, gnawing, or stiffness; it may follow Aconite with consider- 
able benefit, when slight inflammatory symptoms are present. 

Pulsatilla, when the pains, resembling those mentioned under Nux- 
vomica, are moreover attended with a sensation of tension or constriction 
at the affected part; it is particularly indicated for females, or individuals 
of mild, sensitive, or phlegmatic temperaments. 

Mercurius, when the pains are much of the same description as those 
given under Nux-vomica, but considerably aggravated at night, incapaci- 
tating the sufferer from taking rest. (See Rheumatism). 



INFLAMMATION OF THE JOINTS. 

ALLOPATHIC TREATMENT. Acute inflammation of a joint (syno- 
vitis,) demands, in the first place, absolute rest. This is imperative and 
invariable. This object may be aided by properly adjusted splints. The 
limb should be in a position which will relieve the articular surfaces from 
pressure. If the affected joint is in the lower extremity, the limb should 
be in the straight position. If the affection is in the knee, or hip joint, a 
degree of extension may be secured by the weight and pulley, as used for 
fractured thigh (described in the treatment for hip joint disease,) and relief 
from pain secured in this way. Rest and extension, which will separate 
the joint surfaces, and keep them apart, is, in most cases, all the treatment 
needed to ensure recovery. 

Counter-irritation, by applying Tincture of Iodine, or blisters, the use 
of cold by ice bags, compression with bandages, and a wet sponge, etc., 
have all, in some cases, been useful, and are sometimes hurtful, and do not 
compare with the means just described in efficacy. When the inflamma- 
tion and heat in the joint is great, a solution of Sugar of Lead and Opium 
will benefit : Take of Sugar of Lead thirty grains, Acetate of Morphine five 
to ten grains, (or two ounces of Laudanum,) and rain watei' a quart. Mix, 
and it is ready for use. The internal use of Opium may be called for by 
the severe pain. 

In chronic synovitis, rest and extension, as in the acute, are appropri- 
ate means of treatment. The use of blisters and other forms of counter- 
irritation are more useful and less often hurtful. The constitutional state 



486 DISEASES OF THE BONES, MUSCLES AND JOINTS. 

is generally faulty. This is to be corrected by good, nutritious food, fresh 
air, exercise and, sometimes, tonics. The Citrate of Iron and Quinine is as 
frequently useful as any, and may be given in doses of three grains, three 
times a day, if the patient is feeble. 

If absolute rest is enforced in this trouble, the joint lacks its natural 
stimulus — that of motion. At the proper time (which is difficult to deter- 
mine often,) passive motion (moving the joint by the hands of others;) 
must be resorted to, and after a time (which individual judgment only can 
determine,) active motion (by the patient) may be tried. After several 
weeks have passed it is best to try passive and then active motion. 

Passive, then active motion, good food, air, and good hygiene, gener- 
ally, have often restored swollen, painful, and stiff joints, in a few weeks, 
to their natural activity. 

It is often desirable to keep the surfaces of the joint apart by traction 
even when motion, both active and passive, is practiced. The weight of 
the limb may be sufficient, in case of the upper extremity. In the lower 
extremities, which must sustain the weight of the body, the end is met by 
very ingenious splints, invented by Dr. Sayre, of New York. Varieties 
are made for use of the different joints, hip, knee, and ankle. When 
these splints are properly adapted, the patient can go about without pain. 
In this way the functions of the joint are maintained, while all irritation 
is obviated, and the most favorable condition is maintained for recovery. 



COXALGIA-INFLAMMATIOX OF THE HIP JOINT. 

This inflammation, the chronic form of which is called "voluntary 
limping," cannot be traced to any definite cause. It affects, principally, 
children and young people, during the first years of pubescence. Its 
extremely frequent occurrence during the years fourteen to seventeen, 
and in persons of rapid growth, leads us to infer that a rapid growth of 
the bones constitutes a disposition to this inflammation, and that an 
exertion, a cold, or other scarcely apparent circumstances, simply act as 
exciting causes. 

Acute inflammation of the hip joint sets in suddenly, even with a 
violent chill, like all other acute inflammations, with which severe pains 
are associated. The patient locates these pains, at times, in the small of 
the back, at other times, more in front, very seldom in the hip joint; they 
are extremely acute, tearing, burning, stitching, shooting, aggravated by 
every motion of the lower extremities, not altogether, and sometimes not 
at all, relieved by horizontal posture. At the same time, a high fever 
accompanies the pains, the pulse being not unfrequently upwards of one 
hundred and twenty; this circumstance distinguishes the disease from 
lumbago, with which it is easily confounded. Amid symptoms of this 
kind, which may become sufficiently intense to simulate typhus, the 
following objective changes become manifest in one, two or more weeks: 
The affected hip, and the buttock of the same side swell, so that the fold 
between the buttocks is much deeper ; the thigh is somewhat turned out- 
wards, and slightly drawn up towards the abdomen ; the knee is half 
bent; extension and rotation of the thigh are very painful; nor can these 



INFLAMMATION OF THE HIP JOINT. 487 

• 

movements be executed completely. Walking is not entirely impossi- 
ble, but can only be performed with the greatest pain. 

It is very seldom that an improvement begins at this point; as a rule, 
an extensive suppuration sets in, amid frequent chills and burning heat 
of the skin. After this, a short intermission seems to take place in the 
further development of the disease, until the abscess reaches the skin 
and bursts. This may take place backwards, to one side, or in front. 
After the pus is discharged, the patient feels much better, and then worse 
again, provided the suppuration becomes very profuse and continuous. 
As a rule, the prospect of a speedy closure of the cavity is very slim. 

The terminations of the disease are: Very rarely a complete and 
rapid restoration; long-lasting suppuration, with final recovery, and a 
total or partial destruction of the joint. 

The chronic or subacute disease presents a very different group of 
symptoms. The disease commences with vague symptoms in the hip- 
joint, resembling rheumatic pains and alternately exacerbating, remit- 
ting, or even intermitting for some time. These pains may be absent 
and in their stead the patient may only complain of astifTjoint which is, 
more especially, felt during motion. Sensible pressure on the hip-joint 
generally causes more or less pain, and the thigh is usually rotated out- 
wards to some extent as soon as the disease commences. With such tri- 
fling symptoms it may go on for some time, before more serious changes 
become manifest. The pains increase in intensity, and cause the patient 
to limp, the thigh is slightly flexed and turned inwards. Almost with- 
out an exception, a more or less violent pain is at the same time felt in 
the knee, very generally surpassing the pain in the hip joint in intensity. 
The affected limb becomes lengthened, its muscles become relaxed and 
flabby. In the further course of the disease, suppuration sets in, the pus 
escaping on the outside, and destroying life by caries and hectic fever. 
A cure at this stage is a rare occurrence, or else the parts grow together, 
and the joint is permanently stiff. 

ALLOPATHIC TREATMENT. Hip joint disease is simply an inflam- 
mation of that joint, and is to be treated as already described for inflam- 
mation of the joints. 

In incipient hip joint disease, rest in bed and the straight position, 
with extension with the weight and pulley, is to be maintained, the weight 
being sufficient to relieve pain. This will vary from three or four to ten 
pounds. The mode of its application is by long adhesive plasters applied 
to the sides of the leg, and well secured by a bandage above the ankle. 

The foot and ankle should be bandaged, but the plasters must not be 
included within this part of the bandage. 

The lower end of the plasters are then fastened to a narrow board 
with a hole in the center, which is long enough to separate the plasters 
from the ankle, and so prevent irritation, a rope is knotted and passed 
through the hole in the board which is attached to the plasters. The 
rope is then passed over a pulley fastened to the foot of the bed, and the 
weight then fastened to the rope. The rope must draw in the line of the 
limb. In addition to this treatment, good hygiene, which consists in 
plenty of fresh air, comfortable temperature of the room, sponging of the 
body every other day, with water at an agreeable temperature; good. 



488 DISEASES OF THE BONES, MUSCLES AND JOINTS. 

nutritious food and cheerful surroundings, will be sufficient to carry the 
patient through the acute inflammation to recovery. 

It is best to bring the limb at once to a straight line, and the weight 
applied. It ought not to cause pain, or at least after a few hours. 

This treatment should continue six weeks or longer. The time comes 
when exercise must be secured, and at the same time extension contin- 
ued. This is best secured by a suitable splint for hip joint disease. There 
are several varieties of apparatus adapted to this end; one of the best 
is Dr. Sayre's. The splints of Davis or Bauer meet the required end. 

Many cases have been successfully treated by the use of the wire- 
gauze splint of Hamilton or Barwell. If these are used, the body is to be 
supported by crutches. 

A sole-leather, felt, or guttapercha splint, similarly constructed, will 
meet the end. It should extend from the top of the illium (hip bone) to 
above the knee, and broad enough to cover the thigh one-half in. A pro- 
jection from the top of the splint behind, three or four inches wide, 
should extend nearly around the body, and fastened in front with a 
strong piece of elastic band. 

Leather should be softened with cold water, and guttapercha with 
hot water, and moulded to the limb and pelvis, and retained with a ban- 
dage, until it hardens. The inside of the thigh should be covered with a 
suitable short splint. After the splint hardens, permanent fastenings can 
be attached. 

This method of treatment, faithfully and intelligently carried out, as 
a rule, will obviate the necessity of an operation, and secure a satisfactory 
result. When the disease progresses until the bone becomes extensively 
diseased, an operation for its removal is demanded. 

H0MCE0PATH1C TREATMENT. Although the number of homoeo- 
pathic remedies for hip joint disease is but small, yet the success with 
which they are used in this disease, is a source of pride to our practice. 
In view of the almost positive certainty of a correct diagnosis, in most 
cases of hip disease, the clinical results that have been obtained in the 
treatment of this disorder, may be regarded as absolutely reliable testi- 
mony. 

Rhus Tox. At the outset of the disease, when violent fever, hur- 
ried pulse, rheumatic pain from the hip to the foot, and constant desire 
to gain relief by a change of position, but before pus has actually formed, 
will be found an excellent remedy. 

Dose: Six pills in a teaspoonful of water, every five to twenty-four 
hours. 

Belladonna. Under almost the same indications as Rhus Tox., 
except the restlessness is not so marked, and there is more of a tendency 
to a dark-red appearance of the skin over the affected parts; showing a 
deep inflammation. 

Dose : As for Rhus Tox. 

Mercurius. If the formation of pus has really commenced, no rem- 
edy will compare with this, being frequently able to arrest the disease 
and restore the patient to health, as far as the nature of the attack will 
permit any remedy to do so. 

Dose: Six pills, or a small powder, three or four times a day. 



INFLAMMATION OF THE KNEE JOINT. 489 

Calcarea-carb., after the disease has turned, or shows marked 
signs of turning for the better, helps very much by aiding in the nutri- 
tion of the parts affected, as well as the system in general. 

Dose: Six pills twice each day. 

The rest of the treatment may be condensed in the following points : 
The patients should not remain in a state of absolute rest, on the con- 
trary, they had better move about by means of crutches. If pus forms, 
warm poultices may be applied ; they not only promote the formation of 
pus, but very often favor its absorption. Only if carious destruction of 
the joint has taken place, the patients will have to remain quiet, lest spon- 
taneous luxation should result ; in such circumstances, a suitable exten- 
sion apparatus may be resorted to, which will have to be applied, how- 
ever, with a great deal of caution. The diet should be, at all times, plain 
and strengthening; the use of fat is to be rigidly prohibited. 



GONITIS— INFLAMMATION OF THE KNEE JOINT- 
WHITE SWELLING. 

This is one of the most frequently occurring inflammations of joints ; 
owing to the exposed situation of the knees, this might, indeed, be ex- 
pected. 

A simple inflammation of the knee, is generally the result of some 
mechanical injury or of excessive use, and is an unimportant affection, as 
long as the inflammation is confined to the integuments. It is scarcely 
ever attended with fever, is never ushered in by a chill, and runs its course 
within a few weeks. However, as we can never be sure whether such an 
unimportant disease may not result in the more dangerous white swelling, 
it ought to be managed with all due precaution. 

Symptoms. While using the joint, the patient complains of pain and 
impaired mobility; in more rapidly progressing cases the temperature of 
the joint is higher than usual. If the inflammation emanates from the 
soft parts, the pains are generally less than when the bones constitute the 
starting-point. Sometimes the knee swells rapidly, at other times more 
slowly, and most slowly if the bones receive the first shock of the disease. 
In the latter case, the knee preserves its form for a long time, in the other 
cases the swellingsoon modifies any former shape of the knee. As the swel- 
ling increases, which generally has a very white appearance, it grows pro- 
gressively softer, elastic, and finally shows symptoms of fluctuation. The 
cutaneous veins become very much enlarged. The pains generally increase 
with an increase of the swelling. Sometimes not till after the lapse of 
years, and, in a few cases, after that of weeks, distinct fluctuation is per- 
ceived in one or more places; here the skin reddens, breaks, and a pus, 
which is mostly thin and mixed, is discharged. In spite of the evacuation 
of pus, the swelling remains almost unchanged. 

The suppuration in a case of white swelling is generally very tardy. 
The openings may close for a short time, after which they generally open 
again, so that, in a fortunate case, suppuration may cease after many 
months, and the swelling may grow smaller, but the joint remains stiff 
and thick, and the leg somewhat bent. A cure of this disease is witnessed 
only in the case of young people. If the case terminates less favorably, 



490 DISEASES OF THE BONES, MUSCLES AND JOINTS. 

the suppuration gradually superinduces hectic fever, and finally ends in 
death. 

The prognosis is always bad, for no one escapes from such an attack 
without some permanent injury; the difference in favor of young and 
robust individuals is, that death needs not be apprehended in their case, 
which is generally sure to occur in individuals of upwards of thirty years 
of age. 

ALLOPATHIC TREATMENT. The treatment of inflammatory dis- 
ease of the knee does not differ materially from that given for inflamma- 
tion of the hip joint, and joints in general. Rest is the first essential; 
this may be secured, first, by applying a splint to the posterior of the limb, 
including both the thigh and leg, to keep the joint perfectly still. Cold 
applications, or warm, as give the most relief, may be employed. The hot 
wet pack applied to, the knee will be useful, if cold causes pain. 

The evaporating solution of Lead and Opium, given in the treatment 
of synovitis may be used. If the joint continues painful, pull moderately 
on the ankle to separate the ends of the bones in the joint, and if this 
gives relief, the weight and pulley should be employed to produce exten- 
sion, as directed for disease of the hip. A large amount of water in the 
joint, producing enlargement, should be met by pressure, either an elastic 
band or bandage and wet sponge. Pressure would be painful and harmful 
without extension. After six weeks or more have passed, exercise of the 
joint becomes necessary, but extension must be continued. This can be 
done by the proper application of a Sayre's splint for the knee joint. If 
the limb is distorted, the tendons necessary must be divided to bring it into 
shape. 

When the fluid in the joint is not removed by absorption from pressure 
and friction, (rubbing with a simple liniment,) aiding nature, it is neces- 
sary to remove the liquid with an aspirator, or possibly by incision, but 
the wound must be hermetically sealed immediately, and the joint kept 
motionless by a well-secured splint until the wound heals. 

Nearly, if not all cases, can be cured by absolute and permanent rest, 
and extension, as has been indicated, and, in some cases, compression. 

When the inflammatory disease in a joint has advanced to suppuration 
and decay of tissues, it is commonly spoken of as a " white swelling." If 
it is the knee joint that is affected, it is then known as " white swelling of 
the knee joint." The treatment described for inflammation of the knee 
or joints, if properly carried out, will prevent this undesirable state of 
affairs. If it occurs there is pain, irritation, fever, loss of appetite and 
debility. Extension by means of Sayre's splint for the knee (or for such 
other joint as is affected) must be made. This will relieve the pain . The 
services of a surgeon are necessary in the management of these cases. If 
it is impossible to procure a splint, extension should be made with a 
weight and pulley. There is the disadvantage of confinement with this 
manner of extension at a time when it is very important for the patient 
to be much in the open air. The patient should have the benefit of fresh 
air, sunlight, and good food. 

Tonics may be required. There is no better one than the Citrate of 
Iron and Quinine, given in doses of one to four grains, three times a day. 
The Compound Syrup of Hypophosphites is another useful one, especially 



"HEaO0PACCESS3JIUS 



PLEXOR BREVIS POLUClS 



Tu7,crr7+ ef 




TIBIALIS ANTiCUS 



Fl EXOR BREVI3 
KINIMi OICITI 



FLEX CM LOW1J 
' BtBITOBUM 



(491) 



492 INFLAMMATION OF THE KNEE JOINT. 

if there is much discharge, as also is the Compound Syrup of the Lacto- 
Phosphates. The dose of each is a teaspoonful. The former syrup may 
be combined with a fourth Dilute Phosphoric Acid. The dose then will 
be the same. 

When an inflamed joint, acute or chronic, will permit the two surfaces 
of the joint to come together by ajar, without pain, and when there is no 
pain on pressure, the instruments may be removed. A condition of irri- 
tability remains and the joint cannot be used without pain. The case 
requires passive motion and rubbing. Gentle but thorough friction to 
restore the functions of the joint, remove the congestion and irritability. 
The pretense that the hands of some persons have especial power in this 
direction is simply pretense. In the successful cases under their hands, 
they have only by accident stumbled upon the case at a stage when the 
rubbing was the element necessary to restore the use of the joint. One 
so-called cure of this kind, at the hands of a pretender, is the source of a 
wonderful amount of fame to the injury of society, and an unfavor- 
able reflection is made on the medical profession, which is unjust. 

HOM(EOPATIC TREATMENT. Silicea is the medicine of chief im- 
portance in the treatment of the inflammation of the lining or covering 
membrane of the knee-joints, or for the treatment of the enlargements, 
and other mischiefs resulting from such inflammation. 

Dose: Six pills in a teaspoonful of water, three times a day. 

Sulphur and Calcarea are indicated at the onset, or after the pre- 
vious administration of some other medicine, to complete the cure. They 
are of chief importance in scrofulous enlargements of the knee, and may also 
be required as intermediary remedies, when other medicines, apparently 
indicated, cease to produce any decided effect. 

Dose : Give six pills in a tablespoonf ul of water, every morning and 
evening. 

Bryonia may be given, if the trouble results after rheumatism, with 
red and very painful swelling of the knee, particularly, if the slightest 
motion aggravates the pain. 

Dose: Snme as Silicea. 

Pulsatilla is an excellent remedy for the treatment of glazed or 
shining, white, soft, or doughy swellings of the knee, and is, indeed, more 
or less especially appropriate for the treatment of soft, colorless swellings 
of the knee, in general, whether painful or otherwise. 

Dose: In every particular as directed for Bryonia and Silicea. 

External applications are not always appropriate in this disease. Poul- 
tices are injurious if they increase the pains; in most cases, they not only 
relieve the pain, but likewise exert a favorable effect upon the reabsorp- 
tion of the pus in the diseased joint. An uninterrupted recumbent post- 
ure is to be avoided, as long as the patients remain capable of moving 
about; only the diseased limb must not be used for a walk. A moderate 
and constant pressure by a starched bandage is only borne, if the bones 
are not too much diseased; it has the double advantage of antagonizing the 
swelling, and protecting the limb during motion. It has the best effect, if 
the abscess has already broke, for, in such a case, the bandage most decid- 
edly promotes the course of the suppurative process. Amputation is only 
advisable if the joint is utterly disorganized, and the constitution begins 
to show signs of failing under the constant pain and loss of fluids. 



DISEASES OF THE BONES, MUSCLES AND JOINTS. 493 

INFLA3IMATIOX OF THE JOIXTS OF THE FOOT- 
TABS US. 

The inflammation is either seated in the bones, or where they articu- 
late with those of the metatarsus (between the ankle and toes;) or else in 
the articulation of the tarsus (ankle) and tibia (large bone of the leg,) or 
in both localities at the same time. Here, too, mechanical injuries are 
rarely the cause of the inflammation. An inflammation of the metatarsus 
is particularly met with among children, and during the age of pubes- 
cence; an inflammation of the tibia-tarsal articulation occurs more fre- 
quently among adults. 

The Symptoms are most commonly the following: At first a pain is 
felt in walking, particularly during certain positions of the foot ; in a state of 
rest the pain subsides almost entirely. Gradually the joint begins to swell, 
the swelling increasing more and more, and gradually extending over the 
whole foot; at the same time the pains increase, become continuous, and 
walking is entirely out of the question. At last, the pus finds an outlet in 
one or more places. In favorable cases, the suppuration now decreases, 
the strength keeps up, the fistulous openings close, although sometimes not 
till years have elapsed. Or else the swelling continues to increase, even 
after the abscess, the foot becomes completely distorted, and hectic fever 
is the unavoidable consequence. 

The course of the disease always exceeds one, and even more years, 
until the pus escapes outwardly. At all times life is in danger, even in the 
case of children; adults succumb almost always with scarce an exception. 

A peculiar form of tarsal inflammation is a flat foot. Sometimes it 
affects small children, although it is only slightly developed at that age ; 
it mostly shows itself after pubescence, most generally among males if they 
suddenly grow up in night. Every time after the foot is perseveringly 
used, violent pains are experienced in the joint, which becomes stiff after 
walking, with inability to stand upon the affected limb. Little by little 
the foot loses its arched shape, and the patients generally walk on the 
inner edge of the foot. The malformation of the foot may become very 
considerable, and may, materially, interfere with its use. Sometimes the 
trouble does not cease spontaneously, until after the patient is thirty years 
old. This form of inflammation, which, under similar circumstances, may 
likewise occur at the knee, never results in suppuration. Treat only by a 
physician. 

ALLOPATHIC TREATMENT. The principles of treatment of inflam- 
matory disease of the ankle joint, are essentially the same as is laid down 
for the treatment of synovitis in general, and of the hip and knee joints. 
Absolute rest is the first essential. Of all the plans of local applications, I 
believe heat to be the best. It can be applied by the hot wet pack, or by 
immersing the ankle in water as hot as can be borne, when the pain is 
relieved by repeated hot packs, or by the hot foot bath; the limb should be 
elevated, and kept in that position until there is no tenderness on pressure, 
and until the limb can hang down without causing pain. If there is effu- 
sion in the tissues about the joint, compression should be made by firmly 
bandaging a large sponge around the joint, which has been previoufly satu- 
rated with warm water and squeezed as dry as possible. (The foot, ankle 
and leg should be bandaged). The sponge and bandage about the joint 



494 ULCERS. 

should be kept wet with warm water. By the swelling of the sponge, and 
the shrinking of the bandage, considerable compression is produced. Com- 
pression can be made more conveniently by the double India-rubber bag 
which is inflated with air. After a few days, rubbing the joints with the 
hand, will be useful. 

In more advanced cases, extension should be made by the use of 
Sayre's splint for the ankle joint, and the patient permitted to go about'on 
crutches, while the surfaces of the joint are kept apart by the extension. 
The excessive secretion of fluid in the joint may be caused to be absorbed 
by pressure and rubbing. If pus is formed in the joint, or a thickened 
fluid which cannot be absorbed, as determined by the exploring-needle, 
or trocar — it should be withdrawn by the aspirator, or incision as de- 
scribed in the treatment of the knee joint. Extension by means of Sayre's 
splint, should be continued. 

When the disease has advanced to destruction of the tissues of the 
joint (cartilage or bone,) the treatment is too complex to be described 
here. The reader is referred to some recent complete work on surgery, or 
diseases of the joints. If, however, the treatment described here is thor- 
oughly carried out in the beginning of the disease, recovery will be 
reached without serious consequences. 



CHAPTER XXV 



ULCERS. LYMPHATIC TUMORS. DISEASE OF THE 
CINGLOBATE GLANDS. 

Abscess— by this term is meant a collection of purulent matter, result- 
ing from morbid action, contained in a sac or cyst of organized coagula- 
ting lymph furnished with absorbent and secreting vessels. 

Abscesses are divided into acute and chronic. The acute variety is 
preceded by sensible inflammation in the affected part, which is soon fol- 
lowed by suppuration. The commencement of the suppurative process 
is known by a change in the description of pain, which becomes more 
obtuse and throbbing, by an increase of the swelling, and when matter is 
formed, by the perceptible fluctuation of the part, when the abscess is not 
too deeply seated ; lastly, particularly in idiopathic (primary) cases, when 
the formation of pus is considerable, the fever, which had attended the 
earlier stages, is materially lessened, and irregular chills, or rigors, super- 
vene, succeeded again by heat and increase of fever. 

When the abscess is mature, the tumor becomes pointed, or presents a 
conical shape, generally near the center of the inflamed cutaneous sur- 
face ; over this spot the skin assumes a reddish hue, becomes thin, and, 
ere long, gives way and allows the contents of the cavity to escape. 

The signs of the formation, or existence of a chronic abscess, on the 
other hand, are, in the generality of cases, devoid of any apparent disor- 
der, either local or constitutional, until it begins to approach the surface 
and form an external swelling. The secreted matter is unhealthy, thin, 
and contains substances resembling curds or flakes. 



DISEASES OF THE BONES, MUSCLES AND JOINTS. 495 

"When the pus is let out (evacuated,) and the air admitted into the cav- 
ity, inflammation of the cyst arises, and is beneficial, if the cavity of the 
abscess is small, but if it be large, great constitutional disturbance ensues, 
the cavity, instead of contracting and filling up by healthy granulation, 
goes on discharging copiously until, in the end, hectic fever is produced. 

ALLOPATHIC TREATMENT. Acute inflammation of the lymphatic 
vessels (angeiolencitis) requires the application of heat promptly and con- 
stantly. Flannels wrung out of hot water, and the limb, or other part 
affected, covered with them, and the whole well covered in, to retain the 
heat, is a form of hot wet pack which is most serviceable. They should 
be renewed as often as they become cool. The hardened inflamed lines 
may be covered with Belladonna Ointment. Any wound or ulcer causing 
the inflammation is to receive its appropriate treatment. 

Pain is to be relieved, if necessary, with Opium in grain doses. Mor- 
phine in doses of a quarter of a grain, or Laudanum in doses of twenty- 
five drops, repeated just often enough to give relief. 

Free incisions through the inflamed part relieve the tissues strangu- 
lated by the inflammation, and evacuates the pus. Early incisions are very 
important. Pus has often formed in the subcutaneous tissue, which is not 
detected by fluctuation. Too great delay in making these incisions may be 
attended by serious consequnces. 

The patient must be nourished with milk, strong beef tea, and eggs. If 
much depression occurs, Quinine and Brandy, or Whisky, should be freely 
administered. The former in doses of five to ten grains, from four to six 
hours apart, according to the urgency of the symptoms. The latter may 
be given, according to the degree of urgency of the symptoms, in doses of 
a tablespoon ful (half an ounce) to one or two ounces, from half an hour to 
four hours apart, but always short of producing symptoms of intoxication. 

The bowels should be moved by Citrate of Magnesia, or an injection 
of warm water. 

Should the disease become chronic, the strength of the patient should 
be supported by good food and tonics. Poor digestion may be improved by 
teaspoonful or dessertspoonful doses of Sheffer's Liquid Pepsin, * and 
the blood enriched by the Tincture Muriate of Iron in doses of ten to 
twenty drops, largely diluted in sweetened water, three times a day. 

The best local application is the application of the Biniodide of Mer- 
cury Ointment in one-half to a full strength, applied sufficiently often to 
produce slight irritation. 

Inflammation of the lymphatic glands (adenitis,) in the acute variety, 
is to be treated precisely as directed for inflammation of the lymphatic 
vessels. As the inflammation is more localized, hot linseed poultices, hav- 
ing the surface strongly impregnated with Laudanum, may be used with 
great advantage. The surface over the inflamed gland may be covered 
with Belladonna Ointment. Other hot applications are equally appropri- 
ate, as in inflammation of the lymphatics. 

When the general health is poor or the patient scrofulous, such reme- 
dies as the Citrate of Iron and Quinine, in doses of two to five grains should 
be given. Iodide of Potassium with Iron is often an appropriate remedy. 

* Tha formula for making Liquid Pepsin is, take of Saccharated Pepsin (Sheffer'ii) two drama. Hy- 
drochloric Acid a dr.un, Water five ounces. When solution is effected, add Glycerine three ounces. 



496 ULCERS. 

Talze of Iodide of Potassium five drams, Pyrophosphate of Iron a dram, 
Peppermint water eight ounces. Mix. 

Dose : A dessertspoonful three times a day. It can be sweetened or not, 
according to the taste of the patient. 

The Compound Syrup of the Phosphates or Hypophosphates in doses 
of a teaspoonful to a dessertspoonful three times a day is suitable. Cod 
Liver Oil is often required. 

After the disappearance of the acute inflammation, if the glands 
remain, hard rubbing with Iodide of Mercury Ointment will generally 
produce absorption. This ointment may often be reduced one half with 
lard. 

HOMCEOPATHIC TREATMENT. In acute abscesses, apply poultices 
and warm, unmedicated fomentations, and forward the suppurative pro- 
cess. The lancet is never necessary, except when the pus, by its exten- 
sive diffusion or pressure, especially when deep-seated, is liable to injure 
important parts ; or when, from its situation, there is reason to apprehend 
its discharge into any of the cavities of the body. 

When it is necessary to make an opening with the lancet, the incis- 
ion ought to be made at the lowest or most dependent point, where this 
can be safely and readily accomplished ; but when this is impracticable, 
in consequence of the great thickness of the parts between the pus and 
the skin, the most prominent or pointed part should be selected. 

When, on the other hand, this latter point happens to be at the upper 
part of the abscess, the lancet had better not be used at all, but trust rather 
to the use of remedies. 

Hepar Sul., Silicea, Arsenicum, and Lachesis. 

In chronic abscesses, it has usually been found most beneficial" to 
make an outlet for the matter (pus) as early as possible, so as to prevent 
its large accumulation, and thereby avoid the consequent frightful consti- 
tutional disturbance so liable to occur in such cases from the extent of 
the inflammation. After the bursting of the abscess, make the opening 
merely large enough to admit of the exit of the matter. When the col- 
lection of pus is very extensive, it frequently accumulates again after 
having been evacuated, hence it has been recommended to heal up the 
opening immediately, and to make a new one when necessary, but before 
the pus has accumulated in anything near like the first quantity evacu- 
ated. 

HOME TREATMENT. An excellent remedy for all open sores upon 
an inflamed base, milk leg, and inflamed breasts, is tobacco salve. To be 
made as follows: Take one-half pound of Navy plug tobacco, two pints 
of good Vinegar, three-fourths of a pound of Tallow, one-fourth of a 
pound of Lard or Sweet Oil, half a pound of Rosin, half a pound of Bees- 
wax, one ounce of Balsam Fir, one-fourth pound of Burgundy Pitch. 

Cut up the tobacco fine and soak in half an ounce of water till soft. Add 
one-half of vinegar, boil and strain, then add balance of vinegar, steep, 
rinse the dregs and strain ; then boil down one-half and add wax, rosin, 
lard, and Burgundy pitch ; then boil down till water is all evaporated, 
add balance of fir and stir till cold. If too stiff, add lard or oil to the con- 
sistency required. 



SIMPLE REDNESS OF THE SKIX. 497 

CHAPTER XXVI. 



DISEASES OF THE SKIN, 



ERYTIIEJIA-SIJIPLE REDNESS OF THE SKIN. 

Erythema occupies a middle rank between congestion and inflam- 
mation of the skin ; it is easily confounded with a benign form of ery- 
sipelas. 

Its causes are: Mechanical injuries of the skin ; the influence of a 
high temperature, of various medicinal agents; continual moistening of 
one part of the skin by urine, liquid stool, perspiration, tears, and even the 
constant use of moist compresses; constant irritation of the skin by rough 
clothes. In the case of children, erythema seems to be, likewise, caused 
by hearty and fat food. Erythema seldom occurs as a wide-spread affec- 
tion, to which the designation of "epidemic " might be applied. Chronic 
erythema breaks out chiefly in the face, and, more especially, on the 
nose; its causes sometimes seem to be purely local, and, at other times, 
constitutional. 

Erythema is characterized by a more or less diffuse redness of the 
skin, not separated from the normal redness by sharply-drawn outlines, 
assuming a yellowish, not a white tint under the pressure of the finger, 
and continuing for some time, and, finally, terminating in desquamation 
(peeling off). These characteristics belong to all forms of erythema. Ery- 
thema caused by external irritants, most generally breaks out on the 
scrotum, at the anus, between the thighs, in the axillae (arm pits,) face, 
and in the deep integumentous folds of fleshy persons, or at the place 
where the irritating cause exerts its influence. 

After the cause ceases to act, the erythema generally disappears of 
itself in a few days. If the irritation continues, the skin may become 
detached (intertrigo,) and ulcers may form, or the skin may even become 
gangrenous. Erythema arising from internal causes is almost exclusively 
located on the dorsal surface of the hands and feet, where it is never 
absent, even if other parts are, likewise, affected. At first the place exhib- 
its a redness, and in a few days darker-colored papules of various sizes 
spring up, which remain even for some time after the diffuse redness has 
disappeared ; the affected spot, likewise, retains a yellowish tint for some 
time after. In particular circumstances, subsequent crops of this eruption 
break out on its borders, by which means the affection runs a very pro- 
tracted course. This form of erythema is generally attended with a little 
fever, and at the diseased spot a darting-burning pain is generally expe- 
rienced. The former variety, on the contrary, has no fever as long as the 
erythema is of the simple kind ; whereas, the intertrigo of sensitive 
children may be attended with fever. The second variety, without any 
subsequent crops, lasts from one to two weeks. 

In treating the first variety, all that it may be necessary for us to do, 
is to remove the exciting cause. In some individuals, the disposition to 
erythema i3 so great, and it leads so easily to more serious consequences, 
that we are led to suspect behind the local irritation the existence of some 

32 



498 ERYSIPELASo 

constitutional disposition. This is particularly the case with the inter- 
trigo, or soreness of children. Since this soreness is often caused by impro- 
per diet, the first thing to be done is to regulate it with care; if the sore- 
ness continues in spite of this change, a few doses of Mercurius vivus or 
solubilis will cure the trouble very speedily. 



ERYSIPELAS. 



Erysipelas proper is altogether a primary affection, the cause of which 
it is difficult to trace in every case. The disease occurs almost exclusively 
between the age of pubescence and that of sixty, and is of less frequent 
occurrence among old people than among children. Atmospheric influ- 
ences are generally regarded as the cause of erysipelas, but this theory is 
not justified by the evidence of fact. All we know positively is, that ery- 
sipelas often sets in as a sporadic disease, and that sometimes it breaks 
out in the form of a limited epidemic, which never assumes a very exten- 
sive range, and has given rise to the erroneous view that erysipelas is a 
contagious disease. It is a characteristic feature of this disease that every 
new attack of erysipelas increases the patient's liability to other attacks, 
which only becomes extinct at an advanced age. The cause of successive 
attacks of erysipelas is very often to be found in violent emotions, gross 
errors in diet, and in colds, more especially in the action of severe cold 
upon a heated skin. 

The origin of wandering erysipelas is involved in complete mystery; 
it is to be observed that it inclines to sefc in previous to the age of pubes- 
cence. 

Traumatic erysipelas arises in consequence of injuries, if suppuration 
ensues, or even at the start, soon after the infliction of the injury ; or it 
accompanies suppurating inflammatory processes, such as gumboils. It 
may be looked upon as an excess of reaction against the inflammation 
from which it proceeds. This circumstance likewise accounts for those 
cases of erysipelas that supervene during typhus and other constitutional 
diseases as a malignant complication or as a terminal disease. 

Symptoms and Course. True, or the so-called exanthematic erysip- 
elas really only breaks out in the face, whereas erysipelas on other parts 
of the body is, properly speaking, erythema. The appearance of the 
exanthem upon the skin is generally preceded for a few hours or even 
days by a preliminary stage, consisting of a severe fever with marked gas- 
tric symptoms, with which symptoms of cerebral hyperemia, and more 
especially a violent headache, sometimes become associated at an early 
period. During a first attack these precursory symptoms are scarcely ever 
absent; but they do not occur with a return of the disease. While the 
fever is on the increase, the face feels hot and tense, and sometimes rheu- 
matic pains in the nape of the neck are complained of, a vivid redness 
breaks out at a certain circumscribed spot in the face, which spreads 
rapidlyand causes a burning pain. In proportion as the redness becomes 
more intense, the swelling likewise increases and the skin assumes a glis- 
tening appearance. Erysipelas generally breaks out on one cheek, whence 
it spreads to the nose, the eyelids, forehead, ears, less frequently to the 
lips and scarcely ever to the chin. Within two or three days, and some- 



DISEASES OF THE SKIN. 499 

times in thirty-six hours, the erysipelas reaches its acme at the spot where 
it first appeared, amid febrile symptoms, which are sometimes exceedingly 
severe, attended with a foul-smelling catarrh of the mouth, vomiting, and 
most generally delirium; these symptoms, however, are not constant, 
whereas the headache and soporous stupefaction are exceedingly annoy- 
ing. The face is now very much swollen, the features are disfigured to 
such an extent that they are no longer recognizable, the redness has a 
bluish and even brown-red tint, and vesicles of various sizes sometimes 
spring up upon the inflamed surface, which always indicate an intense 
degree of illness. 

The inflammation decreases very rapidly ; the redness disappears 
after the existing vesicles had dried up previously, and had become trans- 
formed into thin and flat crusts, and very soon desquamation commences, 
first in large patches, and afterwards in very small scales. But inasmuch 
as the disease never terminates with its first appearance, and usually 
spreads over the whole head, we find erysipelas in full bloom close to the 
original spot in process of healing, and find the redness gradually diffus- 
ing itself into this spot, whereas it forms a sharp contrast with the sur- 
rounding normal parts of the face. In this manner erysipelas gradually 
wanders over the whole face, even beyond the ears, invading a portion of 
the nape of the neck, and spreading over the forehead and the hairy 
scalp. In this latter case, the patients suffer severe local pains, even after 
the fever abates. The intensity of the fever, as it first breaks out at the 
commencement of the disease, does not keep pace with its gradual pro- 
gression. Whereas, at one spot, the inflammation runs its full course in 
five to six days, yet, on account of its progressive appearance in different 
localities, the w T hole course of the disease lasts from ten days to a fortnight. 
The process of desquamation may last much longer, and the most severely 
affected parts often exhibit, for a long time, a yellowish tint with signs of 
serous infiltration. 

Deviations from this course are not unfrequent. The whole face may 
be covered so rapidly, that it would seem as though the exanthem had 
broke out all over at once. These are cases of intense virulence, where 
one ear, however, commonly remains uninvaded. Moreover, the inflam- 
mation may communicate itself to the cerebral meningae ; generally, how- 
ever, this does not take place until the local process has reached its hight. 
In such a case, the redness very soon assumes a dingy and livid look; the 
skin becomes lax and wrinkled, a most violent delirium sets in, and coma 
and death speedily supervene. This course has been mistaken for a 
metastasis of erysipelas : whereas, in such a case, the same changes take 
place as in other similar cases, namely : that, with the appearance of a 
violent disorder, the previously-existing lesser disease abates and disap- 
pears. Erysipelas seldom becomes associated with diseases of other impor" 
tant organs. Attacks of erysipelas succeeding the first attack are very 
apt to show deviations from the normal course. These attacks are very 
seldom preceded by precursory symptoms, the less so the more frequently 
the attacks have occurred. Nor is the fever as severe, the swelling is 
less, and the spread of the disease over the face takes place more slowly. 
It not unfrequently happens that in subsequent attacks the patients 
are not obliged to lie down, and that their appetite remains the 



500 ERYSIPELAS. 

same as in their normal condition. Subsequent attacks are more like 
erytbema than erysipelas. The frequency of the attacks differs greatly 
in different individuals ; sometimes there are several attacks in a few 
weeks, and, after a short time, cease entirely; or months, and even years, 
intervene between the attacks; in such cases a spontaneous cessation is 
much less frequent. 

Among the consequences of true erysipelas, the following deserve 
particular mention : Swelling of the skin, especially, that of the eyelids, 
nose and lips; the swelling is mostly puffy, the skin having a pale look, 
and being disposed to the formation of comedones; if the attacks are 
very frequent, the swelling may reach a considerable degree of thickness, 
and is very obstinate. Loss of the hair, which almost always falls out if 
the scalp had been intensely affected by the disease; in most cases, the 
hair grows again, but there are exceptions to this rule. Severe catarrh of 
the ear, with obstinate hardness of hearing. Disposition to neuralgia. 

Wandering erysipelas, or erysipelas ambulans or erraticum, attacks 
the face less frequently than the extremities. On one of the extremities, 
an erysipelatous spot appears which heals exactly like the above described 
spots, only there is very little tension and pain, and the general organ- 
ism is not so much involved. From this spot, the erysipelas spreads 
toward the trunk ; the spot which is attacked next, being either in close 
contact with the first, or else all subsequent spots being more or less 
remote from each other. 

Symptomatic erysipelas, as an accompaniment of inflammatory pro- 
cesses, is of no great importance, except when it covers a large extent of 
surface and depends upon septic causes. Generally, it disappears of itself 
as soon as the cause that occasions it, is removed. If it is very intense, it 
may result in suppuration or gangrenous destruction of the skin. If the 
erysipelas sets in, in the course of serious, constitutional diseases, with 
fever, it is always a bad omen. In such cases, the redness is never very 
vivid — rather dingy, having a bluish tint ; the swelling is not excessive, 
and yet the disposition to form blisters is very great ; these blisters do 
not always dry up, but often become transformed into badly-looking 
ulcers, which are apt to become gangrenous. The fever accompanying 
this form of erysipelas, always increases to a high degree, but speedily 
assumes the character of an adynamic fever, the pulse becomes very small 
and frequent, the temperature increases considerably, the cerebral phe- 
nomena become very marked, and sopor and coma set in at an early 
period, and death sometimes takes place so rapidly that life becomes 
extinct already on the third day after the appearance of the inflam- 
mation. 

Erysipelas of babes generally sets in in the first week after the birth 
of the infant, very seldom after the first month. It almost always pro- 
ceeds from the umbilicus, on which account it has been traced with great 
probability to the consequences of an improper management of this organ, 
more especially to a purulent inflammation of this organ, which can eas- 
ily be accounted for by bad management. As a rule, the erysipelas 
spreads from the umbilicus over the abdomen, the sexual organs, thighs, 
less frequently over the thorax and back. The redness is not very vivid, 
the swelling, on the contrary, is very considerable. The children are 



DISEASES OF THE SKIN. 501 

exceedingly restless, feverish, and incline greatly to spasmodic affections 
and sopor. 

ALLOPATHIC TREATMENT. A patient with erysipelas (erysipela- 
tous fever) should be confined to bed in a well-ventilated room. The 
diet should be light, but consisting largely of milk. Cold drinks may be 
given as desired. If the bowels are constipated, they should be moved 
by a saline cathartic, as the Citrate of Magnesia, aided, if necessary, by 
an injection of warm water. If the case be a mild one, and the fever not 
high, it is not generally necessary to resort to the use of drugs. In severe 
cases, the remedies most useful are Quinine and the Muriate Tincture of 
Iron. Quinine, in these cases, should be given in doses of five to ten or 
more grains every four hours. If a slight ringing in the ears is produced, 
the doses are sufficiently large. It is best given in powder enveloped in 
medicine wafers. The Tincture Muriate (Chloride) of Iron is very gen- 
erally given by physicians in doses of ten to thirty drops every four 
hours. It should be largely diluted with sweetened water, and may be 
given immediately after the Quinine. Beyond the support it gives to 
the system laboring under so debilitating a disease, the (direct) benefits 
from the Iron are questionable, but as it is beneficial in this way, it ought 
not to be omitted in any severe case. 

Belladonna is especially antagonistic to this disease. The Extract 
may be given in doses of a quarter of a grain in pill, three or four hours 
apart, or the Tincture may be given in doses of from five to ten drops at 
the same intervals. The Belladonna may be given with the Quinine. 

In cases with high fever, the pulse strong, and there is no depression 
of the system, the Tincture of Aconite should be given in doses of half a 
drop to a drop every hour until an impression is made on the fever move- 
ment, and then continued two or three hours apart, or just sufficiently 
often to continue the effect of moderating the fever. This remedy does 
not require the suspension of any of the others mentioned, but it should 
not be given when there is prostration. 

There is no treatment which will limit the inflammation. The sooth- 
ing effect of the Lead and Opium wash, is often extremely grateful to 
the patient. A half a dram of Sugar of Lead and ten grains of the 
Acetate of Morphine are dissolved in a quart of rain water. A soft mus- 
lin cloth is dipped in this solution and spread over the inflamed sur- 
face. The cloth should be kept wet. If this does not relieve the pain 
markedly, it is well to try anointing the surface well with Olive Oil. 
Two drams of the Fluid Extract of Belladonna to six drams of oil will 
give the oil a decided anodyne property. Glycerine, with ten to twenty 
drops of Carbolic Acid to the ounce, is another good application. 

Prostration or debility, occurring in the course of the disease, should 
be treated in the same manner as when it occurs with continued, or other 
fevers, with nutritious food, milk, beef essence, raw eggs beaten up 
with sugar and water or milk. Nourishment should be given in these 
cases four hours apart. If the pulse should be very rapid and feeble, 
brandy, or whisky in doses of one or two tablespoonfuls may be given 
with the nourishment. The stimulant is beneficial, if the pulse becomes 
fuller, slower, and more regular. Sago, Rice, and other farinaceous articles 
are not to be excluded, if agreeable to the patient. 



502 ERYSIPELAS. 

HOMOEOPATHIC TREATMENT. Aconite may be required at the 
onset, only in case there be much fever, or hot, dry skin at the commence- 
ment; or even during the course of the disease, if required. 

Dose: Dissolve six pills in three tablespoon fuls of water, and give a 
teaspoonful of the solution every three hours, until the pulse becomes 
diminished in force and frequency, and the skin moist. 
Belladonna, when the redness expands in rays, and an acute shoot- 
ing pain with heat and tingling is experienced in the affected part, 
which is aggravated by movement. Erysipelas of the face, with burning 
heat, excessive swelling, so that the eyes are almost closed, violent head- 
ache, thirst, dry, hot, skin, restlessness, disturbed sleep, delirium. 

In such instances, Belladonna, is, generally, alone sufficient to effect 
a cure. There are cases, however, in which it will be found necessary to 
have recourse to Rhus-toxicodendron, in alternation with Belladonna, 
according to the particular symptoms, or group of symptoms present. 
Dose: If singly, of a solution of eight pills to two tablespoonfuls of 
water, give a teaspoonful every two hours, until change, when the 
intervals should be extended to six hours, until the symptoms are 
wholly overcome, or assume distinctive features indicative of another 
remedy. But in those cases, of occasional occurrence, in which the 
symptoms, being severe, are but little moderated, within three hours 
after the fourth dose of Belladonna, Rhus., a similar solution of 
each medicine, administered by teaspoonfuls, at intervals of two 
hours, until change. 
Hhus-toxicodendron is to be preferred, particularly when the dis- 
ease manifests a tendency to extend itself to the brain and its membranes 
and the symptoms closely resemble those which characterize brain fever. 
Rhus is especially suitable for the treatment of erysipelas arising from 
particular kinds of food, operating upon certain individual peculiarities of 
constitution which predispose the patient to such attacks. 
Dose : As directed for, and under Bell. 

Arsenicum is required, either after the previous administration of 
one or more of the foregoing medicines alone, or in alternation with Rhus 
when vesicles of a blackish hue, with a tendency to degenerate into gan- 
grene, present themselves ; or, still more essentially, if great (and rapid) 
prostration of strength occurs. 

Dose: In all respects, whether singly or in alternation, as directed 

under the head of Belladonna. 
Pulsatilla is more especially indicated when the hue of the skin is 
less intense, or of a bluish-red, and the morbid spots frequently disappear 
from one place to reappear in another (fugitive erysipelas). It is further- 
more appropriate when the disease affects the internal and external ear, 
especially in the vescular variety of erysipelas, and after the employment 
of Rhus-toxicodendron. 

Dose: Six pills, in a teaspoonful of water, every three hours. 
Nux-vomica is often of service in cases of erysipelas developed in 
the knee or foot, and characterized by extremely painful, bright-red swel- 
ling. It is more especially advantageous in cases of spurious erysipelas 
occurring in irritable subjects, particularly females, and when mortifica- 
tion of the subcutaneous cellular tissue has ensued. 
Dose: As for Pulsatilla. 

ERYSIPELAS TERMINATING IN ULCERATION. 

Sulphur, Arsenicum. See article on %i Ulcers." 



DISEASES OF THE SKIN. 503 

SUSCEPTIBILITY TO ERYSIPELAS IN THE FACE. 

Belladonna, Rhus. When this disease is repeatedly developed in 
the face, and there is, in fact, an habitual tendency to attacks of this na- 
ture, Belladonna and Rhus (in particular,) either singly, alternately, or 
successively, according to circumstances, are frequently capable of per- 
manently removing the complaint, and of obviating the return of the 
attacks. 

Dose: If singly, of either remedy, give six pills, night and morning 

for a week, (as soon as the acute symptoms of an attack have been 

subdued;) then pause four days, after which the course may be 

repeated, as before, and so on from time to time. If in alternation 

— give first the one (as just directed,) and then after an interval of 

twenty-four hours or longer, proceed with the other, in like manner, 

and soon, occasionally, until the predisposition seems conquered. 

HOME REMEDIES. To relieve the burning and pricking sensation, 

the face or parts attacked may be bathed frequently with Ammonia "Water. 

Or, clean, fine wood-soot from the chimney may be made into an ointment 

with lard spread on cotton batting, and applied upon the affected parts. 

Rye flour boiled in water, and mixed with soft soap is a good applica- 
tion to lay on the affected parts, changing it twice a day. Sometimes the 
burning sensation will be allayed by washing with a solution of copperas, 
half an ounce to a pint of water. 



NETTLE-RASH. HIVES— URTICARIA. 

Diagnosis. Spots or wheals, flat or prominent, and of a dull white 
color, like the sting of a nettle, or redder than the surrounding skin, 
generally encircled with a rosy areola, disappearing in warmth, and 
reappearing when exposed to cold, evolved suddenly, and continually 
changing their situation. 

This eruption is brought to the surface by various causes, not unfre- 
quently arising from indigestion, caused by the use of improper articles of 
food. Before the eruption discloses itself, the patient is affected with rest- 
lessness, languor, oppression and want of appetite, derangement of the 
digestive functions, and fever. When the eruption breaks out, the above 
symptoms become relieved, but considerable suffering arises from heat and 
itching, sometimes accompanied with swelling of the parts affected. This 
disease, in almost all cases arising from a constitutional cause, requires for 
its total eradication a regular course of treatment. 

ALLOPATHIC TREATMENT. Acute Urticaria, depending on irrita- 
tion of the stomach, especially if caused by some food which has been 
eaten, an emetic of twenty grains of Ipecacuanha in half a glass of water 
should be given. After the vomit a simple laxative should be given. A 
Seidlitz Powder or Citrate of Magnesia in a dose of a tablespoonf ul in half 
a glass of water and drunk during effervescence. 

The diet should be simple for several days, consisting of rare lean beef 
or mutton, milk, eggs, bread, and farinaceous food. Bismuth in doses of 
ten or fifteen grains should be given (in milk) before each meal. 

Alkaline drinks should be taken to overcome acidity or irritation of 
the bowel. Ten to twenty grains of the Citrate of Potash in lemonade 
every four hours will be sufficient. 



504 NETTLE RASH. 

In the chronic disease the cause must be carefully sought out and 
removed. Articles of food which are found to disagree must be avoided. 
Sometimes it is necessary to omit one article after another until the offend- 
ing one is found. A pure milk diet is sometimes necessary. Bismuth 
and Citrate of Potash recommended above are often useful. In many 
instances the Solution of Pepsin and Bismuth (Sheffer's formula,) in doses 
of a dessertspoonful before eating, should be tried. If the patient is rheu- 
matic or gouty Wine of Colchium should be tried in doses of a teaspoon- 
ful one or more times a day, to produce a slight action on the bowels. 
When causes in the stomach or bowels are excluded, Fowler's solution in 
doses of three to five drops after meals should be tried ; the remedy should 
be omitted for a time if it causes puffy lids, watery eyes, or abdominal 
pains. 

If the disease occurs periodically Quinine should be given in doses of 
five grains three to six times a day. 

The presence of fleas and insects as causes should be sought for. A 
solution of Corrosive Sublimate in half a pint of water, is a useful appli- 
cation where the disease depends on the bite of insects. 

Bathing with vinegar and water is often beneficial, or sponging with 
a tablcspoonful of Dilute Nitric Acid in a quart of water. 

HOMOEOPATHIC TREATMENT. In acute cases, the remedies found 
most useful are Dulcamara. Aconite, Nux-vomica, Pulsatilla, Antimonium- 
crudum, Belladonna, Hepar-sulphuris, Rhus-toxicodendron and Bryonia. 

Dulcamara, when the exciting cause has been cold or damp; when 
the affection occurs in wet weather, or when we find considerable fever, 
with bitter taste in the mouth, foul tongue, diarrhoea, pains in the limbs, 
and extreme itching, with a burning sensation after scratching. 

Aconite when the febrile symptoms are more intense, the pulse high, 
the skin hot and dry, and great restlessness and anxiety are present. 

Nux-vomica when there is considerable gastric derangement, with 
constipation, more especially when arising from wine, stimulants, or indi- 
gestible substances ; it may, if necessary, follow Aconite in eight or twelve 
hours after the febrile symptoms are somewhat modified. 

Pulsatilla deserves a preference, under similar circumstances, when 
the bowels are relaxed, and the patient is of a quiet disposition, and lym- 
phatic temperament, and the attack has apparently been excited by indi- 
gestible food. 

Antimonium-crudum may follow Pulsatilla should the latter have 
failed to relieve the affection. 

Belladonna is indicated when the affection is attended with a severe 
throbbing headache, with redness of the face. 

Hepar-sulpJimHs has frequently been found useful in urticaria 
accompanied by cold in the head, and particularly when the coryza (dis- 
charge from the nose.) was confined to one nostril. 

Rhus-toxicodendron is one of the most useful remedies in a great 
majority of cases of this eruption, and especially when the affection has 
apparently arisen from some idiosyncrasy of constitution, in which the 
eruption has been thrown out by the use of some particular article of 
food. 

Prescription. In ordinary cases, we may prescribe 6-12 globules, of 



DISEASES OF THE SKIN. 505 

the sixth dilution in six dessertspoonfuls of water, and order one to be 
taken morning and evening, except in the case of Aconite, which may be 
more frequently repeated, when the febrile symptoms seem to demand it. 

In this, as in every other cutaneous eruption, great care ought to be 
taken against driving it inward, by external application or lotions; a 
sudden retrocession, as noted under Scarlatina and Small-pox, being fre- 
quently attended with fatal consequences. When, however, from 
improper treatment, we have reason to dread this having taken place, we 
may generally succeed in re-establishing the eruption, and thereby avert- 
ing any dangerous consequences, by the employment of Bryonia in 
repeated doses. Should, however, marked cerebral symptoms declare 
themselves, the complaint should be treated as described under Scarla- 
tina. 

Z'rtfca Urens has been found useful in some cases; and in those of 
a chronic or extremely obstinate character, Calcarea, Lycopodium. Sul- 
phur, Carb.veg., Caustieum, Acid, nitric, Conium, Natr. mur.,etc, the 
last two, particularly, when the eruption is liable to reappear after violent 
exercise or exertion of any kind ; Calcarea, when exposure to cold fresh air 
produces it; and Acid, nitricuui when it arises from the patient going into 
the open air, after having kept within doors for a day or two. 

HOME REMEDIES. Whenever the eruption appears, rub the body 
•with wheat flour, and let the patient drink freely of hot teas (Sage, Sassa- 
fras, or something similar). Warm saleratus water is a good application 
for the skin. 



DAXDR UFF— PITYRIASIS. 

Pityriasis is a throwing off of the skin, either in thin scales, or in larger 
patches ; it may or may not be accompanied by some other affection of the 
skin, and the skin thrown off may, to all appearance, be perfectly sound; 
or else the process may be accompanied by trifling local or more extensive 
symptoms of thickening of the skin. According as the skin is un- 
changed, or looks red under the scales, the affection is designated as pity- 
riasis simplex or rubra (red). 

The causes of this affection are very obscure; in some cases the disease 
can be traced, with some certainty, to a derangement of the functions of 
the liver, and of the female sexual organs. 

Pityriasis rubra, when spread over more extensive portions of the 
skin, not unfrequently sets in with slight febrile motions, which may 
break out at every renewed appearance of the exanthem. On portions of 
the skin, which itch and burn very fiercely, large red spots of indefinite 
and irregular shapes make their appearance. Accompanied by a pecu- 
liar feeling of tension, the skin on these spots very soon begins to exfo- 
liate. The eruption first manifests itself on the trunk, and only invades 
the face, if exceedingly severe. The almost inevitable itching may cause 
a moisture to ooze from the otherwise dry spots on the skin. This itch- 
ing, which is absolutely agonizing, very commonly interferes with the 
sleep. The affection is very obstinate, but at the same time one of the 
rarer forms of cutaneous diseases. 

Pityriasis, confined to isolated spots, is much less frequently of the 



506 DANDRUFF, 

character rubra than a general pityriasis ; it is most commonly met with 
on the hairy scalp, in the palms of the hands, on the soles of the feet and 
in the face. The itching is much less distressing, but is still very violent 
on the hairy scalp. By scratching the skin till it tears, a moisture is 
secreted from the irritated spot, resulting in the formation of superficial 
scurfs and crusts, and agglutination of the hair. 

In treating a case of general pityriasis, we must not forget that we 
are dealing with a very chronic affection which never promises rapid 
success, and where it would be, consequently, improper to make a fre- 
quent change of medicines, or to repeat the dose too often. The most 
important remedies are Graphites and Arsenicum, with which it is most 
likely that a cure can best be affected. 

The attack may be modified in any and every degree, from that just 
described to that resulting only in the throwing off of small, dry scales 
from the hairy scalp. The treatment is one of the most difficult known 
to the profession of medicine only on account of its tediousness and the 
absolute carelessness of patients who more than half the time neglect to 
use the means which would cure, if used as directed. 

Sepia is, particularly, indicated in the case of females, if the spots 
break out in consequence of menstrual irregularities, or at definite periods 
of the year. 

ALLOPATHIC TREATMENT. For dandruff, there is no more effect- 
ual application than keeping the scalp clean with a strong solution of 
Borax. Frequent daily (or often enough to keep off the scales) shampoo- 
ing with a mixture of equal parts of Soft Soap (Sapo Veridis, made of 
Olive Oil and Caustic Potash) and Alcohol, is most useful. Washing the 
head with weak alkaline solutions is, also, useful. 

After each washing of the head, the hair should be well oiled to pre- 
vent the skin becoming too dry. Olive or Almond Oil, scented to suit, 
are appropriate for this. 

If the scales are thick, the use of a five per cent solution of Oleate of 
Mercury is very beneficial. An ointment of fifteen grains of Red Oxide 
of Mercury, or thirty grains of the White Precipitate, with an ounce of 
Lard and half an ounce of Sweet Oil, is beneficial. 

In old cases, with no derangement of the stomach or bowels, three 
drops of Fowler's Solution should be given after each meal. 

Derangement of digestion, or other indisposition, demands suitable 
treatment. 

HOME REMEDIES. Dissolve Salts of Tartar two drams, in one pint 
of clean rain water. Rub some of this upon the head until a lather is 
formed, and thoroughly cleanse the scalp from all particles of dandruff by 
continued rubbing. Then wash in clean water, and dry the head and 
hair as thoroughly as possible. Continue this for a few times, as often as 
an accumulation of dandruff is noticed 



rSOBIASIS— SCALE ¥ TETTER. 

This is pre-eminently an affection of the male sex; in the case of fe- 
males, it is never attended with sexual disorders. It attacks individuals 
between the seventh and fiftieth year, and occurs most frequently in the 



DISEASES OF THE SKIN. 507 

cold season. It cannot be traced to constitutional derangements, since 
persons who are afflicted with this disease, otherwise, enjoy the most per- 
fect health. With the appearance of some constitutional disease, the pso- 
riasis disappears at once, but returns again as soon as the disease is 
removed. 

Psoriasis begins thus: At various, more or less numerous scattered 
spots, the detached epidermis (skin) forms a small, white rising (psoriasis 
punctata). These spots gradually spread until they reach the size of drops 
(psoriasis guttata;) on removing the scales, we find the skin underneath 
slightly red and bleeding. In proportion as the circumference continues 
to expand, the original spot becomes cleansed of its scales, and a ring 
forms surrounding a healthy-looking skin (psoriasis annularis;) in the fur- 
ther progress of the exanthem, this ring opens, loosing its roundness (pso- 
riasis gyrata) and finally disappearing altogether. All these stages, or 
most of them, co-exist side by side in almost every case of this disease. 

Psoriasis is not attended with itching, or, at most, only at the com- 
mencement, but in no case if it has become an inveterate disease. It may 
remain stationary, though breaking out in new places, or it may intermit 
on its manifestations for months and even years. 

Among external remedies which are never hurtful, and usually effi- 
cient, is the vapor bath, accompanied by frictions with castile soap, or 
brown soap ; cold bathing is of decided benefit, but its effects are not at 
nee perceptible. 

ALLOPATHIC TREATMENT. The treatmentfof psoriasis ought to be 
under the direction of a physician. The principal remedies which are use- 
ful, and sometimes curative, given internally, are Arsenic and Cod Liver 
Oil. The dose of Arsenic should be small — generally three drops of Fow- 
ler's Solution is sufficient — given three times a day, after meals. If the 
eyes become watery, or the lids puffy, or a silvery coat upon the tongue 
occurs, the dose of the Solution should be diminished to two drops or even 
one drop, if necessary. The other remedies which are often useful are 
Quinine, Iron, Phosphorus, Iodide of Potassium, and Colchicum. The 
two remedies first named are, generally, applicable. The Quinine, in doses 
of one or two grains, and the Iron, in doses of a grain, three times a day. 
When other remedies are needed, will be determined by the physician, 
who should see the case once or twice a week. 

Bathing with Juniper Tar Soap, and, also, the use of Ointment of 
Liquid Pitch, are useful external applications. 



SYCOSIS MENT AGRA-BARBER'S ITCH. 

This is, exclusively, a disease of the male sex. If persons who do not 
shave are attacked by it, which is a very rare occurrence, its causes are 
very obscure. In cases where the beard is shaved, the eruption may be 
caused by bad or irritating soap, or by a dull razor, but is almost always 
the result of shaving by a careless and uncleanly barber, who does not 
properly clean and scald his razor, and, although generally so frightfully 
obstinate, yet may heal spontaneously, even without much loss of time ; 
all that need be done is to omit shaving the affected parts. Dirt and snuff 
likewise seem to occasion sycosis (barber's itch). 



508 COPPER-NOSE, BOTTLE-NOSE. 

The disease generally sets in, like herpes labialis (cold blisters,) with a 
sensation of burning, heat and tension ; most commonly, we first notice on 
the chin a small cluster of isolated, red knobs or pimples (tubercles) of a 
pretty large size, each of which is perforated by a hair. Some of these 
tubercles, in a few days, change to pustules, break and form dark crusts, 
without the infiltration, which forms the little tubercle, disappearing on 
that account. In spite of all care, and, generally, in consequence of con- 
tinued irritation, the number of tubercles increases slowly, but uninterrup- 
tedly, the former ones growing larger ; the skin upon which they are seated, 
becomes more and more infiltrated; after breaking, the pustules change 
to ulcers. The patients do not complain of much pain, but their ugly 
appearance fills them with anxiety. The disease is extremely obstinate, 
and may last for years. It is true that it not unfrequently abates in sever- 
ity, and, at times, even disappears altogether; but it breaks out again with 
renewed fierceness, and in such a case, in more than one spot simultane- 
ously. Its first appearance is almost always on the chin ; it is here that the 
disorder exists most commonly in its fiercest intensity, but it likewise 
invades every other bearded portion of the face, and, in severe cases, even 
the eyebrows. 

Fifteen grains of Carbolic Acid to one ounce of Glycerine, applied in 
small quantity after pulling the hair out of the centre of each tubercle, 
every day twice, after thorough washing with good soap, is a very certain 
cure. 

ALLOPATHIC TREATMENT. Removal of the diseased hair, by ex- 
traction with a pair of forceps, a few at a time, is the first requisite after 
subduing the inflammation with warm poultices. Then the application of 
an ointment of Carbonate of Copper two drams to an ounce of Lard, will 
complete the cure. The Oleate of Mercury; or a solution of Corrosive 
Sublimate fifteen grains with Muriate of Ammonia thirty grains in 
eight ounces of Distilled Water; or a dram of Sulphate of Copper and 
four drams of Sulphate of Zinc dissolved in a pint of water, are effectual 
applications. 

The general health and state of the bowels require attention. 



AC N A ROSACEA, GUTTA ROSACEA— COPPER-NOSE, BOT- 
TLE-NOSE. 

Acna Rosacea is an exanthem consisting of tubercles with some dis- 
position to suppurate; suppurating tubercles; and, moreover, of contin- 
ual venous congestion. 

It almost always commences at the tip of the nose, whence it spreads 
over the nose and over both cheeks, finally, over the forehead and rest of 
the face. First, we notice a spot of small extent, painless, and distinctly 
traversed by dilated cutaneous veins. Upon this base single tubercles 
start up, which sometimes suppurate at an early period, but likewise 
spread in size after the pus is discharged. New tubercles keep constantly 
forming, new spots keep constantly breaking out, the skin becomes more 
and more thickened, the veins become more and more varicose, the iso- 
lated little blotches change to large tubercles, cracks and deep rhagades, 
and even ulcers make their appearance, and the face looks very much 



DISEASES OF THE SKIN. 509 

disfigured in consequence of this extreme development of nasal exan- 
them. At first, the affection has remissions, but the dark redness never 
disappears entirely; at a later period the disorder keeps growing all the 
time. 

Abuse of wine and spirits is the cause of the disease in by far the 
larger number of cases; but it likewise breaks out on individuals of very 
moderate habits, as drinkers. Among women the disease is of rare 
occurrence, and only among drinkers of spirits, as a rule, and associated 
with menstrual anomalies. The disease is not often seen previous to the 
twenty-fifth year; its most frequent occurrence is after the fortieth. 
Overheating the system and immoderate drinking are very apt to cause 
a renewed outbreak of the disease. It is exceedingly obstinate, and, in 
its higher grades, is considered incurable. 



HERPES— TETTER. 

All forms of herpes (and they are many), are characterized by the for- 
mation of little blisters, clusters of which are seated upon the inflamed, 
red epidermis; the vesicles of one cluster breaking out simultaneously 
and running an acute course. 

HERPES FACIALIS, FACIAL HERPES. 

This form of herpes accompanies a large number of fevers and chronic 
diseases, without exerting any specially modifying influences over their 
course; except in pneumonia, where this form of herpes is said to con- 
stitute a decidedly favorable omen. As an independent exanthem, it 
seems to manifest itself when indicating the commencement of a catarrh;i 1 
affection, provided the catarrhal irritation is not very intense. A first 
appearance predisposes, most decidedly, to relapses. 

Herpes facialis (cold blisters) most generally breaks out on the lips, 
less frequently on the cheeks, forehead, ears, eyelids. A tension, burn- 
ing, and a marked sensation of swelling, are experienced at a certain 
infiKrated spot, where the blisters start up amid slight febrile motions, 
and an unusual feeling of lassitude. In the face, they are always of a 
tolerably large size, but there are not many of them clustered together, 
they incline to run into one another ; the skin of the spot where they are 
located does not show a very vivid redness; sometimes they are pitted or 
cleft. They contain a clear liquid which soon becomes dim and changes 
to a rather dark scurf that soon falls off, leaving for some time, a red, some- 
what infiltrated spot; burning pains, likewise, remain for some time. A 
few doses of Rhus-tox. will cure this form. 

ALLOPATHIC TREATMENT. The bowels should be kept open by 
the use of Rochelle Salts, Citrate of Magnesia, or Seidlitz Powders. If the 
health of the patient is not vigorous, two grain doses of Quinine (or some 
other preparation of Peruvian Bark,) should be given three times a day. 

The Ointment of Subacetate of Lead is a useful local application, or 
the Oxide of Zinc Ointment may be used. 

If the disease becomes chronic, Fowler's Solution, in doses of three 
to five drops, may be given after each meal. If the eyes become watery, 
or the lids swell, or the tongue has a silvered coating, the dose of Fow- 
ler's Solution should be diminished. 



510 RINGWORM. 

SHINGLES-HERPES ZOSTER, ZONA. 

This form is characterized by the development of clusters of blisters 
(vesicles) of which there are, generally, several, along the tract of one or 
more spinal nerves, assuming, on the trunk, the shape of a zone or belt, 
but, on the extremities, breaking out in a more irregular form. 

Shingles commence almost without an exception with rheumatic pains 
in the parts where it is to break out, and is often attended with great las- 
situde and fever. The preliminary pains are not unfrequently like inflam- 
matory pains. With violent and painful burning, an efflorescence breaks 
out, after which pimples without pus arise, next clusters of vesicles (blis- 
ters) with a tendency to run into one another. These vesicles remain out 
for four to six days, after which they change to flat scurfs. But as a new clus- 
ter may arise after the first, and these successive crops may continue, even 
after the first vesicles are entirely healed, the whole process may last even 
three weeks. It is very seldom the case that scratching^ the friction of the 
clothes will cause a superficial ulceration. There may be no pain during 
the continuance, except the slight burning attending the successive break- 
ing out of new crops of vesicles; but the greatest distress to the patient is 
the burning itching which is especially severe in bed. After the falling off 
of the crusts all pain is gone, or the peculiar itching may perhaps continue for 
some time, or finally — and this is not by any means a rare occurrence- 
intercostal neuralgia of a very obstinate type may set in, apparently the 
more readily the less scantily the herpes was out on the skin. 

HOMCEOPATHIC TREATMENT. Merzereum is to be relied on, giving 
four doses daily, six pills at a dose. 

HOME TREATMENT. Take green rye when about six or eight inches 
high and stew it into a salve with fresh cream. Apply this to the part 
every morning and evening till cured. Always wash the part with castile 
soap suds and dry it each time before using the salve. 

RINGWORM. HERPES IRIS AND CIRCINNATUS. 

Herpes iris consists of a larger blister, which is not unfrequently filled 
with a blood-tinged liquid, and is surrounded by a wreath of smaller vesi- 
cles, around whose external border another and larger wreath may form. 
The course is the same as that of other herpetic vesicles. The affection 
first appears on the dorsa of the feet or hands, spreading on the extensor- 
surfaces from below upwards, and the new clusters of vesicles appearing 
either in the same relative position as the vesicles of herpes generally, or 
else again assuming the form of herpes iris. This form of herpes most fre- 
quently occurs among women and children. 

Herpes circinnatus, which comes out in the same manner as herpes iris, 
is distinguished from the latter by the circumstance that the central blister 
is missing, and that only the wreath of vesicles is present. 

ALLOPATHIC TREATMENT. In the treatment of " ringworm " (her- 
pes circinnatus) simple measures generally succeed at once, as the applica- 
tion of a strong solution of Nitrate of Silver, from ten grains to a dram to 
the ounce; an ointment of ten grains Acetate of Copper to the ounce of 
Lard; a five-percent Solution of Oleate of Mercury in Oleic Acid, containing 
a dram of Ether to the ounce ; a solution of Corrosive Sublimate two grains 



DISEASES OF THE SKIN. 511 

and upward to the ounce of water, or the Corrosive Sublimate Ointment 
with from ten to twenty grains of Corrosive Sublimate to the ounce; or 
Tincture of Iodine, will suffice. These applications destroy the parasitic 
plant which causes the disease. 

In ringworm of the scalp (tinea tonsuraus) the first indication, as in 
ringworm or scald head, is the same. To destroy the parasitic plant is best 
done by applying a blistering fluid (Blistering Collodion,) remove the loos- 
ened epidermis, and then apply an ointment made by mixing twenty grains 
of Corrosive Sublimate, or forty grains of White Precipitate with an ounce 
of Sulphur Ointment, or some of the mixture given for ringworm. The 
scalp should be carefully cleansed every day to remove any loosened scarf- 
skin which may interfere with the ointment (or other application) reaching 
the parasite and the application made twice a day. 

Scrofulous or poorly nourished children will need tonic treatment, as 
a teaspoonful or more of Cod Liver Oil and a teaspoonf ul of the Compound 
Syrup of Hypo-phosphites daily. 

It is claimed that the continuous use of Soft Soap (Sapo Veridis) made 
with Olive Oil and Potash, will cure the disease in two weeks. 



ECZEMA— SALT RHEUMo 

The causes of eczema are either external irritants acting directly upon 
the skin, or else substances that affect this organ through the general circu- 
lation, into which they had been absorbed, or finally constitutional influ- 
ences. Heat, for instance, causes the so-called baker's itch ; and heat, 
intense cold, salt-baths, mercurial frictions, Croton Oil, etc., a number of 
medicinal agents taken internally, fat food or food giving rise to an unu- 
sual deposition of fat, scrof ulosis, affections of the female organs of gener- 
ation, varicose veins, and in general, all kinds of stoppage in the venous 
system, and a number of other similar circumstances and influences uni- 
formly occasion eczema. Among the direct cutaneous irritants we 
distinguish : Neglect in attending to the skin, vermin, friction by clothes, 
continued rubbing of a part, for instance, between the thighs when riding 
on horseback, and by continued walking. 

A good example of eczema is obtained by rubbing Croton Oil upon the 
skin. Upon a red surface a number of vesicles (blisters) or pimples shoot 
up, which, if carefully guarded, heal in a few days, leaving the affected 
portion of the skin injected. If the vesicles are not protected, if they are 
scratched or rubbed against by the clothes, they break and crusts form, 
beneath which, if the irritation continues, the exudation continues like- 
wise, or else may be so copious that no crusts can form, in which case the 
affected part always looks red and moist. If the irritation continues, the 
eczema spreads to the adjoining parts; scratching even communicates it to 
remote parts; besides the vesicles, pustules form likewise. 

Eczema of the legs (salt rheum) really depends almost exclusively 
upon varicose veins, more especially upon dilation of the small cutaneous 
veins, whereas the larger vessels may continue in a perfectly normal con- 
dition. This eczema is extremely obstinate, itches most horribly, gener- 
ally exacerbates in the spring and fall, and is a species of eczema rubrum 



512 SALT RHEUM, 

with occasional formation of pustules and an infiltration of the skin that 
makes it look very badly. 

Eczema seldom runs an acute course ; the extremely acute form of 
"eczema universale" is very rare; on the other hand, it not unfrequently 
commences as an acute exanthem, slight fever, but very soon 

assumes a chronic character. All the different forms of eczema itch more 
or less; scratching, which it is impossible to avoid, is a main cause of the 
onward spread, and the protracted course of the disease. Every kind of 
eczema may heal and does heal spontaneously, provided the chief requi- 
site towards a cure, namely, rest in a lying position, and absolute cleanli- 
ness is attended to. Eczema of the leg and scrotum give the least hope 
of a cure» 

ALLOPATHIC TREATMENT. In an acute attack of Eczema in a 
person of robust constitution, the bowels ought to be briskly moved. Ten 
grains of Calomel, followed after six hours, by a dessert to a tablespoonf ul 
of Epsom Salts, or Citrate of Magnesia, or a double Seidlitz Powder. 
This should be followed by ten to fifteen grain doses of Citrate of Potash 
or Cream of Tartar in Lemonade, a sixth of a grain of Tartar Emetic 
should be added to each dose, and given from two to four hours apart. 

If "the patient is not strong. Calomel should not be given, but a saline 
laxative of a dessert to a tablespoonful of Epsom Salts or Citrate of Mag- 
nesia, or a Seidlitz Powder. This should be followed by Cream of Tartar 
in doses of ten to twenty grains, in Lemonade, from two to four hours 
apart. 

The eruption should be poulticed with Flaxseed Meal or Slippery Elm 
spread thin between very thin layers of muslin or soft linen dipped in 
warm water, spread over the eruption, and covered with oiled muslin. 

When there is much burning, the following powder, sprinkled on the 
eruption, before the poultice is put on, is useful : Take Camphor half a 
dram, Ether a sufficient quantity to powder the Camphor, four drams each 
of Oxide of Zinc and Starch. Mix. 

Old chronic cases of this disease are known as Salt Rheum. The 
crusts should be softened by poulticing with Flaxseed meal or Powdered 
Slippery Elm. until they can be easily removed. 

After the crusts are removed and the surface carefully dried, the Ben- 
zoated Oxide of Zinc Ointment should be applied constantly, and all irri- 
tating applications cease, though an occasional cleansing may be necces- 
sary. If the secretion does not disappear, or greatly diminish, one of the 
best applications which can be made is a dram of Tannin dissolved in an 
ounce of Glycerine. The ointment may be used again in a short time after 
the Tannin and Glycerine are used. 

Tonics will be needed, and the principal ones are Quinine, Iron, 
Arsenic and Cod Liver Oil. The Cod Liver Oil may be given in doses of a 
teaspoonful three or four times a day. The Citrate of Iron and Quinine 
in two to five grain doses, three times a day; it should be dissolved in 
Syrup of Ginger or Orange Flower Water. These are particularly indica- 
ted, if the patient is in poor health with impoverished blood. All chronic 
cases are benefited by Arsenic. It should be given as Fowler's Solution, 
in doses of three to six drops, after meals. It can be combined with the 
Citrate of Iron and Quinine, as in the following formula: Take of Citrate 



DISEASES OF TIIE SKIN. 513 

of Iron and Quinine a dram and a half, Syrup of Ginger or Orange Flower 
Water four ounces, add Fowler's Solution a dram and a half. 

Dose: A teaspoonful, three times a day. 

In the use of Fowler's Solution, if the eyes become watery or the 
lids sw r elled, or the tongue has a silvered coating the dose should be 
diminished. 

HOME TREATMENT. Take Beef Marrow, Sulphur, Black Pepper, 
White Turpentine, of each equal parts, mix together and make au oint- 
ment to apply to the tetter. 

Another beneficial ointment can be made as follows : Take of fresh 
Sheep's-Sorrel leaves, fresh Calendine leaves, and Red Clover leaves and 
flowers, each a handful ; beat them up well in good cream or fresh butter 
that has not been salted. Then squeeze off the cream or butter, and use 
it as an ointment, applying it over the tetter two or three times a day. 

Bathing the affected parts in strong Saleratus water has been known 
to cure effectually a number of cases. 



BOIIs-FER UNC UL US-ABSCESS US JS UCLEATUS. 

Diagnosis. Round or rather cone-shaped hard elevations of different 
sizes slowly inflaming and suppurating, discharging matter generally at 
first, tinged with blood, but still retaining a portion of morbidly-altered 
cellular tissue, which may form the nucleus of other elevations after those 
which appeared first have healed. 

ALLOPATHIC TREATMENT. The maturity of a boil may be has*- 
ened by poulticing with Flaxseed meal, or powdered Slippery Elm, when 
it may be allowed to break, and run out into a poultice. Water dressings 
covered with oiled muslin may be used instead. 

Boils which contain pus, and do not come to a head, should be opened. 
Boils occurring singly, or in crops which do not soon suppurate, but 
remain hard, may be made to disappear by brushing them over with 
Tincture of Iodine; sometimes crops of them may be suppressed by early 
resorting to this application. 

When boils occur in successive crops, it is probable poultices will 
induce their farther development, and should not be used if this appears 
to be the case. But if they are painful, a poultice, having incorporated 
in it Stramonium (Jamestown Weed.) or Tobacco, or that has Lauda- 
num, or Fluid Extract of Belladonna should be poured upon its surface. 
A plegget of cotton, saturated with equal parts of Carbolic Acid and Gly- 
cerine, with, or without one-half part of Fluid Extract of Belladonna, 
placed over a group of boils, is often effectual in relieving the pain. Soap 
plaster is a good application for these groups of boils, but after they open, 
Resin plaster should be used. The diet should be plain and nutritious. 

Occasionally a boil can be aborted by touching the inflamed pimple 
with the Acid Nitrate of Mercury, or the solid stick of Nitrate of Silver. 

The system of persons having boils requires supporting. For this 
purpose, Quinine and Iron should be given. The former may be given in 
sugar coated pills (Warner's,) in doses of from two to six grains three 



014 CARBUNCLES. 

times a day. "When ringing of the ears is produced, the dose should be 
decreased. The latter may be given with Chlorate of Potash. 

Dissolve four drams of Chlorate of Potash in four ounces of boiling 
imter, add three and a half ounces of simple syrup, and half an ounce of 
Tincture of Chloride of Iron, 

Dose : A tablespoonful three times a day. 

If the case does not improve, Iron and Arsenic may r given instead 
of Iron and Chlorate of Potash. Take of Citrate of Iro.j and Ammonia 
two drams, Fowler's Solution eighty minims, simple syrup one ounce, Anise 
water sufficient to make eight ounces. 

Dose: A dessertspoonful three times a day. 

A tenth of a grain of the Sulphide of Calcicum given hourly, is 
claimed to prevent the recurring crops of boils. Sometimes a trip into 
the country is necessary for their cure. 

HOM(EOPATUIC TREATMENT. These sores yield readily to internal 
treatment and without pain, while the treatment with drawing salves is 
often distressingly painful. No external application need be used, but as 
soon as the parts begin to look red and cause pain, we give Arnica every 
two to four hours. If the swelling still increases and a small spot of pus 
has already made its appearance, give Arnica and He-par SuL in alternation 
every two to four hours. If the tumor has been allowed to go on so long 
that pus has formed deep in, the sore has become very painful and still 
does not discharge, but fluctuates on sudden pressure, an incision may be 
made with a lancet, after which the pain will cease and the pus run out. 

Poultices of bread and milk or kindred substances should not be 
applied too soon, lest the natural development of the tumor should be 
interfered with. This is the reason why many persons are afflicted with 
fresh boils, every six to eight weeks; the acrid matter is not permitted to 
be fully expelled from the organism. 

Pork and fat food must be avoided by those who are the subjects of 
such sores. A single small dose of Sulphur, allowed to act for months, 
will entirely eradicate the tendency to boils. 



CARBUNCLE. ANTHRAX- FERUNCULUS MALIGNANS— 
FUSTVLA NIGRA. 

Diagnosis. A livid, bluish, or black spot upon an extended surface, 
extremely painful, readily running to gangrene, and proving fatal, occa- 
sionally from the extension of mortification. The disease is attended by 
headache, thirst, foul tongue, sickness, loathing of food, languor, jactita- 
tion, (trembling) and sleeplessness. 

ALLOPATHIC TREATMENT. Carbuncles should be early cut through 
to their base by a crucical (+ ) incision and dressed with a Flaxseed Meal 
poultice or the mixture of Carbolic Acid one part, and Glycerine two 
parts. After the slough comes away, the ulcer may be washed with a 
solution of Carbolic Acid one dram in five ounces of water, or oiled with 
Olive Oil or Glycerine, containing twelve drops of Carbolic Acid to the 
ounce. 

The internal treatment is the same as recommended for boils. The 
diet should be plain and nutritious, as lean meat, milk, eggs, and simple 
starchy articles of food. 



DISEASES OF THE SKIN. 515 

HOM(EOPATHIC TREATMENT. The best remedies in this affection 
are in the order of their names : Ars., Silicea, Mercurius. 

Arsenicum is, by all means, the most efficacious remedy, and the 

more especially so if gangrene is approaching or has appeared. 

Sitirea. When administered in the beginning, in simple carbuncle 
is frequently found sufficient to effect a perfect cure. 

rierrurifis. Pain, worse at night, attended with copious sweats 
which give no relief. If the strength is greatly reduced by the loss of 
blood, etc., China, three doses a day for a week, will greatly assist nature. 



FAVUS. IIOXEY-COJIB TETTER, SCALD-HEAD. 

This cutaneous affection is characterized by the accumulation of mul- 
titudes of fungi around the roots of the hairs, hence theirexclusiveappear- 
ance on the hairy portions of the skin. 

Favus is a disease of the lower classes. It only attacks individuals 
who pay no sort of attention to cleanliness. In other respects such indi- 
viduals may enjoy either the most perfect health, or else be of sickly and 
cachectic constitutions; favus may attack either sex. This exanthem can 
be transferred to other persons by hats, caps and other head gear, likewise 
by sleeping in the same bed; it has likewise been transmitted purposely 
from one individual to another. 

A single favus-efiTorescenee has its origin in the orifice of a small 
gland in the form of a small, imbedded, not painful papule, which is per- 
forated by the hair, and keeps constantly increasing in breadth and bight, 
until the characteristic crust finally arises from it. This crust has the 
shape of a dish, with a rounded central depression and round elevated 
borders; it has a yellowish or gray tint, without any exudation under- 
neath, and has a peculiar odor. 

The consequences of favus are partial atrophy of theskin in consequence 
of the crusts being imbedded in it ; eczema occasioned by the scratching ; 
destruction of the hair on the affected parts; on the other hand, this dis- 
order has no influence upon the general state of the constitution. The 
disease runs a very chronic course, yet spontaneous cures occur, although, 
very tardily and not without corresponding modifications in the hygienic 
circumstances of the patients. 

According to what we have stated concerning the history of the dis- 
ease, we deem an internal treatment of it useless and ineffectual. This 
can only be cured by removing the crusts in which the fungi are imbed- 
ded, and by preventing their return. The surests means of accomplish- 
ing this result, is care and cleanliness. The removal of the crusts is 
secured by softening them with oil, and afterwards removing them, 
together with the perforating hair. This is a very tedious but sure under- 
taking. Every sickly-looking hair has to be pulled out singly, for the 
reason that the disease has already invaded the soil in which it grows. 

Dr. H ile. of Chicago, says this eruption is treated with success in 
some cases by means of Tris-versicolor; a cerate is applied to the scalp, 
and a few drops of t'.ie Tincture, even as many as twenty, in half a tum- 
blerful of water, given internally, in teaspoonful doses, three or four times 
a day 



518 HONEY-TETTER— SCALD HEAD. 

ALLOPATHIC TREATMENT. In this disease (scald-head— favus) as 
m ringworm and tinea-tonsurans and barber's itch, the object of treat- 
ment is to destro}' the parasitic plant occasioning the disease. The crusts 
may be got rid of by poultices or preferably, by constantly applying a 
mixture of equal parts of Sulphurous Acid and Glycerine. A piece of lint 
may be saturated with the mixture, laid over the part and then covered 
with oiled muslin. This same mixture may complete the cure, or a solu- 
tion of Corrosive Sublimate, five to ten grains to the ounce may be used. 

The hair must be pulled out in the affected part and for a little space 
around it. The cure is now easy, but without which is almost impossible. 

The food should be good. Two to five grains of the Soluble Citrate of 
Iron or the Citrate of Iron and Quinine may be given three times a day. 
After the cure is complete the occasional application of the Oleate of Mer- 
cury should be made or a hair pomade used, with which has been mixed 
five grains of Corrosive Sublimate to the ounce: Take of Corronve Subli- 
mate, five grains, Simple Ointment an ounce, Otto of Roses three or four 
drops. Mix, and use as a hair pomade. 

HOME TREATMENT. Take of good wood Soot, Saltpetre, and Sul- 
phur, each one teaspoonful, Lard two tablespoon fu Is ; mix together and 
form an ointment. Apply to the head every night and morning, first 
washing with Castile Soapsuds. 

Another ointment to be made in the following manner is, also, bene- 
ficial: Take a handful each of Jimson Weed leaves, Yellow Dockroot, 
and Mullen leaves, Lard half a pound, boil together until the leaves are 
crisp; squeeze, strain out the Lard, and then add six ounces of Tar. To 
be applied as an ointment to the head . 



ITCH-SCABIES. 

This contagious, inflammatory affection of the skin is characterized 
by an eruption of pointed vesicles, transparent at the summit, and filled 
with a viscid and serous fluid, in which lives a very small insect. These 
are subsequently mixed with, or terminate in, pustules. With the excep- 
tion of the face, they appear in every part of the body, but much more 
frequently and abundantly about the wrists, between the fingers, and at 
the bend of the joints, etc., and are accompanied by incessant and almo>t 
insuperable itching, without fever. There are several varieties of the 
disorder, but it is often very difficult to distinguish their characteristic 
differences. 

External Treatment. The local application of Sulphur, either in 
the form of lotion or ointment, should be used. 

The above method of treatment, combined with the free and frequent 
use of soap and water, undoubtedly suffices, in mild and recent cases, to 
remove this troublesome affection ; but as in those of longer standing, it 
may be found inadequate to destroy the mites which have now been 
clearly demonstrated to be the cause (not the result) of the disease, the 
following course of treatment should be adopted, and will usually succeed 
in accomplishing a speedy and permanent cure: Let the patient be 
placed in a hot bath, and the hands, wrists, and other affected parts be well 
rubbed with fine sand (or a sand ball,) for the purpose of tearing open the 



DISEASES OF THE SKIN. 617 

passages and cells where the vermin have burrowed and located them- 
selves. In persons of tender or delicate skins, brisk rubbing with a coarse 
towel, after the bath, may be sufficient to effect the required object; but 
the use of fine sand, or pounded chalk, is to be preferred. When the patient 
has been dried, all affected parts should then be well rubbed with a lotion 
made of Olive or Almond Oil and a few drops of some essential oil, thus: 

To two tablespoonf uls of Almond Oil add twenty drops of the Oil of 
Sassafras. 

The rubbing in, and, if needful, in inveterate cases, the hot bath and 
frictions, should be repeated every three days for a fortnight or so, or until 
the cure is complete. When, as is sometimes the case in certain habits, 
boils are associated with itch, and continue to break out for some time 
after the removal of the latter, the remedies prescribed in the article on 
Boils should be had recourse to. 

The sudden suppression, by external means, of some of the eruptions 
which have been mistaken for, or occasionally follow, or have been devel- 
oped during the existence of inveterate itch, lias, undoubtedly, as not unfre- 
quently happens in other chronic eruptions, been repeatedly attended with 
serious consequences. 

ALLOPATHIC TREATMENT. The remedy for scabies, itch, is Sul- 
phur, upon going to bed. The body should be rubbed well with Soft Soap 
and a little warm water, for fifteen or twenty minutes, then a warm bath 
for thirty minutes or more, then an Ointment Compound of two parts Sul- 
phur, one part Carbonate of Potash, and twelve parts Lard, should be thor 
oughly rubbed over the whole body, especially to the affected parts. The 
patient may bathe the next morning. This treatment should be repeated 
for three separate nights. A solution of Sulphate of Copper— one ounce to 
the pint — may be used after the bathing, instead of the Sulphur Ointment. 
Clothes should be exposed to the fumes of burning Sulphur (Sulphurous 
Acid Gas). 



ABSCESS-FSO US-JPSOTTIS. 

(Lat. Abscedere, to separate,) a collection of pus in a circumscribed 
cavity. 

The causes of abscess are often involved in obscurity, excessive exer- 
tions, a cold, rheumatism, mechanical injuries, caries of the bones, may 
be mentioned as probable causes. The name is given to collections of pus 
in some of the naturally existing cavities of the body. Of these we do not 
propose to treat in this article. 

An abscess may be acute or chronic, according to the character of the 
inflammation which produces it. The formation of an acute abscess is 
ushered in by a sudden, or else rapidly-increasing violent pain, which it 
is difficult to define. It often radiates upwards or downwards, and soon 
produces a stiffness which materially interferes with the natural motions 
of the adjacent parts, the pain is generally, not always, of a throbbing 
character, and soon shows redness of the surface, if not too deeply seated ; 
swelling and violent fever is mostly present, attended with increase in the 
pulse very marked. Pus forms rapidly, and is often so profuse in quantity 



518 ABSCESS. 

as to indicate its first appearance by a succession of chills, distinct or sud- 
denly following each other, called creeping chilis, known by the sensation 
of "little chills playing tag up the patient's back." The fully-formed 
abscess can be reabsorbed, which is, however, rarely the case. AVhen the 
pus has formed in considerable quantity near the surface, its presence may 
be readily discovered by the feeling of "fluctuation" produced by placing 
the fingers of one hand on one side of the swelling, and with those of the 
other, giving a smart tap on the opposite side. If the cavity formed, and 
contaningthe pus is very deeply seated, it often baffles the skill, of the 
most experienced surgeon to determine its presence and exact location. 
The pus usually tends towards the surface, which it reaches by a gradual 
thinning of the intervening tissues; but if these be very resisting, it may 
travel in other directions, possibly to break into some of the natural cav- 
ities, lungs, or abdominal cavity, when it will be likely to result in death. 

It is in these cases that an early incision by the surgeon is especially 
called for before "pointing" has taken place. In chronic abscess the 
pain, redness, fever, and increased temperatures of the parts may be 
absent, and for this reason, it is also commonly known as cold abscess. In 
most cases, its progress is slow, and it may remain for along time without 
any increase in size, or any tendency to open through the skin. Usually 
it is necessary to open it ; this may be done by simply cutting directly 
into the cavity. 

Treatment is not surgical, except so far as the necessary slight 
amount of cutting into the cavity. In the first place, we have to try to 
scatter the inflammation before the suppuration sets in, even if this can- 
not be accomplished in all cases, it is at all events certain that the spread 
of the inflammation may be prevented by appropriate treatment. The 
following is the best : 

ALLOPATHIC TREATMENT. Ulcers will be benefited by some of 
the following applications: Ten or twenty drops of Carbolic Acid in ah 
ounce of Glycerine, sometimes half a dram to a dram of Tannin should be 
added; a strong solution of Nitrate of Silver— forty grains to the ounce— 
or the solid Stick; a solution of Sulphate of Copper, three to ten grains to 
the ounce; Powdered Iodoform dusted over the ulcer, is an excellent appli- 
cation, as is pure Salicylic Acid. An Alum Curd (Alum dissolved in white 
of an e^g) may be used, or if it prove ineffectual, the surface may be dusted 
with powdered burnt Alum. 

HOMEOPATHIC TREATMENT. Bell., especially if the fever IM 
accompanied by copious perspiration, and every motion aggravates the pain 
extremely. 

Rhus., should be given if the fever consists of a burning, dry heat 
with intense thirst, if the trouble seems to have originated in a cold, and 
the pains are worse at night, and when the patient is lying down, or at 
rest. 

If these two remedies do not effect an improvement, and the fever is 
mingled with chilly creepings, the pulse becomes very much accelerated- 
and the skin is at times very hot, and at other times drenched with perspir, 
ation, we should at once give Mercurius, which is the only remedy that 
can at this stage arrest suppuration, if such a result can be accomplished 
at all. 



DISEASES OF THE SKIN. 519 

If an abscess forms, we give Hepar Sulph., in order to promote the 
suppuration, for the main point now is to evacuate the pus as rapidly as pos- 
sible and by this means to heal the sore as soon as the pus is discharged. 

If the opening becomes fistulous, we must be prepared for a very tardy 
recovery. 

Sulphur is espcially suited for chronic abscess, and for a tendency to 
suppuration, depending on a scrofulous constitution, when the pains are 
stinging in their character, and the pus of a healthy color. 



WHITLOW Or. FELON. 

Is so well known that no description is needed. As soon as it is sus- 
pected that one is beginning to appear on the linger, remove the kind of 
skin lining from the inside of an egg shell in as long a strip as you can and 
wrap tightly around the affected finger. This will, if used in time, stop the 
further progress of the disease, but is painful. If it has gone on until pus 
is already formed, the lance must be applied clear to, and a little way along 
the bone at the seat of pain, being careful that the knife does not cut across 
any muscle. After it is lanced apply poultices. Among the best of which 
is a linen pad, saturated with cold water, frequently removed and covered 
closely with a piece of oiled silk, bladder or similar substance. 

ALLOPATHIC TREATMENT. The earlier the periosteum (membrane 
covering the affected bone) is divided with the knife, the sooner will the 
patient have relief. Saving the bone depends on the promptness of this 
measure, and serious difficulty is prevented by early resorting to it. Subse- 
quently dressings are the same as for Carbuncles or Boils. 



CHILBLAINS. 



External Treatment Tincture of Arnica may, in many cases, 
be advantageously applied externally to the parts affected simultaneously 
with the internal exhibition of the same medicine, in repeated doses. 

Application: To five parts of water add one of the concentrated Tinc- 
ture of Arnica, andbathe the parts freely with this lotion, three times 
a day. 
Tincture of Cantharides. In recent chilblains, induced by expo- 
sure to intense cold, this remedy may be applied externally with great 
success. It operates against the formation of vesicles or blisters, and aids 
in subduing the congestive action. 

AppJicition: Add four drops of the tincture, to two tablespoon fuls of 

water, and bathe the parts with the lotion three times a day. 
Tincture of Causticum is to be preferred to either of the foregoing 
for broken chilblains of old standing, and for those cases in which the 
ulceration has eaten deeply into the flesh. 

Application : Add four drops of the Tincture to two tablespoonf uls of 
water, and apply the lotion as directed for Cantharides. 

ALLOPATHIC TREATMENT. Useful applications for chilblains are: 
Take of Carbolic Acid a dram, Simple Ointment {or Lard) two ounces. Mix 
for an ointment; the surface may be painted with Tincture of Iodine. 

Equal parts of Turpentine and Chloroform will give relief. 



620 FROZEN LIMBS. CORNS. 

FROZEN LIMBS. 

Application of Snow. In slight cases 01 rt frozen fingers," or other 
limbs, or portions of the body, the well-known practice of applying snow 
to the affected parts, is beneficial. 

Camphor (Saturated Tincture). When Snow cannot be procured, 
this is a valuable substitute. For young children this is more particularly 
applicable, especially when the face is the seat of the injury. 

Application : To five parts of Spirits of Wine add one of the Tincture 
of Camphor, and bathe the parts with this lotion freely twice a 
day. 

Acidum-nitricum is a most efficient remedy in severer cases, both 
for internal and external exhibition. 

Dose: Of a solution of six pills to the wine-glassful of water, give a 

teaspoon ful every three hours. 
Acidum-nitricum (externally — second dilution). This remedy may 
simultaneously with its internal administration be applied externally. 

Application: Add four drops of the Tincture, at the second dilution, 

to two tablespoonf uls of water, and bathe the parts with this lotion 

three times a day. If convenient, it were preferable to saturate a 

piece of linen rag with the lotion, and to apply it to the frost-bitten 

part, covering the whole over with oiled silk. 

Diet and Regimen. Plain, wholesome, nutritious, but unstimulat- 

ingdiet; a sufficiency of active exercise in the open air; free ventilation; 

frequent change of linen ; the free use of cold water. 



CORNS. 

That these troublesome excresences not unfrequently arise from an 
inherent vice of constitution, is evident, from the fact of many individu- 
als who wear tight boots and shoes (unquestionably the principal exciting 
cause) escaping them, while others, with every precaution, suffer severely; 
such being the case, the main object must be, by a course of properly-se- 
lected internal remedies, to eradicate the predisposing cause or condition. 

After removing the corn, which has been destroyed by the application 
of Acetic Acid, the place where it was situated, must be relieved from 
pressure. For this purpose corn plasters of variows sizes, having holes 
in the center, may be obtained or made from the soft felt of an old hat. 

Palliative Treatment. Great alleviation of suffering has been 
found to result from bathing the feet in warm water, and from subse- 
quently resorting to the following application: 

Tincture of Arnica. A lotion composed of a weak solution should 
be applied to the corn, after it has been previously soaked in warm water, 
after being pared down with great care. The skillful reduction of the corn 
by an experienced operator, may likewise be mentioned as a ready and 
prompt palliative treatment. 

Equal parts cf Spirits of Ammonia and lemon juice applied twice 
daily, after thoroughly soaking the feet in warm water, is excellent 



PART T^WELF'THL 



CONSTITUTIONAL DISEASES. 



CHAPTER XXVII. 



ACUTE CONTAGIOUS DISEASES. 



MEASLES— MORB ILL 

Measles attack individuals of every age and sex, but least frequently 
very old people and infants. Inasmuch as almost everybody has an attack 
of measles in his early youth, they are on this account seldom met with 
among old people. One attack of measles generally protects persons 
against a second one; exceptions, however, are not very rare, although 
it behooves us to guard against mistaking roseola for measles. 

The ordinary season for measles are the months when catarrhs are 
common, from October till April. 

Symptoms and Course. The incubation-period of the measle-con- 
tagium, until the efflorescences break out upon the skin, is eleven or at 
most twelve days. The" general health does not seem in the least dis- 
turbed in the first eight to nine days of this period ; definite preliminary 
symptoms show themselves in the last two or three days These prelimi- 
nary signs are falsely said to have been noticed at an earlier period; but 
as catarrhal affections are very prevalent during epidemic measles, it is 
very likely that purely catarrhal symptoms have been mistaken for the 
prodromi (premonitory symptoms) of measles. The prodrorai proper 
begin with a slight catarrh of the nose, lassitude and some fever. This 
fever increases considerably on the second day, frontal headache super- 
venes, the eyes look red, are sensitive to the light, but. the conjunctiva is 
seldom puffed up. On the third day there is another increase of fever, 
the patients feel unable to sit up, the tongue is thickly coated, the appe- 
tite gone, and in the night from the third to fourth day, immediately 
previous to the appearance of the exanthem, a hoarse, barking cough 
sets in resembling croup, which, however, is scarcely ever attended 
with the danger that generally characterizes croup and never changes to 
true croup. These symptoms may increase to a considerable degree of 
intensity, may be associated with vomiting, delirium, sopor; at timas 
however, they are entirely wanting, or so slight that it is not deemed 

521 



522 MEASLES. 

necessary to confine children to the room. This is the reason why the 
measles spread so rapidly through the schools, for it is on the day previ- 
ous to the breaking out of the measles that the infectious principle is 
most active, and that the measles are most easily communicated. 

We account for this circumstance by the fact that in the last twenty- 
four to twelve hours previous to the appearance of the exanthem upon 
the skin, distinct, lentil-sized measle-spots are perceived, in almost every 
case, on the sides of the fauces. Without doubt, it is the extension of 
these spots to the larynx and trachea that causes the peculiar croupy 
cough, and we have always considered it an excellent diagnostic sign to 
find this cough associated with red spots on the palate, in which case we 
w r ere able to positively predict the appearance of the eruption within 
twenty-four hours. In other respects, the prodromi have no distinctive 
peculiarity from which the character of the exanthem might be inferred; 
it can, at most, only be suspected after several cases had already occurred 
in the place, or in its immediate vicinity. 

The measle-exanthem breaks out gradually, in one case more rapidly 
than another. The first spots always show themselves in the fa e, most 
commonly on the cheeks and temples. They are of the same size, of a 
bright redness and with rather sharp outlines; after being out for a short 
time, they become somewhat raised above the skin and harder. With more 
or less speed, generally within twenty-four to thirty-six hours, the exan- 
them comes out over the whole body from above downwards, and is fully 
out in forty-eight to sixty hours, so that no new spots appear; up to that 
time, new spots had continued to break out in addition to the first spots 
that were more or less scattered and isolated. The spots keep growing 
in size to such an extent that some of them run together, and the nor- 
mal skin, in the place of spots, exhibits here and there irregular rei 
patches. 

In proportion as the exanthem comes out more profusely, its color gen- 
erally grows darker, sometimes with a bluish tint. With the fuller devel- 
opment of the eruption the constitutional symptoms most commonly 
increase in intensity. The catarrh of the conjunctiva and the cough, espe- 
cially, grow much worse. The pulse sometimes increases to one hundred 
and forty beats. Sometimes the skin is dry, but at other times covered 
with perspiration. In very rare cases the constitutional equilibrium 
remains undisturbed, even during the eruptive stage; however, in every 
considerable epidemic a child with measles is occasionally seen running 
about the streets. 

If the exanthem runs a mild course, its decrease commences at the end 
of the third day, seldom before this time, and continues with great rapidity 
until the eruption has entirely disappeared. The spots grow smaller, 
assume a distinctly yellowish tint, which is especially marked on pressure 
with the finger, and within twelve to twenty-four hours the spots have 
completed their disappearance without leaving a vestige of their existence. 
Very frequently, however, the yellowish tint remains for several days. The 
fever declines very speedily, but the bronchial catarrh most generally con- 
tinues for a few days longer, and resolution sometimes does not take place 
until a considerable quantity of mucus has formed. Not unfrequently the 
patient is at this period attacked with diarrhoea for one or two days. Pro- 



ACUTE CONTAGIOUS DISEASES. 523 

fuse perspiration is not the rule, but is not by any means an unusual 
occurence. 

Desquamation (peeling off) commonly commences on the seventh day, 
but may delay until the fourteenth. The skin comes off in bran-shaped 
scales, very seldom in larger patches; in the face and on the extremities 
the desquamation is most distinct. During this period, the general health 
is generally good ; except that the bronchial catarrh and still less frequently 
the diarrhoea may continue to some extent. 

Among the malignant deviations we name the following: 

The spots when first coming out, are of a pale-red color, which do 
not increase in intensity, nor do they acquire the yellowish tint. Within 
the snots hemorrhagic appearances are manifested, and between the spots 
ecchymoses are noticed. The spots fade away soon after their appearance, 
or else they fide very suddenly at the regular period or before. 

In the case of children the pulse exceedsone hundred and forty beats, 
and in the case of adults one hundred and twenty beats; moreover it is a 
small pulse. The tongue is dry. Angina tonsillaris. Diaphoretic mem- 
branes form in the buccal cavity. The respiration becomes hurried and 
superficial. Sopor and delirium after the second day of the eruption. 

Of great importance are certain complications of measles, that are 
very apt to occur and which were formerly regarded as metastases, because 
the exanthem disappears with the appearance of these complications. 
Laryngitis with croupous exudation i j of rare occurrence while the exan- 
them is still out; it is more commonly met with after the exanthem has 
left the skin. A slight bronchitis is an accompaniment of every case of 
measles ; it only assumes a dangerous character, if it continues beyond the 
stage of decline, or reappears again during the stage of desquamation, or 
otherwise assumes a very acute form. It is very apt to run into an 
exceedingly obstinate chronic catarrh. 

Enteritis (inflammation of the bowels) is a rather frequent complica- 
tion in some epidemics; it excites legitimate apprehensions, for the reason 
that other consecutive diseases, more particularly scrofulosis, are apt to 
follow in i l s train. Affections of the brain are rare; their intensity is 
rarely such as to excite apprehensions; the supervention of sopor is a bad 
sign, because it may usher in a fatal general paralysis. 

Of the highest importance are likewise the numerous and always 
obstinate sequela} (results of the disease) of the measles, which make this 
exanthem one of the most malignant, whereas, its ordinary normal course 
and character entitle it to be regarded as one of the most harmless. Among 
these sequelae we distinguish : 

Chronic conjunctivitis (inflammation of the eyes,) with impaired vis- 
ion : chronic ostitis, with deafness; chronic ozoena; chronic inflammation 
of the lymphatic glands, mostly without suppuration ; chronic inflam- 
mation of the parotid and submaxillary glands. 

Chronic bronchial catarrh, which gives rise to a peculiar spasmodic 
cough; or real whooping-cough, which is much more severe as a sequelae 
of measles than when setting in at other periods, and which very often 
developes a most dangerous pneumonia. 

After measles, children are very frequently attacked with scrofulous 
symptoms. It is very likely that, in the case of little children, the mea^ 



524 MEASLES. 

sles simply act as an exciting cause of scrofulosis ; but it is likewise among 
larger children that, after an attack of measles, all sorts of phenomena 
make their appearance, which we are in the habit of designating as scrof- 
ulous, and which go to show that a morbid change has been impressed 
upon the whole activity of the organism. 

Tuberculosis (consumption,) likewise, frequently breaks out after 
measles. 

ALLOPATHIC TREATMENT. In mild cases of uncomplicated measles 
the treatment will consist of good hygiene, and the relief of such symp- 
toms as annoy or give trouble. 

The patient should be in a large, well-ventilated, but somewhat dark- 
ened room, with a temperature which will be comfortable for attendants 
to sit in— sixty-eight or seventy degrees— and should be uniform day and 
night. Such a temperature is comfortable, and in it there is no danger of 
taking cold from temporary or accidental uncovering of the patient. 

The diet should be light and simple, consisting of milk, or milk and 
water, raw eggs beaten up with sugar and water, gruel, toast, and such 
other farinaceous articles as the patient desires. Any simple drinks, cold 
water, lemon, or orangeade, gum, barley, or ricewater, flaxseed tea, etc., 
may be allowed as freely as desired. 

Emetics and cathartics are not to be given, but if the bowels have not 
moved for a couple of days, an injection of warm water or a laxative dose 
of Castor Oil (a dessertspoonful,) or Citrate of Magnesia (a teaspoonful to 
a dessertspoonful for older children,) should be given. The injection is 
to be preferred, on account of the irritable state of the bowels. 

Remedies arc indicated for the relief of the bronchitis and cough, or 
restlessness. Opium and Hyoscyamus are best suited for this. From 
five to ten grains of Dover's Powder, with half a grain of the solid Extract 
of Hyoscyamus, or fifteen to twenty drops of Laudanum, with an equal 
quantity of Fluid Extract of Hyoscyamus, may be given from two to six 
times in the twenty- four hours. For children, opiates may be given as 
directed for Bronchitis or Pneumonia. Owing to the danger from severe 
bronchitis or pneumonia, it is best, in severe cases, to have an oiled mus- 
lin jacket worn over a flannel shirt. 

A malignant form of the disease will require tonics and stimulants. 
Of these, Quinine may be given in doses of half a grain to three grains, 
three to six times a day. If the pulse is weak, Carbonate of Ammonia in 
doses of one to ten grains, in half a teaspoonful to a tablespoonful of Spir- 
its Menderus, two to six hours apart. Brandy is similarly indicated, and 
should be given in liquid food, in doses of half a teaspoonful to a table- 
spoonful, or more, according to the age of the patient and severity of the 
S3 r mptoms of prostration, and may be given from three or four times a 
day to hourly. 

For high fever, with a strong, bounding pulse, no remedy acts better 
than Aconite. A drop of the Tincture can be given, to an adult, every 
hour until an impression is made on the fever, and then at longer inter- 
vals, to maintain the effect. When the eruption is especially irritating, 
much relief will be afforded by oiling the skin as in scarlet fever. 

Complications of any kind should be treated as directed for the special 
diseases, bearing in mind that supporting treatment only is appropriate 



ACUTE CONTAGIOUS DISEASES. 525 

for serious complications. The precautions directed by the New York 
Board of Health, against the spread of scarlet fever and measles, should 
be observed. 

An unusually high fever, when there is no sweating, will be benefited 
by a cool sponge bath or wet pack. 

Sleeplessness, which is not relieved by the Opium or Opium and 
Hyoscyamus given for cough, may be relieved by giving to an adult 
twenty grains each of Chloral Hydrate and Bromide of Potassium in 
syrup and water in one dose at bed time. 

A prostrated condition of the system follows some cases of measles, 
particularly in adults, which favors the development of any diathesis 
(tendency to disease) which may exist in the patient. Consumption is 
the most frequent exposure, and exertion should be avoided for some 
time after recovery from measles. The debilitated system should be 
built up by tonics of Quinine and Iron, with such hearty food as the 
patient will take. The Citrate of Iron and Quinine, given in doses of 
half a grain to a grain to a child, or three grains to an adult, dissolved in 
Syrup of Orange or Orange Flower Water, three times a day, is as suit- 
able as any tonic. Other tonics, embracing the same principles, may be 
given. 

The Health Board of New York enforce the following Sanitary Regu- 
lations against Scarlet Fever and Measles: 

"Care of Patients. The patient should be placed in a separate 
room, and no person except the physician, nurse, or mother, allowed to 
enter the room, or to touch the bedding or clothing used in the sick room, 
until they have been thoroughly disinfected. 

"Infected Articles. All clothing, bedding, or other articles not 
absolutely necessary for the use of the patient, should be removed from 
the sick room. Articles used about the patient, such as sheets, pillow 
cases, blankets, or clothes, must not be removed from the sick room until 
they have been disinfected, by placing them in a tub with the following 
disinfecting fluid : eight ounces of Sulphate of Zinc, one ounce of Carbolic 
Acid, three gallons of water. 

"They should be soaked in this fluid for at least one hour, and then 
placed in boiling water for washing. 

"A piece of muslin one foot square, should be dipped in the same 
solution and suspended in the sick room constantly, and the same should be 
done in the hall way adjoining the sick room. 

"Feather beds and pillows, hair pillows and mattresses, and flannels 
or woolen goods, requiring fumigation, should not be removed from the 
sick room until this has been done. "Whenever the patient is removed 
from the sick room, inform the Bureau of Sanitary Inspection, when the 
disinfecting corps will, as soon as possible thereafter, perform the work 
of fumigation. 

"All vessels used for receiving the discharges of patients, should have 
some of the same disinfecting fluid constantly therein, and Immediately 
after use by the patient, be emptied and cleansed with boiling water. 
Water closets and privies should, also, be disinfected, daily, with the 
same fluid, or a solution of Chloride of Iron, one pound to the gallon of 
water, adding one or two ounces of Carbolic Acid. 



526 MEASLES. 

"All straw beds should be burned, but must not be removed from the 
sick room without a permit from this department. They will be removed 
by the disinfecting corps. 

" It is advised not to use hnndkerchiefs about the patient, but rather 
soft rags for cleansing the nostrils and mouth, which should be immedi- 
ately thereafter burned. 

"The ceilings and sidewalls of the sick room, after removal of the 
patient, should be thoroughly cleansed, and lime-washed, and the wood- 
work and floor thoroughly scrubbed with soap and water. 

"As a fumigating, antiseptic, and disinfectant, Chlorine Gas stands, 
unrivaled. The ingredients used in its production should be in glass or 
earthen deep dishes or saucers placed in the higher parts of the room. 
The Gas will descend, being heavier than the air, and become mixed 
with surrounding air. The following articles are used for its production: 
One part of common Salt mixed with one part Black Oxide of Manganese, 
and placed in shallow earthen vessles; two parts Sulphuric Acid previ- 
ous'y diluted with two parts by measure of water, is then to be poured 
over it and the whole stirred with a stick. The room with the infected 
articles should be then shut up tightly, and remain closed for several days. 
The cleaning, scrubbing, and white washing can then follow/' 

HOMOEOPATHIC TREATMENT. Aconite, which is particularly indi- 
cated when the fever assumes an inflammatory form, attended with dry 
heat of the skin, heat in the head, with confusion and giddiness, redness 
t.f the eyes, intolerance of light, general weakness or prostration; when- 
ever marked febrile or inflammatory action becomes prominent. 

Dose: Six pills every two to four hours, in water. 

Pulsatilla is also very efficacious in this affection, and is frequently 
indicated in the commencement, by the striking predominance of the 
characteristic catarrhal symptoms attendant upon measles, further quali- 
fied by aggravation towards evening. This remedy is of great utility in 
bringing out the eruption, when it is longer than the average period in 
making its appearance. Pulsatilla is also valuable when any derangment 
of the stomach is present, or when the cough, which so generally accom- 
panies the disease, is worse towards evening or in the night, and is atten- 
ded with considerable rattling of phlegm in the chest, or copious, thick, yel- 
lowish or whitish expectoration, sometimes followed by vomiting or 
symptoms of approachiMg suffocation; further, when there is cold in the 
head with a thick, yellowish or greenish nasal discharge. 

Dose : Six x>ills every four hours, in water. 

Bryonia is an excellent remedy, when the eruption is faint, retarded 
or imperfectly developed, and the respiration much repressed and laborious 
attended with achings in the limbs; also, when there is a dry cough and 
the patient complains of shooting pains in the chest, increased by a full 
inspiration. 

Dose : As for Pulsatilla. 

Sulphur is, in general, highly beneficial after the active symptoms of 
the disease have yielded to the action of immediate treatment, and espe- 
cially after the previous administration of Pulsatilla, particularly when 
we have reason to suspect a scrofulous or other constitutional taint. Sul- 



ACUTE CONTAGIOUS DISEASES. 527 

phur will, frequently, in such cases, be most effective m eradicating the 
predisposition to chronic affections engendered by measles. 

Dose: Six pills in a tablespoonful of water, every morning (fasting) 
for ten days. 

Check of the Eruption. The disease has frequently terminated 
fatally, from the eruption being driven in by sudden exposure to cold or 
change of temperature. 

Bryonia is generally found efficacious in re-evolving the eruption, 
and preventing disastrous consequences. 

Done: As directed above. 

Pulsatilla is indicated, if looseness of the bowels, with mucous dis- 
charge, follow the supression. 

Dose: As directed for Bryonia. 

after effects of measles — COUGHS. 

In general, the treatment of such affections will be most effectually 
conducted by following the instructions furnished separately in the arti- 
cle on "Coughs." 

Looseness of the Bowels. Explicit directions on this subject will 
be found in the article on "Diarrhoea." 

Inflammation of on Discharge from the Ears. (See page 182.) 

Tenderness of the Skin. Mercurius. This remedy, administered 
for a brief time, is generally sufficient to remove the tenderness which is 
so peculiarly apt to result from measles. 

Eruptions on the Skin. Nux- vomica is indicated, in cases of this 
kino resulting from measles, by the presence of an eruption of minute 
white grain-like elevations. 

Dose: Six pills every evening for a week. 

HOME TREATMENT. Measles in their uncomplicated form gener- 
ally require but little, if any. medical treatment. 

The patient should be placed in a large well ventilated room, and it is 
better that he should remain in bed, and should have all the cold water 
which he desires. The diet should be light, such as wheat or rice flour 
gruel, toast water, milk and water, tapioca, sago, or other light food. He 
may be allowed a more liberal diet, as the fever subsides. The eyes 
should be excluded from the light. If the eruption be long in coming out, 
or recedes after it has appeared, apply mustard poultices over the abdo- 
men, to the feet, ankles and wrists; and if there are symptoms of inflam- 
mation of the lungs, apply a mustard poultice over the whole chest, 
which may be removed as soon as decided redness bas been produced. 



SCARLET FEVER-SCARLATINA. 

This is distinguished from other eruptive fevers by the fact of the 
eruption being an exanthema, an efflorescence, or a rash; these terms 
not being strictly applicable to vesicles and pustules. Scarlet fever is 
highly contagious, and it may be communicated by means of fomites 
(producers of contagious disease). The infectious material remains for a 
long time in garments, bedding, carpets, wall-paper, etc , preserving its 
power of producing the disease. It is, doubtless, occasionally transmitted 



528 SCARLET FEVER. 

through the air at great distances; and, hence, sometimes breaks out 
spontaneously without any agency of affected individuals, or clothes of 
any kind. It is difficult to determine the duration of the period from 
the time of exposure to the contagious principle to the full development 
of the first well-marked symptoms. Austin Flint, and other recognized 
authorities, argue that twenty -four hours, often, is the extent; but eight 
days is generally allowed to be the period in a vast majority of cases. As 
a rule, the disease is experienced but once; but exceptions are not very 
rare; the author has known of a case where the same individual has been 
attacked four times. The contagion is most freely active soon after the 
appearance of the exanthem. As soon as the fever has subsided, the con- 
tagious nature of the disease has, most probably, become extinct. Chil- 
dren are much more susceptible to the special cause than adults. After 
forty years, very few persons are attacked; also children, under two years, 
rarely contract the disease, and many persons appear to be entirely free 
through life, notwithstanding numerous exposures. The largest number, 
and most malignant cases occur between the second and seventh year; a 
much smaller number between the eighth and twenty-fifth year; from 
twenty-five to forty it is very rare. 

Scarlatina very often occurs in a neighborhood, either in company 
with or immediately after, epidemic measles. It also, not unfrequently 
occurs in company with small-pox. 

Symptoms and Course. The disease is variable, both in its symp- 
toms and course, and we will now endeavor to point out the fixed types 
of scarlet fever: The patients exhibit the symptoms of a severe cold 
(catarrhal fever,) which unlike measles, is not often attended with 
a cough, but with inflammation of the throat, and loss of appetite and 
generally, occasional vomiting; the pulse is very rapid; the skin seldom 
moist. After the preliminary stage has lasted two days, the exanthem 
makes its appearance, generally with a marked increase of the fever, and 
other preliminary symptoms. Children are attacked with convulsions at 
this stage more frequently than at any other. The eruption is first visi- 
ble in the throat, on the tonsils, etc.; externally, on the neck, whence it 
spreads downwards over the rest of the body. First, we notice closely- 
crowded red spots (stigmata,) these very speedily run into each other, 
causing a homogenous, faintly-dotted redness, or else they grow in size, 
and running together form single spots of a darker color, seated upon a 
faintly-red skin ; or, finally, small vesicles spring up upon the red surface 
most generally in consequence of the intense character of the skin affec- 
tion. The exanthem is, in cases running a natural course, generally fully 
out in twenty-four hours after the first external appearance; during all 
this time the fever has continued as high, or even more intense, 
than before; the thirst great, the tongue coated, or, cleared of its coat, 
showing a dark strawberry appearance. One of the most constant of the 
symptoms of this fever is this strawberry tongue. The urinary secretion 
is much less; sometimes a little cough makes its appearance now, but 
rarely assumes a violent form. The throat is very sore, dark red, and 
swollen ; the surface of the body is also swollen. On the fifth or sixth day 
after the appearance of the eruption, it begins to pale off, with lessening 
of the fever and much more so the sore throat {angina). 



ACUTE CONTAGIOUS DISEASES. 529 

Soon after this, the process of desquamation (peeling off,) begins. It 
always begins on the neck with small scales; on the body, and more par- 
ticularly on the hands, the skin peels off in large patches; the itching 
is now severe, and may be allayed by rubbing the itching parts with some 
pure clean oil; the appetite now speedily returns and the patient feels 
quite well ; in fourteen days at the latest the desquamation is completed. 

Such is a plain case, and unless some important variation takes place 
frequent sponging of the whole body, cooling drinks and pure air, are all 
the remedies needed. But variations are so frequent that too much watch- 
fulness is impossible. As soon as a change takes place in any symptom, 
study, at once, its meaning, and if not fully satisfied as to the result being 
favorable, call aid without delay. 

ALLOPATHIC TREATMENT. Rigid isolation should be provided in all 
cases of scarlet fever, as a precaution against its spreading. They must 
be watched most carefully in every instance, for some of the most danger- 
ous complications (co-existing diseases) and sequela? (resulting diseases) 
occur in those cases, which, from their very mild character, have been left 
almost, if not entirely to themselves. Competent medical aid should in 
all cases be called upon the first appearance of a serious symptom, or one 
that is not well understood or certain to result favorably. 

Mild cases of scarlet fever do not call for active measures of treatment, 
but whether the disease is mild or severe, the strictest attention should be 
paid to hygiene (health rules). To this alone mild cases can be safely 
trusted. The room ought to be large and freely ventilated. The temper- 
ature of the room should be carefully kept at seventy degrees, except 
when the fever is extremely high, it may be as low as sixty-five degrees. 
The clothing on the bed should not be heavy enough to increase the heat of 
the body or to be disagreeable to thepatient, nor light enough to cause chil- 
liness. The body linen and the bed linen must be changed everyday. After 
the fever has begun to decline and the heat of the skin greatly diminished 
during the latter part of the disease, the heat of the room should not fall 
below seventy degrees day or night. If the child is pale, weak, and chilly 
the temperature of the room should be kept as high as seventy-two 
degrees. 

Chilliness and taking cold must, in all cases, be avoided after the fever 
has begun to decline and the scarf-skin shed off (desquamation) on account 
of the liability of causing inflammation of the kidneys and dropsy, the 
most dangerous complications and sequelae we have to contend with. 
The patient should be kept in bed until the desquamation entirely ceases, 
nor should he be allowed to leave the house within four weeks. 

At first light food only should be given, such as milk and its prepar- 
ations, meat broths, egg beaten up with sugar and water, given raw, 
arrowroot prepared with milk and water, and gruels, but nothing more 
substantial should be given during the earlier stages of the disease. Cold 
water, lemonade, and juice of fruits may be freely allowed. As the fever 
declines and the patient recovers, the regular diet should be gradually 
resumed. If, however, there is great weakness or the case has run some 
time beef essence, juice of meats, egg beat up with sugar and milk should 
be given frequently and in such quantities as the child can be induced to 
take. Small quantities of wine, wine whey, milk punch or egg-nog 

34 



580 SCARLET FEVER. 

should also be given. A teaspoonful of whisky or brandy and two or 
three tablespoon fuls of sherry wine, is a dose for a child one to three years 
old. One or two tablespoonfuls of whisky, or brandy and a wineglassful 
of wine is a dose for an adult (grown person). 

In general a tepid bath should be given twice a day, the temperature 
of which should be ninety degrees, if the fever is moderate, or eighty 
degrees if very high. The patient is undressed and immersed in the 
water for fifteen minutes or half an hour, until the heat of the body is 
reduced and the patient quieted. If the bath is not practicable, frequent 
sponging of the whole body, with tepid or cool water, as the fever is mod- 
erate or high, every two, three or four hours, or the application of the 
wet sheet — wet pack — once a day, should be practiced. In the applications 
of the wet sheet, the sheet should be wrung out of cool water of sixty 
or seventy degrees, according to the degree of fever, and the patient, 
stripped of all clothing, is enveloped in tha sheet and then surrounded 
with several blankets. Usually after remaining in the pack for about an 
hour, free sweating takes place. The pack is then removed, the patient 
wiped dry and placed in bed. When the heat of the body is one hundred 
and four degrees, or higher, the cold lost pack should always be used, and 
will render most signal service. If not as high, frequent sponging is pre- 
ferable in domestic practice. 

In no case should the bath with water, in any form, be given when 
the patient is sweating, or the skin moist. 

When the body is wiped dry, after each bath, sponging, or pack, it 
should be well rubbed with oil, from head to foot, except the face and 
scalp. One of the best ointments for this purpose is the following: Take 
of Glycerine one dram, Rosewater Ointment one ounce. Mix. Only that 
part of the body which is being rubbed should be uncovered at a time, or 
the whole can be done under the bedclothes. Glycerine one part and 
Sweet Oil four parts is a good application, or pure Lard may be used 
alone for the purpose. This oiling of the body relieves the itching and 
burning of the skin, keeps it moist and soft, and is in a general way, ben- 
eficial, as is shown by the lowered temperature and pulse. It should be 
applied at least twice a day, even if a bath is not given as often, and con- 
tinued during the stage of disquamation. As a rule, cathartics should 
not be given, but constipation should be relieved by injections of warm 
water. 

For the sore throat, a solution of Chlorate of Potash one dram to the 
pint of water, of which the patient can drink at will, is probably all that 
is needed to be done in mild cases. This remedy is beneficial in a general 
way, as well as giving relief to the throat. If the glands are enlarged 
(hard lumps about the neck,) Tincture of Iodine may be applied with a 
camel's hair brush or feather. When the throat is severely inflamed, 
compresses wet with cold water should be applied to the sides of the 
neck. They should be changed often, to maintain a uniform degree of 
cold. Pounded ice may be applied to the sides of the neck, in little bags, 
if the inflammation of the throat is so violent and the fever high. The 
solution of Chlorate of Potash, kept cold, should be given often as a drink 
and a gargle, if the patient is old enough. Small lumps of ice may be 
held in the mouth, or icewater frequently swallowed. When the violence 



ACUTE CONTAGIOUS DISEASES. 531 

of the inflammation has begun to decline, or the cold becomes disagree- 
able to the patient, or if suppuration (forming of pus or matter) begins, 
the cold should be displaced by warm applications; warm poultices kept 
on the neck by a light kerchief, or a flannel cloth wrung out of hot water 
and applied to the neck, well covered with cloths, to retain the heat. If 
the discharge accumulates in the throat and nose, it should be removed 
by a soft cloth swab or feather wetted in a solution of Alum, in green tea 
or sage tea, or Borax mixed with honey and water. When the discharge 
is of a fetid or suppurative (pus-like) character, the following application 
should be made to the throat, with a soft swab, three or four times a day : 
Take of Carbolic Acid twelve drops, Glycerine one ounce. Mix. If the nose 
is invaded with the inflammation, it should be carefully cleansed, and the 
same mixture carefully and thoroughly applied with a feather or camel's 
hair brush. 

When the secretion from the throat is profuse, Belladonna is indica- 
ted until the throat becomes dryer, the pupils dilated or the secretion 
diminishes. The Tincture of Belladonna is an appropriate form, and may 
be given in doses of one to five drops to a child, or fifteen to twenty drops 
to an adult, four to six hours apart. The medicine may be continued 
just sufficiently often to maintain a slight dryness of the throat. 

Quinine should be given through the whole course of the disease, 
from the beginning of high fever until recovery is well established, and 
the appetite good. The dose is from one to two grains for a child, three 
or four times in the twenty-four hours; and three to five grains for a 
grown person, at the same intervals. 

As soon as the desquamation (shedding off of scarf skin) begins, the 
Tincture of the Chloride of Iron should be given in five-drop doses to a 
child, and from fifteen to twenty drops to an adult, three times a day. It 
should be given well diluted in water. 

In malignant cases, in which the system is overspread by the disease, 
denoted by excessive frequency of the pulse, the chief reliance is on alco- 
holic stimulants, in the forms before mentioned, and they should be freely 
given. 

Uremia (urea, constituent of urine remaining in the blood) is the 
most serious result of diseased kidneys, and is indicated by prolonged 
convulsions, headache, disturbance of the sight, or insensibility, and 
should be promptly met by a cathartic dose of Epsom Salts— two table- 
spoonfuls for a grown person, and one to two tablespoonfuls for a child. 
Free sweating should be produced quickly, by the use of the warm wet 
pack, or better, by the hot-air bath, once or twice a day. The hot air-bath 
can be given by putting the patient, stripped of clothing, in a cane-seated 
chair, then wrap a large blanket around both the patient and the chair, 
from his neck to the floor, covering the whole in tightly, except the pa- 
tient's head; then burn alcohol in a saucer under the chair until free 
sweating is produced. Hot flannels should be applied constantly to the 
loins. The physician should be promptly sent for upon the first appear- 
ance of any of these symptoms. He will probably give Elaterium for a 
cathartic. 

Dropsy will be treated by hot-air baths, or the hot wet pack, once or 
twice a day. The bowels should be kept open by Rochelle Salts or Castor 



532 SCARLET FEVER. 

Oil, in doses of a teaspoonful for a child, or a tablespoonful for an adult, 
repeated every six hours until the bowels open. The Quinine and Iron, 
before mentioned, should be given through this complication. The fol- 
lowing mixture, to act on the kidneys, is useful : 

Take of Acetate of Potash one dram {or half an ounce;) Tincture of Digi- 
talis one dram {or half an ounce ;) Syrup of Squills three drams {or an ounce 
and a half;) Water two ounces {or eight ounces). Mix. 

Dose : A teaspoonful every four hours to a child, or a tablespoonful to 
an adult. 

Use the smaller quantities in filling the formula for a child, and the 
larger for a grown person. In the absence of this mixture, the patient 
may drink quite freely of a decoction (tea) of Juniper Berries, or Water- 
melon Seeds. 

If discharge from the ear occurs, it should be frequently syringed 
with warm castile soapsuds, and the Carbolic Acid and Glycerine, before 
mentioned, applied. 

As a preventive of scarlet fever, Belladonna has some reputation. 
Take of Extract of Belladonna three grains, Alcohol one dram, Water half 
ounce. Mix. 

Dose: A drop morning and evening, for each year of the child's age. 

Clothing, and other articles, which have been exposed to the poison of 
scarlet fever can be cleansed by immersing them in boiling hot water, or 
exposing them to a heat of over two hundred degrees. All unnecessary 
articles of furniture or clothing should be removed from the room, before 
the scarlet fever patient occupies it. See also the sanitary rules of the 
New York, Board of Health, printed on pages 506 and 507. 

HOMEOPATHIC TREATMENT. In those cases in which the disease 
appears in its simple form, the skin presenting the characteristic hue, 
with a smooth and glossy surface, Belladonna is a specific remedy. 

Even in the severer forms of scarlet fever, when the throat is con- 
siderably affected, and high fever or congestive symptoms set in and 
which if not properly treated: or if they occur in a bad habit of body, may 
assume the malignant type, attended with ulcerated sore throat, extension 
of the inflammation to the air-passages, delirium, spasm, etc., Bell, is a 
very valuable remedy. It should be given as soon as the throat and tongue 
become affected with dryness and burning, and there is a desire, but com- 
plete inability to swallow even drinks or saliva; with sense of suffocation; 
further, when the throat is of a bright-red color, having its surface excor- 
iated, or covered with white specks, or stringy mucus, or presenting the 
appearance of thrush ; the tonsils swollen, and the tongue of a bright fiery- 
red hue, sometimes interspersed with dark-red patches at a later period of 
the disease; also when delirium exists. If the disease has taken a favor- 
able turn, we may allow Bell, to continue its action ; but if, after twenty- 
four to thirty-six hours, the swelling and inflammation increase rather 
than diminish, as in the case sometimes in strumous constitutions, or if we 
already perceive an appearance of ulceration commencing, with increase 
of mucus, give at once Mercurius. If, on the other hand, the ulcers pre- 
sent a livid appearance about the edges, and emit an offensive odor, or, 
when there is an excessive thirst for small quantities of water, and an 
extreme prostration of strength, Arsenicum is to be preferred to Mercurius, 



ACUTE CONTAGIOUS DISEASES. 633 

and if this medicine prove inadequate to a complete cure, it should be fol- 
lowed by Nux-v., (see Ulcerated Sore Throat). Nux-v., is moreover of consid- 
erable efficacy, when a large quantity of viscid mucus is secreted from 
the inflamed and tumefied lining of the fauces, which adheres so tena- 
ciously, that it is with difficulty expelled, and sometimes even threatens 
suffocation. Pulsatilla is, also, useful in such cases. 

When the fever assumes a clearly inflammatory type, and the pulse 
runs high, we may administer Aconite in the same manner as given under 
Inflammatory Fever, which see. 

When the quickness of the pulse, and other febrile inflammatory 
symptoms are subdued, and the affection of the throat again appears most 
prominent, we may return to Bell., especially if the skin retain the pecu- 
liar scarlet hue. 

Opium may follow the Bell, when there is burning heat of the skin, 
drowsiness, stupor, heavy breathing, open mouth, eyes half closed, rest- 
lessness with vomiting, or convulsions. 

Pulsatilla is indicated when derangement of the stomach and diges- 
tive organs is a prominent symptom, the face pale, red, or bloated; dispo- 
sition fretful and sensitive, or melancholy, with crying or tears, without 
sufficient cause. 

COMPLICATED FORMS OF SCARLET FEVER. 

Varieties of scarlatina not unfrequently occur in which the charac- 
teristic peculiarities of the efflorescence are wanting, namely, the color, 
which is not a bright scarlet, but of darker hue, and the effect of pressure 
which does not leave the white impression after it. There are, also, cases 
in which small granular elevations appear upon the surface of the red 
patches. These variations from the foregoing description of the manifes- 
tations afforded by scarlet fever, are not to be mistaken for indications of 
a different disease, but should be accepted as signs of a different type of the 
same disease. There are, also, instances in which the eruption is con- 
fined to internal parts, when, with the characteristic acceleration of pulse, 
there is sore throat, and the mouth and throat are bright red, hot, swol- 
len, and often very dry. This variety will be subject to treatment, such 
as that already detailed, according to the special indications present. 

Other instances, again, oceur of a yet more insidious character, which 
are not distinguished until the dropsical swellings supervene, and which 
either evince no eruption at all, or so slightly as to escape notice. 

This variety must, in all instances, be treated as directed for the like 
symptoms supervening as the after-effects of the disease when the erup- 
tion has been struck in or imperfectly developed. Another very danger- 
ous complication, which is frequently associated with scarlet fever, con- 
sists of inflammation of the upper part of the windpipe. 

This variety should be subjected to the treatment prescribed in the 
article devoted to the consideration of that particular disease, so long as 
symptoms of this nature continue— returning, however, to the specific 
treatment of the primary disease (scarlet fever) as already directed in 
this chapter, as soon as the complication is subdued. 

Another variety is characterized by degenerating into a low typhoid 
type, in which case, the following treatment becomes requisite. 

Ammonium-carb., Arsenicum, Acidum-phosph., Secale-com. 



534 SCARLET FEVER. 

From amongst these remedies, a selection should be made by accur 
ately studying the symptoms of the case, and by comparing them with 
the indications afforded under the head of each symptom respectively. 

Cases in which the throat becomes the chief seat of danger, require 
the following treatment: 

Arsenicum is indicated in the majority of cases in which severe and 
dangerous sore throat accompanies scarlatina, the tonsils being swollen 
into hard tumors, often as large as apples, attended with snorting and dif- 
ficult breathing, enlargement of the adjacent glands, and remittent pulse. 

Dose: Six pills every two to four hours. 

Acidtim-nitric, Aconitum, Lycopodium, Belladonna. If little 
or no improvement should have followed the administration of Arsenicum 
within the time just stated, proceed with these remedies in succession in 
the order in which they are placed. 

Dose as for Arsenicum. 

AFTER-EFFECTS OF SCARLET FEVER. 

Scrofulous subjects in particular are subject to a multitude of consecu- 
tive ailments of scarlet fever, which are often of an obstinate character, 
and require careful treatment and great precaution. 

Excessive Susceptibility to Take Cold. In general, also, we 
may number amongst these after-effects, when the skin has been cast, an 
exceeding susceptibility to take cold, which, if not obviated, may entail 
serious consequences. 

Treatment. As accessory precaution we may mention great care as 
to diet, sufficient exercise out of doors, if possible, but only in very dry 
weather, warm clothing, and avoidance of drafts, without, however, 
resorting to the extreme of coddling or the exclusion of free ventilation, 
which is as essential to thorough recovery as medicine. 

Calcarea should, in the majority of cases, be administered, unless there 
be symptoms which distinctly point to other remedies, in repeated doses. 

Kawness of the Face. Chamomilla, Belladonna, Aurum- 
trip. Chamomilla may, in most cases, be employed singly with perfect 
success against this troublesome consequence. When, however, an inflam- 
matory tendency continues, and the affected parts are much swollen and 
painful, etc., it will be desirable to resort to alternate administration of 
Chamomilla and Belladonna as follows; and if no relief follows take 
Aurum-trip. Four doses daily. 

Offensive Discharge from the Nose. Aurum is indicated by 
offensive discharge of matter, from the nose, with soreness and swel- 
ling of the interior, following scarlet fever. 

Soreness of the Nose, etc., with Swelling of the Glands. Mer- 
euritis and Hepar-s. Silicea, Sulphur, Calcarea. Mercurius is 
required when there is soreness of the nose and face, with swelling of the 
glands on the inner side of the lower jaw, followed, if necessary, by one 01 
more of the other remedies named. 

Puffiness and Swelling of the Face and Extremities, etc. 
Belladonna is in most cases sufficient to overcome the following 
symptoms, occurring as the after-effects of scarlet fever, namely:— Puffi- 
ness of the face, swelling of the hands and feet, lingering fever in the 
evening, glandular enlargements, chaps about the mouth, severe headaches, 
stammering, etc. 



ACUTE CONTAGIOUS DISEASES, 5S5 

Dropsical Swellings, etc. Arnica, Belladonna, Helleborus t 
Acidum-Phosph., Gelseminurn. One or more of these remedies 
respectively according to the detailed indications afforded respecting them 
in the Repertory should be administered, when symptoms of water on the 
brain supervene, such as dullness of the mental faculties, with evident 
painful effort to think clearly ; excessive drowsiness; weakness of the feet 
and repeated falling down ; squinting dilation of the pupils, etc. 

Arsen icum, Ilelleborus, Digitalis. Selection should be made from 
these remedies, particularly when symptoms of water on the chest super- 
vene, such as.' painful oppression of respiration, aggravated by motion or 
by lying on the back; the patient is suddenly disturbed in sleep by a suf- 
focative sensation, which compels him to sit up, or even to get up, and 
seek for air; or even inability to lie down, necessitating a sitting or even 
a perfectly erect posture; short, dry, and even spasmodic cough, and 
stitching, crampy pains between the shoulders ; excessive anxiety, etc. 

Mumps. Mercurius, Carbo-veg. Mercurius is specific in the ma- 
jority of cases of mumps under these circumstances. 

Dose: Four globules in a teaspoonful of water every six hours, until 
amelioration or change; but if no improvement whatever should 
ensue within four hours after the second dose, or especially if there 
be reason to believe that the patient has been treated with Mercury, 
proceed with the next remedy. 

Carbo-veg. This remedy is required in cases in which a few doses 
of Mercurius produce no effect whatever, and more particularly when the 
patient has been subjected to doses of Mercury, or if induration begins to 
be developed. 

Dose : In every respect as stated above for Mercurius. 

Calcarea, Kali-carb. These remedies are invaluable in very obsti- 
nate and continuous cases, and should be selected, if the symptoms be 
conformable to those recorded of these medicines in referring to the "Re- 
pertory." 

Dose; Of either remedy, as selected, give six globules in a tablespoon- 
ful of water, morning and evening for ten days, if the malady does 
not sooner yield. 

HO jIE REMEDIES. The milder forms of the disease require but little 
treatment. Keep the patient in a well ventilated room, place him upon 
spare diet, and sponge the surface of the body occasionally with tepid 
water, if the heat of the skin is great. Instead of sponging with tepid 
water, take a lump of suet and rub the body with it, except the face and 
scalp, morning and evening. It has the effect to remove that pungent 
heat much more effectually than water. The greasing should be com- 
menced as soon as the disease is recognized, and continued during the 
whole course of it. During the stage of convalescence or when the skin 
is peeling off apply it in the morning and give the child a warm bath in 
the evening, rubbing it well with a soft towel. 



SMALLPOX. 

This disease is by medical practitioners of the present day, divided 
into two varieties: — the distinct, when the pustules on the face are clearly 
defined, and do not run into each other— and the confluent, when they 
coalesce and form one continuous whole. 



686 SMALLPOX. 

When the symptoms are less severe than those properly characteristic 
of the disease, and eruption on the face slight, it is called the modified 
smallpox. We generally find this description in such persons as have been 
properly vaccinated,— a precaution, which, although not always a preserva- 
tive against the attacks of smallpox, greatly lessens its virulence, and 
gives a milder character to the complaint, when taken. 

Symptoms. The disease is frequently very sudden in its attacks, com- 
mencing with chilliness and shivering, followed by symptoms of fever, 
headache, severe pains in the small of the back and loins, languor, weari- 
ness and f aintness ; the patient, also, complains of oppression of the chest, 
and acute pains in the pit of the stomach, increased by pressure. The 
eruption makes its appearance at the close of the third day, first on the 
face and hairy scalp, then on the neck, and afterwards spreads over the 
whole body. Symptoms of cold — as sneezing, coughing, wheezing, and fre- 
quently difficulty of breathing, often accompany this disease. 

The eruption first displays itself in the shape of small, hard-pointed, 
red elevations, which can be felt under the skin of the forehead, before it 
is possible to discover any eruption with the eye which, in about three 
days, present a bladder-like appearance, surrounded by an inflamed cir- 
cular margin, and become depressed in the center as they enlarge. About 
the sixth or eight day, the watery secretion in the pustule becomes con- 
verted into matter, and the depression in the center disappears. 

"When the pustules are very numerous on the face, it generally becemes 
much swolen, and the eyelids are frequently closed up. On the first 
day, a small lump, like a millet-seed, may be felt on each of the eleva- 
tions above noticed, distinguishing this eruption from all others. The 
pocks continue coming on during the first three eruptive days, and each 
pock runs its regular course; thus, those which first appeared are forming 
into scabs or drying off, whilst the others are suppurating. The drying 
off commonly takes place on or about the eighth or fourteenth day, accord- 
ing as the pustules may happen to be distinct or confluent. 

When the pustules have obtained their full development, they gener- 
ally burst, in mild cases emitting an opaque, watery discharge, which dries 
into a crust and falls off; whilst, in severe ones, we find a discharge of 
thick, yellowish matter, forming scabs and sores, which leave, on their 
healing, permanent marks or pits. Red stains, caused by increased vascu- 
lar action, always remain for a while after the eruption; but if no ulcera- 
tion has taken place, they disappear in process of time. 

In confluent smallpox, all the precursory symptoms are more severe, 
the fever runs high, and frequently continues so throughout the course 
of the disease; the pain in the pit of the stomach and difficulty of breath- 
ing are more complained of, and in children, the eruption is frequently 
preceeded by convulsions and delirium; the latter symptom, indeed is fre- 
quently present with adults, during the suppurative or secondary fever, 
which not uncommonly assumes a character akin to typhus, and sometimes 
carries off the patient on the eleventh day. All cases in which we have 
generally a deeply-rooted morbid constitutional taint to contend against, 
require the utmost skill of the experienced practitioner to ward off a fatal 
result. An extensive inflammatory blush of the face or trunk almost 
invariably precedes the eruption in the confluent variety of smallpox. 

Salivation, with soreness of the throat and small white ulcers or pus- 



ACUTE CONTAGIOUS DISEASES. 537 

tules on the tongue and in the upper part of the gullet, frequently declares 
itself in both forms of this disease, but particularly in the confluent. 

Before we come to the medicines to be administered in the different 
stages of the disease, we may say a few words upon the general treatment 
of the patient. 

Cool and fresh air are our best auxiliaries, the emanations from the 
patient in this complaint being of a nature to react upon the organism, 
and warmth being calculated to increase it3 activity. So beneficial is 
cool air found in this malady, that taking a child to an open window when 
attacked with the convulsions, frequently present, will generally be found 
to afford immediate relief. Great cleanliness must also be observed, and 
the linen frequently changed. 

"When the vesicles declare themselves, and begin to form into pustules, 
the room ought to be kept as dark as possible, to aid in preventing the 
risk of disfigurement, a precaution deducible from common experience, 
since we find that the parts of the frame exposed to the action of light 
are always those most strongly marked by the ravages of the disease. 

To avoid the pits, and consequent disfigurement left by this disease, 
many physicians have adopted a mask or plaster for the face, of different 
substances, such as gum, mucilage, calamine, etc. The application of 
collodion to the face, or of oil when the collodion can not be tolerated— 
has been found of service in preventing disfiguration from pock-marks, 
but the most successful of all means, so far employed, is that followed by 
physicians of the Kegular Homoeopathic school. 

ALLOPATHIC TREATMENT. As there are no specific remedies for 
smallpox, its treatment will be palliative and supporting. If the person 
has not been vaccinated, this is the first thing to be done after exposure. 
Five or six points should be inserted in each arm. It is a good practice 
to resort to this in any one whether vaccinated or not, at any time before 
the appearance of the eruption. It will mitigate, if not prevent the dis- 
ease. Aside from this, the treatment is the same as in other continued 
fevers. The room should be large and well ventilated, and all unneces- 
sary articles removed from it, carpets, curtains, etc., that they may not 
be infected and act as conductors of the disease (fomites). The best dis- 
infectant in this disease is Iodine. A couple of drams of the Tincture 
should be placed in the vessels which receive the sputa or other excre- 
tions, and three drams of the scales may be put in a chip basket and 
hung over the patient's bed. If the room is not kept free from smell, 
the number of vessels containing Iodine may be increased, or a few 
scales may be vaporized by sprinkling them on a hot shovel. 

Carbolic Acid may be used with the Iodine by moistening one or two 
cloths, a little over a foot square, with a solution of Carbolic Acid in 
water, and hanging them up in the room, and adding a quarter part of 
Carbolic Acid to the Tincture of Iodine in the vessels receiving the excre- 
tions. 

Chlorinated Lime and Labarraque's Solution, Quick Lime and Per- 
manganate of Potash in solution, are also useful disinfectants, and may 
be employed on account of cheapness. The nurse should, after waiting 
on the patient, wash his hands in clear water with soap, and then wash 
them in a disinfectant fluid. 



538 SMALLPOX. 

Complete isolation is the only real safegard against a spread of the 
disease. Destruction of clothing used about the patient, and in the sick 
room, is necessary. 

During the invasion of the disease, the febrile movement may be less- 
ened by frequent tepid sponging, cool drinks, such as cold water, lem- 
onade or orangeade, or cold barley or rice water. 

The writer favors full doses of Quinine, five to ten grains every four 
hours, until the fever is lessened, and if the pulse be bounding, strong, 
and frequent, Tincture of Aconite may be given in doses of one drop every 
hour, to an adult, until the fever and pulse are comfortably reduced. 

Emetics and cathartics are not to be given, but constipation is to be 
relieved by injections of warm water, or the mildest laxatives, as directed 
in measles. 

During the eruption, and before suppuration, the measures before 
mentioned are to be continued or not, according to the severity of the 
symptoms. 

Nausea and vomiting will be relieved by five to ten-grain doses of 
Bismuth, with five grains of Oxalate of Cerium, or five-drop doses of 
Dilute Hydrocyanic Acid, or one-drop doses of Carbolic Acid or Creosote 
in water every hour, until relief follows. Cold, or possibly heat, applied 
over the stomach will aid. 

Diarrhoea is to be relieved by Bismuth in ten to fifteen-grain doses in 
milk, with, if neccessary, an opiate, as a dessertspoonful of Paregoric or 
ten to fifteen drops of Laudanum. 

Restlessness and watchfulness will be relieved by a grain of Opium, 
and one or two grains of Extract of Hyoscyamus Acid, or twenty grains 
each of Hydrate of Chloral and Bromide of Potassium, given in solu- 
tion with sugar, given at bed time. This will insure a nights sleep. 

It is to be expected that Dilute Hydrochloric Acid in doses of ten to 
twenty drops, or Dilute Phosphoric Acid in doses of half a teaspoonful 
largely diluted in sweetened water, and taken three or four times in 
course of the day, as a drink, will prove beneficial, as it has done in other 
continued fevers. 

Systematic feeding should be begun in this stage, and should consist 
largely of milk, eggs beat up with sugar and milk, or water, (as directed 
in scarlet fever) strong beef tea or essence, poached eggs or cooked in the 
shell in hot (not boiling) water, toast, rice and water; simple farinaceous 
food may be given. The patient should be fed during this stage four 
times a day, and oftener if there is any appearance of the strength fail- 
ing, when food, such as milk or eggs should be given at not longer inter- 
vals than four hours. Feeding is most important during the suppurative 
stage. Upon any appearance of exhaustion alcoholic stimulants should 
be given ; from one to three teaspoonfuls of brandy or whisky may be 
given with three to four ounces of milk or egg and water, a couple of 
hours apart. If the symptoms of prostration increase the stimulant may 
need to be increased. It is beneficial when it renders the pulse fuller, 
slower, softer and regular. 

Complications require treatment appropriate to those particular dis- 
eases. Local treatment consists of measures to prevent the pitting and 
to relieve itching, which becomes intolerable. 



ACUTE CONTAGIOUS DISEASES. 539 

For the former purpose the following have been found, in a degree 
useful: Careful evacuation of the vesicles with a fine needle; it is a tedi- 
ous thing to do. Second, after rupture inserting into each vesicle a fine 
point of Nitrate of Silver. It is claimed to be most successful if done on 
the second day of the eruption. Third, the application of the Tincture 
of Iodine twice a day during the papular stage of the eruption. Fourth, 
exclusion of the light and air by means of a plaster. A mixture of Tan- 
nin and Iron is employed in cases in the N. Y. Hospitals. It produces a 
black mask. Coating the face with Olive Oil and dusting upon the oiled 
surface twice a day with equal parts of the Sub-Nitrate of Bismuth and 
prepared chalk. Pulverized Charcoal made into a paste with Olive Oil 
or Glycerine is a simple application and as effectual as any. Calamine is 
used in the same way as the pulverized charcoal. 

The application of Collodion once or twice daily with a camel's hair 
brush while the eruption is papular, is said to be successful. It should 
be begun when the eruption first appears, and acts by excluding the air 
and compressing the papule. The application of guttapercha, dissolved 
in Chloroform, acts in the same way. These applications are made usu- 
ally to the face only. 

The terrible itching is thought to be greatly relieved by smearing the 
pustules with cold cream, a mixture of equal parts, by bulk, of Lime-water 
and Linseed or Olive Oil, or a mixture of one part of the solution of the 
Subacetate of Lead to seven parts of Almond Oil. 

When the pustules burst, they should be dusted and kept coated with 
Oxide of Zinc in powder, or mixed with pulverized Starch. If fissures 
(cracks in the skin) and excoriations occur, a mixture of Oxide of Zinc, in 
Glycerine or Olive Oil, two drams to the ounce, should be made. 

Thorough vaccination, at four or five points, is an almost sure protec- 
tion against small-pox, and a certain protection against the disease proving 
fatal. Children should be vaccinated in infancy, and re-vaccinated not 
later than six or eight, years, and still again before childhood passes. When 
epidemics of small-pox occur, all persons who have not been vaccinated 
within three or four years, should be re-vaccinated. 

HOMOEOPATHIC TREATMENT. Aconitum may be required in the 
first, and early in the second stage; if the fever runs high, the thirst is 
excessive, the skin very hot and dry, the pulse quick, hard and full, and 
the breathing laborious and rapid. 

Aconite should, also, be resorted to as an intermediary remedy, at 
any stage of the disease, when distinctly indicated by symptoms of this 
description. 

Do.se ; Six pills every two to four hours. 

Antimonium-tart., (Tartar Emetic) is well indicated in this disease, 
from the close analogy which the eruption it is capable of producing bears 
to that of small-pox, and may, therefore, be, also, administered with advan- 
tage during all stages of the disease, unless some other remedies should be 
more urgently called for by the nature of the symptoms; this should be a 
constant remedy, tightness across the chest, perhaps attended with nausea 
and vomiting, or diarrhoea, before the eruption is fully out, and the exist- 
ence of a hollow, sounding cough, with loud, mucus rattling, is an addi- 
tional index for the employment of Antimonium-tartaricum. 



540 SMALLPOX. 

Dose: Dissolve ten pills in two tablespoon fuls of water, and give a 
teaspoonful of the solution every three hours, until amelioration or 
change. 

Chamomilla is sometimes of great service during the course of the 
disease in children, when the following distinctive symptoms appear: — 
difficulty of breathing, with predominant looseness of the bowels, deep 
green stools, severe colic, tenderness of the belly, and vomiting; it is like- 
wise calculated to be useful during the maturative stage, when much 
restlessness and whining prevail, and the rest is much disturbed by a 
troublesome cough at night. 

Dose: Four pills in a teaspoonful of water, every two hours. 

Belladonna, This remedy may follow Aconite or Chamomilla, when 
either of the latter have been indicated, should symptoms of disturbance 
of the brain have set in, characterized by flushed countenance, intoler- 
ance of the eyes for light, headache and delirium, great thirst, nausea and 
vomiting, or, when there is redness of the tongue at the tip and margins; 
belly tumid and painful, particularly about the region of the stomach, 
with sensibility on pressure; prostration of strength and stupor. 

Dose: Of a solution of four pills to two tablespoonfuls of water, give 
a teaspoonful every two hours. 

Opium is useful, when there are symptoms of stupor or strong incli- 
nation to sleep; it may be employed after Belladonna, or even preferred to 
the latter remedy, in cases in which there is continuous lethargy, with 
open mouth, half-closed eyes, and snoring breath ; or, again, when there 
is violent delirium, with incessant tossing about of the hands. 

Dose: Six pills carefully placed upon the back part of the tongue, 
every three hours until change. 

CONFLUENT SMALLPOX. 

Aconite is indispensable when the fever runs high, and threatens to 
continue, as it usually does in this more malignant form of the disease; 
and it will be necessary to diverge even from other important considera- 
tions, from time to time, (having commenced with the administration of 
this remedy.) to return to it for the purpose of effectually acquiring an 
ascendency over the fever. The alternate administration of Sulphur is 
often necessary when the fever does not appear to be the least modified, 
within two hours after the second dose of Aconite. 

Dose : Six pills in a little water to be given every two hours. 

Mercurius is highly serviceable in confluent smallpox, after the pre- 
vious administration of two doses of Aconite, as above directed, when the 
following symptoms predominate: — Inflammation of the eyes, soreness 
of the throat and nose, offensive breath (salivation,) cough, hoarseness, 
tenderness of the stomach, excessive looseness of the bowels, particularly 
characterized by incessant straining, and, sometimes, bloody evacuations. 

Dose: Six pills in water every two hours. 

Pulsatilla is highly useful in confluent smallpox, characterized by 
the presence of an efflorescence analogous to that of measles, before or du- 
ring the development of the eruption, especially when nausea or vomit- 
ing and marked aggravation towards night, additionally qualify the 
general symptoms. 

Dose: Six pills every two hours. 

Arsenicum should be administered after the second dose of Pulsa- 



ACUTE CONTAGIOUS DISEASES. 541 

tilla, (or even of An timonium-tart, or Ipecacuanha, in the event of nei- 
ther of the others having proved efficacious.) when the nausea and vom- 
iting continue unallayed, especially if the patient complains of excessive 
thirst and dryness of the mouth, the tongue being foul and dark, and the 
prostration of strength severe. Arsenicum is also of great value in cases 
of a hard type, and when livid spots are observed on the skin before the 
eruption is out, or when— other symptoms corresponding — the scabs are 
of a dark brown color and very offensive, more particularly if this man- 
ifestation be further characterized by intense weakness and languor, 
thirst, nausea, or vomiting, with more or less severe pain in the region 
of the stomach,— or, again, when the fever assumes a putrid typhoid 
character. 

Dose: Six pills every two hours, in water. 

Curbo-vcg. should be admistered when the eruption assumes a 
gangrenous appearance; or when the pustules are thin and unhealthy, 
and the scabs and incrustations are of a dark brown color, and emit a 
very offensive smell. 

Dose : As directed for Arsenicum. 

Acidum-muriaticum may be employed with great advantage in 
cases of a bad type, in which the fever assumes a typhoid character, and 
when the patient exhibits a continual tendeney to sink downwards 
(towards the foot) of the bed. 

Dose: As for Arsenicum. 

China may be advantageously administered against the debility 
resulting from profuse diarrhoea or discharge from the pustules. 

Dose: Six pills every four hours. 

Sulphur is a useful remedy at the maturity of the eruption, and as 
the dr}*ing process is about to set in ; it will often tend materially to 
forward the total disappearance of lingering traces of the disease, as 
well as to overcome any latent mischief which has been left to rankle in 
the system by this virulent disorder. The alternate administration of 
Rhus at this period will be required, if there be aching pains in the back 
and extremities, aggravated towards night, but somewhat relieved by 
motion. % . 

Dose: Of Sulphur, singly, six pills (for adults,) or for young per- 
sons four pills in a wineglassful of water every morning the 
first thing (fasting,) continuing this course for a week; if in alter- 
nation with Rhus., give three globules of either medicine in rota- 
tion, the one six hours after the other, until amelioration or change. 

Check of the Eruption. Bryonia, Antimonium-tart. The 
administration of either of these remedies, according to special indica- 
tions, will become requisite when the eruption is checked, and the chest 
is more prominently affected. 

Dose: Of either remedy, six pills every two hours. 



MODIFIED SMALLPOX— VARIOLOID. 

This is merely a mild description of smallpox, and, as we have before 
said, is the form which the disease generally assumes when it attacks 
those who have been properly vaccinated. We must regulate our treat- 



642 VARIOLOID. 

ment according to the symptoms, being guided in the selection of the 
remedies by the indications before given. 

$ Complications and After-effects of Smallpox. We should 
watch closely, during the progress of the disease, or symptoms of " Inflam- 
mation of the Lungs," or of their enveloping membranes (pleurisy,) and 
the treatment, in cases in which such complications occur, should be 
regulated according to the directions especially afforded under the head 
of those particular maladies respectively. 

Boils, Glandular Swellings, etc. Amongst the many severe 
after-effects of smallpox, we may number glandular swellings and other 
scrofulous affections, developed by the malignancy of the disease, inflam- 
mation of the eyes, boils, etc.. which will be most effectually treated by 
reference to the separate articles devoted to these subjects respectively. 

Cough. In this respect, the reader is recommended to refer to the 
separate article on this subject. 

Asthmatic Affections. Antimonium (Tartar Emetic) is, in the 
generality of cases, the most available remedy in cases of this kind, result- 
ing from the smallpox. 

Dose: Four pills night and morning, until amelioration or change. 

Looseness of the Bowels. China, Phosphorous. China is, in 
the majority of cases, more available when there has previously been 
excessive loss Of animal fluids, especially, if the symptoms assume an 
intermittent character. 

Dose: Six pills in a wmeglassful of water daily, the first thing in the 
morning, until change. 

Phosphorus is, especially, adapted for the treatment of blond sub- 
jects, or of a spare, slender habit of body, and fragile frame, when this 
relaxation continues any length of time. 

Dose : As directed for China. 

Diet and Mode of Life. In these particulars, we should be guided 
by the virulence of the attack ; but, in all instances, the beverages should 
be cold, as a warm diet, and neglect of the precautions before mentioned, 
may convert the mild into the malignant form. Whilst the fever runs 
high, water, or toast and water should alone be allowed; but when the 
affection is going off, mildly nutritious food, such as lean meat, farinace- 
ous food, cocoa, and plain broths, or beef tea, are allowable. In mild cases, 
thin gruel, or farinaceous food, in small quantities, may be allowed 
throughout. Even after recovery, in some cases, it is necessary that the 
patient abstain, for a considerable time, from animal food in a large 
quantity. 

It should not be omitted, that a plain, nutritious, and even generous 
diet, taken in small quantities at a time, and at regular periods (when 
there are no lingering after-effects.) combined with regular habits in other 
respects, and with the bracing effects of the open air, tend greatly to per- 
fect the cure. The general regulations in respect of diet and regimen, 
which apply to other eruptive fevers, or to fevers in general, hold good 
with regard to smallpox. 

It may be remarked that, after recovery from an attack of malignant 
smallpox, the patient's constitution often requires a thorough renovation, 
and that he should, therefore, be put under a course of medicine best cal- 
culated to attain that result. 



ACUTE CONTAGIOUS DISEASES. 543 

HOME MEASURES. In severe cases, when the pustules are very 
troublesome, they may be anointed with Oil of Almonds, or gently sponged 
with tepid water, when they become hard, — or dusted with pure starch, 
when a thin, acrid, or otherwise unhealthy discharge runs from them. 
The hair of the head should be clipped, for the sake of the cleanliness and 
comfort of the patient; and the hands should be muffled, to prevent injury 
to the pustules from scratching. 

11 1 am willing to risk my reputation as a public man," wrote Edward 
Hine to the Liverpool Mercury, "if the worst case of smallpox cannot be 
cured in three days, simply by the use of Cream of Tartar. One ounce of 
Cream of Tartar dissolved in a pint of water, drank at in tervals,when 
cold, is a certain, never-failing remedy. It has cured thousands, never 
leaves a mark, never causes blindness, and avoids tedious lingering.'' 

+ ~_ 

CHICKEN-POX. 

Symptoms. A disease, bearing considerable resemblance, in its exter- 
nal character, to smallpox, but differing in its duration, and symptom- 
atically, being considerably milder, generally requiring no medical assis- 
tance, but merely attention to diet, and but rarely becoming dangerous, 
except when it extends itself to the lungs or brain. The fever, however, 
occasionally runs high. 

When this affection attacks an individual, and smallpox is epidemic, 
which is not unf requently the case, it is often mistaken for that disorder, 
but it soon discovers its real character, by the rapidity with which the 
eruption declared itself, the vesicles (in many instances, closely resembling 
the pustules of the smallpox) being generally, fully matured by the third 
day, and the whole eruption disappearing at the end of the fourth or fifth 
without leaving any mark. 

HOMOEOPATHIC TREATMENT. Aconite is required when much 
fever is present. 

Dose: Of a solution of four pills to two tablespoonfuls of water, give 
a teaspoont'ul every six hours, until amelioration or change. 

Coffea is to be preferred when extreme restlessness and anxiety are 
present without a great degree or fever. 

Dose: A solution of four pills, as directed for Aconite. 

Belladonna should be given if the brain become evidently affected. 

Dose: A solution of four pills, as directed for Aconite. 

Antimonium-tartaricum may be given to accelerate the develop- 
ment of the eruption, when it is slow in making its appearance. 

Dose: Dissolve six pills in two tablespoonfuls of water, and give a 
teaspoont'ul of the solution every four hours, until the eruption is 
thoroughly evolved, and the fever subsides. 

Mercnrins may be given when the watery secretion of the vesicles 
becomes converted into thick, yellowish matter, as in the small-pox, and is, 
also, beneficial if strangury be present. 

Dose: Two pills in a teaspoonful of water, every four hours, until 
amelioration or change. 

Check of the Eruption. This should be treated as directed for 
6mall-Pox under similar circumstances, (see page 52) 

Cases, in which this disorder appears with manifestations closely 
resembling many of those which characterize small-pox, may be similarly 
treated, according to the particular indications present. 



544 FEVER AND AGUE. 

CHAPTER XXVIII, 



EPIDEMIC AND ENDEMIC INFECTIOUS DISEASES. 



FEVEB AND AGUB—INTEB3IITTENT FEVEB. 

We have now to enter upon a class of fevers differing essentially from 
those already considered, in possessing a marked character of their own, 
in the simplicity of their form, the periodicity of the different stages, (al- 
though the periods of fever-fits are not necessarily regular,) and the uncer- 
tainty of their duration; at the same time it may be noticed that one of 
the distinctive features of intermittent fever consists in the fact that the 
febrile action does not individually constitute the disease, but appears 
rather as an occasional development of other morbid processes. 

Intermittent fevers cannot be better described than as a compound of 
acute and chronic disease; acute during the continuance of each attack, and 
chronic in the continuance of liability to the attacks. 

Symptoms. These must be classified in three distinctive stages; (1) a 
chill or cold fit, (2) followed by heat, and terminating (3) in perspiration 
more or less profuse; these three stages constitute a paroxysm ; after which 
for a certain period, called the interval or respite, the patient is, generally, 
free from suffering. The fever-fits are characterized by the red deposit in 
the urine. 

These periods are, generally, of definite duration ; but occasionally 
indefinite and irregular. If the paroxysms return at regular intervals of 
twenty-four hours, the fever is termed a Quotidian,— of forty-eight, a Ter- 
tian,— of seventy-two, a Quartan ; even longer intervals have been observed 
between the attacks, as that of seven days, which is somewhat inappropri- 
ately termed an eight-day intermittent fever. If two fever-fits take place 
within each period, the ague is said to be doubled ; as a double Quotidian, 
or Tertian, etc. 

These fevers are sometimes found existing in the simple form above 
noted ; that is, that each fever-fit (as it occurs) assumes the character of 
simple fever; in other instances, however, the fever-fits (as they occur) 
assume the characteristic features of inflammatory or typhoid fever, or of 
complications involving the respiratory or digestive functions respectively, 
etc. The absence of continuity, or regular process to a crisis will then iden- 
tify the febrile symptoms as appertaining to this class in general, whereas, 
the peculiar implication of particular organs will qualify the specific char- 
acter of any particular variety. 

They are exceedingly indefinite in duration, and frequently assume a 
tediously chronic form. An individual once attacked with ague, is fre- 
quently liable to a return of it in after life, if the disease has not been rad- 
ically extirpated in the first instance; nay, more, any attacks of disease to 
which he may afterwards be subjected, are peculiarly apt to assume the 
intermittent form. 

Ague is rarely dangerous in this country, except when of long contin- 
uance, and then, owing to the weakness which it occasions, and the injury 



EPIDEMIC AND ENDEMIC INFECTIOUS DISEASES. 545 

which it inflicts upon the constitution ; it may, however, lead to obstruc- 
tions and indurations of the more important organs, particularly of the 
liver and spleen, or may induce dropsical affections. 

It should not be omitted, however, that the sudden development of 
eculiar symptoms in connection with the fever-fits, may be more or less 
ominous, and should be watched and treated with especial care. Some- 
times, however, intermittent fevers appear (as a wholesome crisis) in the 
last effort of the constitution to expel morbid humors, which have long 
preyed upon the system; and in such ease, if treated with due care 
(which will assist in their development,) they will serve to carry off the 
causes of tedious chronic disorders. 

But in hot climates, or in low, marshy countries, this disease is exceed- 
ingly fatal, in consequence of the brain and its tissues, the lining mem- 
brane of the stomach and bowels, the lungs, and the investing membrane 
of the stomach and bowels becoming affected; in such instances, whe i the 
disease gains ground, the patient loses strength and becomes emaciated; 
every fresh paroxysm entails an increase of suffering, and the perspiration 
fails to relieve; he complains of a sensation of weight in the region under 
the false ribs, particularly the right, with griping pain in the bowels, flatu- 
lent distention of the belly, looseness of the bowels or constipation, and 
constant thirst ; or of headache, cough, and shortness of breath ; the tongue 
is furred, and dry at the tip ; the skin hot, harsh, and dry ; the urine scanty, 
the belly tumid, the extremities become dropsical, and sleep is restless or 
broken. 

Death may ensue from collapse in the cold stage, from the absence of 
perspiration, and from the disease passing into continued or remittent 
fever, or from disorganization of some important part, such as the brain, 
lungs, spleen, or liver. 

AVe shall now proceed to a general consideration of the three stages of 
the disease, premising that the various modifications of the symptoms will 
be found more in detail, under the medicines when we enter upon the 
consideration of the remedial treatment. The symptoms wmich precede 
the chill are a sense of languor, or general uneasiness; yawning, headache, 
stupor, pains in the limbs or back ; the toes and fingers becoming numb, 
and the nails blue. These are followed by the following, which belong to 
the fever stage. Coldness of the extremities, with a feeling as of a stream 
of cold water running down the back, and extending itself to the chest 
and belly; general prostration of strength, insupportable coldness, exter- 
nal and internal tremors, chattering of the teeth, respiration labored and 
hurried, with inability to draw a full inspiration, and oppression at the 
chest. The head is variously affected, sometimes with headache, at others 
with drowsiness, stupor, or delirium; the pains noticed in the premoni- 
tory symptoms are generally present, and, in some instances, the patient 
complains of pain all over ; the tongue is moist, the eyes are heavy and 
sunken, the features pinched, and the lips and cheeks livid ; the rigors 
sometimes run on to convulsions. 

The pulse is weak and oppressed, sometimes slow, at others quick and 
frequently intermitting, and often, from the severity of the rigors, scarcely 
perceptible. 

The heat of the body, except at the extremities, is generally above the 
natural standard, while the patient complains of cold. 

35 



616 FEVER AND AGUE. 

Sometimes the patient feels only a slight degree of cold, without tre- 
mors, but accompanied with symptoms of functional derangement, and 
in a few hours the hot fit declares itself. The duration of the cold stage 
is from an hour to four hours; and it runs without any marked interval, 
into the hot stage, which presents all the characteristics of a modified 
inflammatory attack, with hot dry skin, and thirst, oppression at the 
chest, hurried and anxious breathing, and acute pains in the head, regions 
of the spleen, liver, etc.; there is also occasionally a degree of disturbance 
about the brain, or even delirium. 

The general duration of the hot fit is from four to twelve hours, when 
it terminates in the sweating stage; when this does not take place, it is 
apt to run on to continuous fever, or take the form of a remittent, a not 
uncommon issue of this disease in warm climates. 

After the hot fit has continued a longer or shorter period, profuse per- 
spiration sets in, commencing in the forehead and extremities, and quickly 
diffusing itself over the whole body; as soon as it makes its appearance, 
the uneasiness and other symptoms begin to disappear, and the patient, 
in simple ague, continues free from suffering until the next paroxysm. 

Causes. Marshy districts are noted as being the hotbeds of this mal- 
ady ; the presence of stagnant water in the immediate vicinity of dwel- 
lings will provoke it; as occasionally, also, conditions which will engen- 
der low typhus ; the continued prevalence of epidemic disorders may also 
be cited amongst the causes of intermittent fever; a continuance of fish or 
farinaceous diet is also apt to produce it; it may, moreover, arise from 
taking cold, indigestion, internal obstructions, the presence of inactive 
humors which oppress particular organs, from peculiar constitutional ten- 
dency or the like, occasioned by acute diseases, or by difficult chronic 
affections, or even from purely local irritation. 

Nervous or inflammatory fever may change into an intermittent, or 
the latter take upon itself, if it continue, the character of either of the 
two former, or become remittent ; this frequently happens in hot cli- 
mates 

The medicines should generally be administered in the interval 
between the paroxysms but when these are extremely short, or when 
they are attended with after-pains of the preceding paroxysms, they should 
be administered when the sweats, or other concluding features of the 
attacks, begin to subside. 

ALLOPATHIC TREATMENT. The principles of treatment of inter- 
mittent fever may be briefly given as follows : When there is violent 
derangement of the functions of the bowels, or in cases of long standing 
intermittents, it is well to begin treatment with a cathartic. In the for- 
mer condition a healthy action of the bowels is to restore, and, in the 
latter case, a cathartic unloads from the intestines and intestinal glands 
the accumulated diseased secretions, and leave the intestinal tract free and 
active to absorb the anti-malarial remedies. 

If, however, there is not time to move the bowels, and get the system 
under the effect of the antimalarial remedies, time ought not to be lost by 
waiting for the action of a cathartic, but the specific treatment should be 
begun at once. Two to four Compound Cathartic Pills, or such other lax- 
atives as will move the bowels thoroughly without being severe, may be 



EPIDEMIC AND ENDEMIC INFECTIOUS DISEASES. £47 

used equally as well. The Calomel has no special application beyond its 
action upon the upper part of the intestine as a cathartic. An efficient 
cathartic for this purpose is five grains of Calomel with half a grain of 
Resin of Podopl^ilum, followed in six hours by a Seidlitz Powder or a 
tablespoonful of Citrate of Magnesia or Castor Oil (the oil mixed with an 
equal part of Glycerine and flavored with Oil of Cinnamon or Winter- 
green). 

The remedies which act with complete certainty against this disease 
are the preparations of Peruvian Bark, preferably the Sulphate of Quin- 
ine. The system cOmes fully under the effect of Quinine in five or six 
hours after it is taken. It is a point in the proper treatment that a suffi- 
cient quantity of the remedy be given before six hours of the time of the 
next expected paroxysm, to thoroughly affect the system. To do this, a 
safe and effectual plan is to give ten (10) grains of the Sulphate of Quin- 
ine as soon as the fever of a paroxysm has passed, and another dose of ten 
(10) grains six hours before the time of the next expected paroxysm. A 
better effect is obtained by giving with the Quinine on this plan an 
eighth to a quarter of a grain of Morphine. The Quinine may be given 
in black coffee, with chocolate and sugar, or licorice and sugar. One of 
the nicest ways of giving Quinine is to envelop the powder in a moist- 
ened medicine wafer when it is easily swallowed. It may be, also, given 
in capsule or in Gelatine or Sugar Coated Pills. 

These pills should always be examined before purchasing, by cutting 
one of them open with a knife to see that the interior is fresh and soft. 
Quinine is most active when given in solution. This is effected by 
adding to a mixture of Quinine and water a minim (drop) of Aromatic 
Sulphuric Acid for each grain of Quinine. Generally, have the acid in 
excess as in the following prescription: Take of Sulphate of Quinine 
forty grains, Aromatic Sulphuric Acid one dram, Water a sufficient quan- 
tity to make four ounces. Mix. Each tablespoonful contains five grains 
of Quinine. If this mixture is used chewing a little licorice or choco- 
late until the mouth is well coated just before taking the mixture, will 
mask the taste of the Quinine. If taken in some of the previous ways 
the efficacy of the Quinine will be increased by a dose of Aromatic Sul- 
phuric Acid (two or three times as many drops as there were grains of 
Quinine) taken diluted in sufficient sweetened water to make a pleasant 
drink. 

If sufficient Quinine is taken to produce a ringing of the ears before 
an expected paroxysm, that paroxysm will, in all probability, be pre- 
vented. Other plans of administering this drug are: in doses of three to 
five grains, from two to four hours apart, until the ringing of the ears, deaf- 
ness or roaring in the head (called cinchonism) is produced. It is, also, 
an effectual plan. 

The tendency of the disease is to recur at its regular periodical periods 
—the third, fifth, and seventh days. After a week has passed, the tendency 
of the disease, generally, is to return every seventh day until three or four 
septenary (seventh day) periods have passed. It is advisable, therefore, to 
continue the use of the Quinine in daily quantities of three to five grains, 
until ten days have passed ; but on the seventh day, or late in the sixth day 
a full dose of ten or fifteen grains should be taken, and every seventh day 



518 FEVER AND AGUE. 

thereafter, until four septenary periods have passed. Even then it is not 
safe to abandon the use of the remedy unless the patient has become strong 
and hearty. 

It should be remembered, that the remedy is just as effective against 
the next seizure, if given during a paroxysm, as if given during the inter- 
val, so that if paroxysms occur with great frequency, no delay ought to be 
allowed before giving the remedy, but it should be given at once. If only 
six to twelve hours can elapse before an expected seizure, twenty grains of 
Quinine ought to be given in two doses in the latter case, and fifteen or 
twenty grains in one do-°-« in the former. 

Ten grains of Quinine possess a greater anti-periodic effect, if given 
at one dose than twenty grains given in small closes at short intervals dur- 
ing the intervals between paroxysms. 

Other preparations of Peruvian Bark are effective, given in the same 
way, but less so than Quinine. Quinidia, Cinchonidia, Cinchonia, the two 
latter have the advantage of being cheaper than Quinine. The Precipi- 
tated Extract of Bark (Chenoidine) given in double the quantities of Qui- 
nine is, also, efficient, and very cheap. The Cincho-Quinine is, also, an 
effectual remedy, is less bitter than Quinine, and costs about one-third less. 
The impure alkaloid of Quinine is comparatively tasteless, especially when 
mixed in three-fifths its quantity of Tannin— sugar may be added— and 
taken in powder, dry on the tongue, and swallowed with a drink of water: 
or the Tannate of Quinine may be given in a similar way, and is compara- 
tively tasteless. The dose is one-third more than the Sulphate of Quinine. 
All these preparations, not taken in solution, should be followed by a dose 
of Aromatic Sulphuric Acid, as directed above under the directions for 
Quinine, as soon as the mouth is fully freed of the medicine. 

When a tonic effect of Bark is needed, the other preparations are 
generally to be preferred to Quinine. The dose for this purpose is gen- 
erally two or three grains three times a day. In case they are used in this 
way, it is generally advisable to give an anti-periodic dose of Quinine at 
the weekly periods, as before mentioned. 

In all cases where ague has existed for some time, the blood has be- 
come impoverished, — of poor quality — the patient is ansemic, and requires 
the use of Iron. It is advisable to give it in connection with tonic doses 
of some of the preparations of Bark. The Citrate of Iron and Quinine 
or Cinchonidia in doses of from three to five grains, generally meets the 
required indication. The Sulphate of Cinchonia may be given in pills 
with Iron as follows: Take of Sulphate of Chinchonia a dram, Reduced 
Iron half a dram. Make into thirty pills. 

Dose: Take one three times a day. 

The other Alkaloids of Bark, and the Precipitated Extract of Bark 
may be used instead of the Sulphate of Cinchonia. 

Other Salts of Iron, as the Dried Sulphate of Iron, may be used 
instead of the Reduced Iron. The Muriate Tincture of Iron, is one of the 
best preparations of Iron in these cases in doses of fifteen or twenty 
drops given in sweetened water three times a day, or other preparations of 
Iron may be used alone, in which case the tonic doses of the preparations 
of Bark should be given separately. In some eases I have found the 
Citrate of Iron and Strychnine in doses of two or three grains three times 
a day, a most useful tonic. 



EPIDEMIC AND ENDEMIC INFECTIOUS DISEASES. 549 

Other medicines sometimes have to be resorted to in the cure of ague, 
from force of circumstances, or other causes. 

The one most useful after the preparations of bark is Arsenic. The 
most eligible form for giving this remedy, is in Fowler's Solution, (taste- 
less Ague Drops). It is not very suitable as a sole remedy against ague, 
but if given for this purpose, the dose is ten or fifteen drops in water, 
three times aday after meals, when given as the sole cure for ague. Puffi- 
ness of the eyelids and watering of the eyes may be disregarded, if the 
stomach or bowels do not become disordered, after a few days — three to 
five, according to the susceptibility of the patient — the dose should be 
decreased by two drops each day, until a dose of two drops is reached. 

The most important part which Arsenic plays in the cure of intermit- 
tents, is in the cure of chronic malarial infections, and to prevent relapses, 
when the paroxysms are broken up by the preparations of bark. For this 
purpose it is often combined with tonic doses of bark and Iron, as in the 
following: Take of Quinine a dram, ValleVs Mass of the Carbonate of 
Iron a dram, Arsenious Acid one grain. Make into thirty pills according 
to art. It is advised, however, that the Arsenic be always given sepa- 
rately in the form of Fowler's Solution, (because it may be necessary to 
suspend its use for a time, when the other tonics ought to be continued ; 
another reason, the Arsenious Acid may not be properly mixed in the mass 
on account of unskillful druggists, and, serious consequences might fol- 
low,) and Iron and tonic doses of Bark given, also, separately. The dose 
of Fowler's Solution for this purpose, is three to six drops after meals, 
upon puffiness, or watering cf the eyes, or derangement of the stomach or 
bowels occurring, its use ought to be suspended for two or three days, 
until these symptoms disappear,) and then begun again. Full doses of Qui- 
nine should be given at the septenary periods, as before directed. 

The Sulphate, or Muriate of Berberina and Hydrastia, probably rank 
next to the preparations of Bark, in the cure of intermittents. The dose 
of Berberina is fifteen to twenty grains given in capsules, medicine wafers 
or pills, on the same plan as directed for Quinine, or in five-grain doses 
every three hours, until twenty grains are taken. Hydrastia, which is 
really a Muriate of Berberia, may be given in the same way. It may be 
combined with Iron in pill. Salacin (Alkaloid of Willow Bark,) is some- 
times successful in arresting the paroxysms. Thirty to forty grains 
should be given in the intervals.' Eight or ten teaspoonfuls (even,) of 
common salt, taken with intermission, will often arrest the disease. Ten 
drops of Nitric Acid in a glass of sugar and water taken every six hours 
will sometimes succeed. The Hydrochlorate of Ammonia a dram between 
paroxysms, will often arrest the disease. The Carbazolate (Picrate) of 
Ammonia in doses of a quarter to half a grain in pill three times a day, is 
an old remedy which often succeeds. It can be given in pill. 

Just previous to an expected paroxysm, a hypodermic injection of a 
quarter of a grain of Morphine will often arrest or mitigate it. A full Qose 
of Opium by the mouth is in a less degree efficacious. 

During the hot stage cold drinks and cold bathing may be freely in- 
dulged in. If any medicines are needed in this stage a half a drop to a 
drop of Tincture of Aconite may be given every half hour until the pulse 
and fever is reduced, when its administration should be stopped. Taking 



550 FEVER AND AGUE. 

the bed before the expected chill, covering the body and keeping it warm 
with hot bottles has warded off " the chill." A teaspoonful of Chloroform 
swallowed with mucilage or syrup has prevented the paroxysm. 

The difficulty of effecting a cure, especially in chronic cases, is experi- 
enced by the patient remaining in the malarious district where he is con- 
stantly receiving additional doses of the poison. So that sometimes it is 
necessary for the patient to remove to a locality where malaria is un- 
known. 

The best preventive of ague, aside from removal from the malarious 
district, is frequent doses of Quinine from daily to twice a week of two to 
five grains each, and the use of Iron to overcome the anaemia. The pre- 
judice against taking Quinine for a long time, for fear of injury, is wholly 
without foundation. 

Poisoning by malaria is most apt to occur in the evening, night, and 
early morning. It is obvious, then, that remaining in the house during 
these parts of the day is advisable, preferably in an upper room (it is pro- 
bable that the poison does not rise as high as the second story of a house 
which is high— 10 or 12 feet between joists). It is also claimed that if the 
open doors and windows are closed with fine muslin screens from sunset 
until the dew is off in the morning, the occupants of the house are in no 
danger — the poison cannot pass through these screens. 

The enlarged spleen from ague, will generally yield to the remedies 
which cure the ague. This difficulty is treated of in diseases of the spleen 
(Chap. XY). The ointment of the Red Iodide of Mercury seems particu- 
larly applicable in cases of chronic enlargement. A Belladonna plaster 
worn over the side generally relieves the pain materially. 

The anaemia and dropsy occasioned by chronic ague will be relieved 
by the tonic treatment recommended to prevent relapses. 

In pernicious (congestive or sinking chills) intermittents, no time 
should be lost in giving an anti-periodic, and nothing but Quinine is to be 
relied on. Twenty grains should be given at once, by the mouth, or forty 
grains by injection into the rectum. The dose should be repeated every 
five hours during the intervals, unless marked Cinchonism (ringing of the 
ears) is produced. The patient has, in some instances been kept under 
this effect of the remedy for a long time after the paroxysm has passed; 
subsequent doses after the patient merges from the paroxysm, will vary 
from ten to twenty grains. The hypodermic injection of Quinine is 
sometimes necessary here, and is, in the opinion of the writer, to be always 
preferred. From five to ten grains may be given at a dose : Take of Sul- 
phate of Quinine a dram y Sulphate of Morphine a grain, Dilute Sulphu?Hc 
Acid forty minims, Water one ounce. Mix and filter. A dram contains 
seven and a half grains. The dose may be repeated, given in this way, in 
half the time given by the mouth or bowel. 

Excessive Cinchonism is not necessary, but promptness and intelli- 
gent boldness are necessary for success. Large doses must be given for a 
longer period than for the milder disease, but the treatment is governed 
by the same principles. 

HOMEOPATHIC TREATMENT. In the treatment of ague, the type, 
although by no means to be held as unimportant, is yet of very secondary 
consideration to the other features of the malady. 



EPIDEMIC AND ENDEMIC INFECTIOUS DISEASES. 551 

China or Quinine. This well-known, but too frequently abused 
remedy, is of great efficacy in those fevers which owe their origin to the 
influence of marsh miasm, and are peculiarly prevalent at particular 
seasons of the year. It may be given when the fever commences with a 
sense of languor, or general uneasiness of the heart, anxiety, headache 
sneezing, great thirst, craving hunger or nausea, and pain in the bowels. 
It is, also, indicated when the fever has set in with absense of natural 
thirst— during the cold stage— but thirst is experienced after the heat and 
during the sweating, or thirst between the hot and the cold stage, and 
when the chill and fever are followed by a copious sweat. It is contra- 
indicated when thirst exists during the hot stage. Turgidity of the veins, 
with heat in the head, and natural warmth, or increased heat of the body, 
with or without increased heat of the surface. Or, again, determination 
of blood to the head, commonly with redness and heat in the face, with 
chilliness of all the other parts of the body, and even external coldness 
or only a feeling of internal heat in the face, with coldness of the cheeks 
to the touch, and cold sweat on the forehead, are further indications for 
the employment of this remedy. In many cases, China, although not capa- 
ble of effecting a radical cure, is yet of great utility as a palliative; it 
should, under such circumstances, be exhibited immediately before the 
cold stage. In such instances, the consecutive treatment should be adapted 
to the remaining or supervening symptoms. 

Dose: Of China, four drops in a teaspoonful of water every hour in 
the interval between the fever-fits— the same dose being repeated as 
the symptoms occur in like manner. When directly specific, how- 
ever, a single dose of this medicine will generally remove the fever. 
Of Quinine, one grain in the same intervals. 
Lobelia. This remedy promises to be of equal efficiency with China 
in the treatment of ague, and may be particularly selected, in many 
instances, even in preference to China; but in the majority of cases which 
appear to indicate the latter remedy, when that, however, has been pro- 
ductive of only temporary relief, and particularly when derangement or 
foulness of the stomach is present. 

Dose: Of a solution of ten pills to four tablespoonfuls of water, give a 
teaspoonful every three hours, until amelioration or change; or a 
dose in the like proportions, two hours before the anticipated return 
the attack. 
Arsenicum is one of the most important remedies in intermittent 
fevers. It is indicated when the different stages are not definitely marked, 
but the fever and heat and shivering appear simultaneously — or when we 
find cold shuddering alternately with heat, or a sensation of cold internally, 
with heat, or an imperfect development of the paroxysms; or burning heat 
as if molten lead were coursing through the veins, communicating an 
unpleasant sensation of heat to the hand, when placed upon the body of 
the patient; great restlessness; excessive, almost insatiable thirst, oblig- 
ing the sufferer to drink constantly, although but little at a time; depres- 
sion, marked prostration of strength, and anxiety; nausea, desire to vomit, 
retching, and even vomiting; severe and burning pains in the stomach, 
and insupportable pains all over the body, especially, in the limbs. One 
marked characteristic of Arsenicum is, that all the sufferings of the 
patient, pains in the limbs, etc., increase in intensity during the parox- 
ysm, and others develop themselves ; another is, its marked periodicity, 



552 FEVER AND AGUE. 

generally, either Tertian or Quartan, and the rigors generally setting in 
towards evening. It, is, therefore called for in these cases, where we meet 
with a well-marked periodicity of imperfectly developed paroxysms, with 
some, or any of the symptoms above mentioned. It is the remedy when 
large doses of Quinine have been used with no good result. 

Dose : Six pills in a tablespoonf ul of water; administer during the inter- 
val between the fever- fits, three doses, as often as they continue to 
recur. Or in cases of the continuance of the cold fit, or exhaustion 
so severe that the patient is unable to rally, even during the inter- 
vals,— of a solution of twelve globules to three tablespoonf uls of 
water, give a teaspoonful at intervals varying from a quarter of an 
hour to two hours, according to the severity of the case, doubling 
the intervals, or suspending treatment as soon as reaction sets in. 
The thirtieth potency is best. 
Ipecacuanha is usefully employed in the majority of cases of marsh 
fever, at some stages of the disorder, especially, in the earlier periods. 
Some instances occur in which it is sufficient of itself to effect a cure ; in 
other instances, it is most successfully followed by other and appropriate 
remedies, or coupled with Nux-v. in particular. It is indicated by the 
following symptoms: much shivering, with but little heat, or vice versa ; 
increase of the shivering by external warmth ; oppression at the fore part of 
the chest; want of natural thirst, or at least, little thirst; dryness of the 
mouth, nausea, vomiting, and other symptoms of deranged digestion. 
Dose: As directed for Lobelia. 

Nux-vomica is, especially, indicated by excessive weakness at the 
commencement of the fever; the shuddering mixed with or immediately 
followed by heat ; warmth of the cheeks, with internal chilliness; feel- 
ing of heat in the face, with shuddering in the remaining parts of the 
body ; heat in the head, with coldness of the body ; burning pain in the 
eyes; or giddiness, with feeling in the head as if from intoxication, desire 
to lie down, with trembling of the limbs; fainting, or a sensation 
of paralytic weakness and prostration, with cramps in the different 
extremities, particularly the calves of the legs and feet; difficulty of 
breathing, palpitation of the heart, anxiety, irascibility, fear of death and 
even violent delirium ; derangements of the alimentary organs, such as 
want of appetite; dislike to bread ; bitter and sour eructations, tension of 
the belly, or spasms of the muscles in that region, and constipation ; burn- 
ing, itching miliary eruption, and burning itching sensation over the 
whole body. During the fever: coldness and blueness of the skin, desire 
to be constantly covered, even during the access of heat and perspiration; 
occasionally stitches in the side, shooting pains in the belly, aching in 
the back and limbs, and dragging pain in the belly during the rigors. 
During the hot fit particularly: headache, buzzing in the ears, heat in the 
head or face, with redness of the cheeks, and thirst. 
Dose : As for Lobelia. 

Pulsatilla, like the two medicines last mentioned, is an excellent 
remedy in agues complicated with the stomach or bilious symptoms, 
whenever the slightest attack of indigestion brings on a relapse. Its 
more peculiar indications are vomiting of phlegm at the commence- 
ment of the cold stage; want of natural thirst, all through the fever, or 
thirst, only during the hot fit; simultaneous heat and shivering, aggra- 
vated in the afternoon or towards evening; shivering when uncovered; 



EPIDEMIC AND ENDEMIC INFECTIOUS DISEASES. 553 

anxiety and oppression of the chest during the shivering. During the hot 
stage, redness and swelling of the face, or redness of the cheeks only, and 
perspiration on the face. The presence of diarrhoea, and the patient being 
of a mild disposition, are corroborative indications for its employment. 

Dose: Six pills every four hours. 

Cedron, Chills regular and very severe, with cramps, and tearing 
pains in upper and lower extremities. Dry heat, followed by profuse per- 
spiration. Numb, dead feeling in legs; they feel enlarged. The entire body 
feels numb. This remedy is especially serviceable in the intermittents of 
semi-tropical countries. 

Dose : Ten drops in one-half glass of water. Teaspoonf ul every two hours. 

Belladonna. Severe headache, with giddiness, or heat and redness 
of the face, pulsation of the large blood-vessels of the neck, and excessive 
aggravation of pain from meditation; partial shivering and shuddering, 
with heat in other parts; great heat with slight shivering; or violent 
shivering with moderate heat; absence of natural thirst, or, on the con- 
trary, intense thirst ; extreme susceptibility, tearfulness, or depression of 
spirits, and desire for death, particularly when the sufferings are at their 
hight. 

Dose: Pour pills in a teaspoonf ul of water every three hours, during 
the first interval which occurs after treatment has been undertaken 
and afterwards at lengthening intervals. 

Ignatia is indicated, when, with heat of some parts of the body, there 
is coldness, chill, and shuddering of others; also where the heat is only 
external. Its best characteristic is, when the chills are easily relieved by 
external warmth, and attended with thirst. 

Dose : As for Bryonia. 

Apis. Violent headache, amounting almost to unconsciousness ; pain 
in the limbs and all over the body, thirst more during the heat; sensitive- 
ness at the pit of the stomach ; scanty urine and swollen feet. Chill about 
four p . m. 

Dose : As directed for Ignatia. 

Xatrum-m. is especially advantageous, for cases which have been 
mismanaged with excessive doses of Bark or Quinine, particularly as fol- 
lows: Ague-fits, commencing with headache, general aching pains, predo- 
minant or prolonged shivering, great thirst during the hot fit, and nearly to 
the same extent during the cold stage; also, dryness of the mouth and 
tongue; tenderness of the pit of the stomach to the touch ; bitter taste and 
loss of appetite; debility; sallow complexion; soreness of the corners of 
the mouth. 

Dose: Six pills in a teaspoonful of water every four hours, the first 
interval after treatment is undertaken, and three hours before the 
return of every attack, until amelioration or change; and afterward 
at longer and longer intervals. 

Carbo-vegetabilis is particularly indicated, when throbbing at the 
temples, aching in the teeth, and in the bones of the extremities, and the 
coldness of the feet precede the paroxysm ; when thirst is present only dur- 
ing the shiverings, and there are rheumatic pains in the teeth or limbs 
before or during the attack; or nausea, giddiness, and redness of the face 
during the hot fit; further, when an intense, burning pain, occupying the 



554 INFIiAMMTORY FEVER. 

prominent part of the forehead and the eye on the right side accompanies 
the fever. Where Quinine has failed, this is another excellent remedy 
Dose : As for Natrum. 



INFLAMMATORY FEVER-SYNOCHIA. 

Diagnosis. Rigors (chills) — generally considerable — followed by 
burning heat; pulse strong, hard, and greatly accelerated ; dryness of the 
skin, mouth, lips and tongue; the latter generally of a bright red, in 
some cases slightly coated with white ; thirst; urine red and scanty; con- 
stipation ; respiration hurried in accordance with the pulse; amelioration 
of symptoms as the pulse assumes a more normal state. It runs its course 
with rapidity, rarely exceeding fourteen days, and progressing with regu- 
larity to a crisis, which shows itself in profuse perspirations, diarrhoea or 
hemorrhage, principally epistaxis (nose bleeding). The period mentioned 
is its ordinary period of duration, but under careful treatment the perfect 
crisis is considerably hastened and without the long convalescence entailed 
by the usual heroic antiphlogistic treatment. 

It is peculiarly apt, if not carefully treated, to change to typhus, or, 
by mestastasis, to fix upon some important organ. 

Causes. Sudden chill, or check of perspiration, exposure to wet or 
damp winds, or dry, easterly winds, violent emotions, such as grief, joy, 
anger, etc., high living, external injury, local inflammations, and from 
slight attacks of fever mismanaged. 

Individuals of what is termed a plethoric habit are particularly sub- 
ject to this disease ; it mostly attacks between the ages of fifteen and thirty- 
years . 

Under diagnosis we have just now given the symptoms usually present 
in synochia; we, however, find it complicated, in many cases, with cere- 
bral (brain) disturbance which you will find more fully considered under 
Inflammation of the Brain. 

HOM(EOPATHIC TREATMENT. When the symptoms above described 
are present, give at once a dose of Aconite, every two tosix hours,according 
to the intensity of the fever. The pulse should be carefully watched and 
also the appearance, first, of simple moisture of the skin, and afterward, 
of copious sweating, which generally takes place after a few doses of Aco- 
nite. The intervals between the doses must be lengthened as soon as this 
favorable change takes place. 

A slight degree of delirium is frequently present in this affection, 
chiefly at night, which— unless it threatens to run on to inflammation of 
the brain, in which case Belladonna must be given — Aconite of itself is 
sufficient to subdue. When, however, during the course of the disease, 
other important symptoms besides those mentioned develop themselves, 
different remedies, such as Bell., Bry., etc., must be given. 

Belladonna is, especially, useful after the previous employment of 
Aconite ; but it may, also, be employed at the commencement of the attack 
in all cases where the cerebral (brain) system seems most prominently 
affected, and there is great heat in the head, with violent headache, par- 
ticularly in the forehead, and redness of the face; distention of the arteries 



EPIDEMIC AND ENDEMIC INFECTIOUS DISEASES. 555 

of the temples; nocturnal sleeplessness, with furious delirium; eyes red, 
shining and fiery ; general internal and external heat; burning thirst 
and agonizing restlessness. 

Bryonia. When the state of excitement is chiefly confined to the 
organs of the chest (thoracic viscera) or when there is gastric complica- 
tion, and the fever inclines to degenerate into typhus. 

This medicine is accordingly indicated when, in addition to the usual 
symptoms of inflammatory fever already given, we find a heavy stupefy- 
ing headache, with a sensation as if the head would burst at the temples, 
much aggravated by movement, vertigo and giddiness on rising up or 
moving, burning heat of the head and face, with redness and swelling of 
the latter; delirium; oppression at the pit of the stomach; excessive 
thirst, sometimes followed by vomiting ; constipation ; aching or shooting 
pains in the limbs, short cough, oppression of the chest, and laborious 
breathing. 

A dose every three to six hours, according to the urgency of the symp- 
toms. 

Cantharis is good in irritative fever, especially when the following 
symptoms are developed: the fever is very intense during the night, and 
is accompanied by burning of the skin, strong accelerated pulse, general 
redness of the surface, dryness of the mouth, and violent thirst. Fur- 
ther, when pains are complained of in the right side of the body, attended 
with great anxiety and raving. 

Chamomilla is best when the attack is brought on by a fit of anger 
or vexation; present burning heat and bright redness of the cheeks, 
tremulous, anxious, palpitation of the heart, extreme irritability of tem- 
per, and over sensibility of the senses, alternate chill and heat and some- 
times spasmodic attacks. A dose or two of Aconite is generally needed 
in the beginning. 

When inflammatory fever seems to arise from a primary inflamma- 
tion of some important, organ, such as head, lungs, liver, stomach or bow- 
els, the appropriate treatment will be found under the title ''Inflamma- 
tion of Head, Lungs, Liver," etc. 

Bryonia is indicated by headache and giddiness, with dry heat pre- 
ceding the attacks of shivering; by the predominance of cold or shiver- 
ing, with redness of the cheeks, heat in the head, and headache; or 
marked heat, followed by shivering; by stitches in the side, excessive 
thirst, thickly coated tongue, bitter taste in the mouth, disgust at the 
sight of food, nausea or vomiting, and constipation, especially in the case3 
occurring in the spring. 

Dose: Six pills in a tablespoonful of water every morning, or as nearly 
at that period as possible, during the interval between the attacks. 



TYPHOID FEVER-TYPHUS— FEVER— ENTERIC FEVER. 

Typhus occurs in two forms that do not differ much from each other, 
namely: abdominal typhus and exanthematic typhus. More recently, 
this last-named form has become much less frequent than the former. In 
spite of these differences, the description of both forms is pretty much the 



556 TYPHOID FEVER. 

same; up to this period, we have not succeeded in discovering the reason 
for the appearance of either one or the other form. 

Typhus originates in some infectious agent ; all that is known of this 
agent is: that it is caused by the decomposition of animal substances. 
Hence, typhus occurs most frequently where the decomposition of ani- 
mal matter is most favored by circumstances, namely : in large cities and 
hospitals; likewise, in localities which are least favorably situated for 
carrying away the products of decomposition, such as cities built in a flat 
country and with imperfect drainage. The infectious principle at times 
seems to act with great intensity; at other times very mildly, so that 
typhus in crowded localities sometimes breaks out with an extraordinary 
virulence; and other times with comparative mildness. According to all 
probability, a graduated difference of this kind is chiefly owing to the 
quantity of the infectious agent that acts upon the organism, not to its 
quality. The contagion is reproduced by the patient. We cannot share 
the views which prevail concerning the formation of a contagion. We 
do not consider any form of typhus contagious. An apparently conta- 
gious transmission of typhus only takes place among those who have 
been for some time exposed to the emanations from the infected individ- 
ual, not among those who have only been in contact with the patient for 
a short period of time These remarks apply to exanthematic typhus, 
which is considered as decidedly contagious, but which only appears so 
for the reason that it produces a larger quantity and a more infectious 
quality of contagious matter. Physicians in private practice are seldom 
attacked, notwithstanding they are brought in closest contact with the 
patients when exploring their chests; hospital-physicians and nurses, on 
the contrary are taken down very often. More recently the level of the 
surface-water has been more particularly examined with reference to 
typhus and cholera; a high level is supposed to favor the breaking out of 
these plagues. We are still without any reliable data in this respect. In 
large cities the construction of wells and water-closets deserves great at- 
tention; where both are so close together that the well-water can be con- 
taminated by the contents of the closets, typhus is very likely to occur. 
This subject is, without doubt, worthy the most serious attention of the 
board of health, for typhus is not only one of the most dangerous, but 
likewise, one of the most frequent diseases. 

A few points can easily be inferred from what we have said, such as: 
epidemic and endemic, slightly endemic and sporadic type of typhus; 
breaking out of typhus in very damp and hot years, during the hot months 
of the summer and in the fall; likewise, in crowded hospitals, more par- 
ticularly, if they are full of wounded soldiers; or in densely populated 
streets, tenement-houses, on ship-board, etc. Typhus occasioned by an 
insufficient supply of food, or by unwholesome and deteriorated food, is 
less easily accounted for. 

One attack of typhus does not always, but very generally, protect 
against a second attack. There are certain other circumstances that 
almost positively preclude the possibility of typhus, especially, abdominal 
typhus ; these are : Intermittent fever, consumption, cancer, heart-disease 
of the higher grade. Age does not establish any positive lines of demar- 
cation; except infants, persons of any age may be attacked, but more par- 



EPIDEMIC AND ENDEMIC INFECTIOUS DISEASES. 557 

ticularly young people and individuals up to the age of fifty. Vigorous 
constitutions are more easily attacked, and likewise more severely. 

Exciting causes are: Fear and anxiety; a sudden change of diet 
when persons settle in a locality where typhus is endemic; catarrh of the 
intestines; mental depression, both by excessive mental labor as well as 
by care and grief. 

Symptoms and Course. In abdominal typhus, the ulcers in the intes- 
tines act the most important part; they have even given rise to the name of 
this form of the disease. However, it behooves us to premise the statement 
that in their various phases, these ulcers do not correspond with definite 
phases in the total course of the disease. 

Except these two almost constant phenomena, typhus does not offer 
any permanent, characteristic signs. The brain, especially, remains unal- 
tered; the lungs, on the contrary, show at first, symptoms of irritation; 
afterwards pneumonia. During the first weeks of the disease, the mus- 
cles have a somewhat characteristically dark color, and the internal sur- 
face of the arteries has, likewise, a dark-red appearance. In exanthem- 
atic typhus, the intestinal ulceration does not exist, whereas, in this form, 
likewise, the spleen is considerably hypertrophied and softened, and the 
vessels, also, have a bright appearance as if injected. 

Abdominal typhus very rarely breaks out suddenly; it is, generally, 
preceded, for a few days, or even a week by indefinite symptoms, such as 
lassitude, indisposition to work, loss of spirits, impaired appetite, very 
seldom hunger, almost bordering upon a voracious desire for food; wander- 
ing rheumatoid pains in the limbs, especially in the back, headache of the 
indeterminate type, sleep full of dreams. 

The disease is generally ushered in by a chill of moderate violence, or 
by a marked fainting sensation, which is soon followed by the character- 
istic feeling of illness, namely: an inability to stand erect or move about, 
and a desire to lie down. Very seldom one of these conditions is entirely 
wanting, so that it is difficult to point out the real beginning of the disease ; 
instead of one severe chill, we often meet with a succession of very feeble 
chills. The disease now developes itself in the following manner: The 
patients feel weak, have neither the strength nor the desire to rise from 
their beds; headache, at times more frontal; and at other times, in the 
more violent cases, in the occiput, throbbing and very distressing; com- 
plete loss of appetite ; altered, generally pasty taste ; vomiting not very- 
frequent; bowels quite torpid in the first week; restless sleep ; when 
waking early in the morning, the patients commence very soon to com- 
plain of phantasms whifch they cannot avoid; yet they talk very ration- 
ally and are perfectly conscious of seeing phantasms. The pulse is gener- 
ally full, very seldom exceeding one hundred beats, very often dicrotic 
(double or rebounding,) the temperature is high, the skin feels burning 
hot. The breathing is almost constantly hurried, anxious, the patient 
talks hurriedly, yet is able to take a long breath. The spleen is generally- 
swollen, the swelling increasing rapidly in size, and is not un frequently- 
painful. The abdomen does not show any constant alterations, but when 
pressed upon, the patients complain of pain in this region, and a gurgling 
sensation is communicated to the finger, with which the pressure is made. 
The tongue is at times coated very thickly, at other times it only has a 



558 TYPHOID FEVER. 

whitish coating, and again it looks quite clean, but the coating changes as 
the disease progresses. Sometimes the patients complain of a little hack- 
ing cough, and exhibit symptoms of a slight bronchial catarrh. The urine 
is less in quantity, saturated, notwithstanding that the patients often 
experience a very violent thirst. All these symptoms remain in force 
only in very violent cases ; most generally a sensible remission of these 
symptoms takes place towards the end of the first week. 

Second Week. In the second week the symptoms of the disease 
undergo a marked change, unless the morbid process takes a turn towards 
recovery, which is very seldom the case. For the present, we only speak 
of typhus of a moderately severe type. In this stage, the patients lose 
their consciousness more and more; they are either lying in a state of 
lethargic apathy, or else it is only with great difficulty that they are able 
to reply to questions, or to give utterance to their own ideas. In the even- 
ing and during the night, this soporous prostration is generally interrupted 
by a state of nervous exaltation, during which the patients manifest their 
internal nervousness by animated talking, or by constant endeavor to 
escape from their beds. Sensations of pain now cease entirely; when 
asked how they feel, they answer: " Quite well." They express no desire 
for drink, but they swallow the offered beverage hurriedly and greedily ; 
when repeatedly asked to do so, they put out their tongues slowly and 
tremulously, and forget to draw them in again. 

Another evidence that the influence of the brain is almost entirely 
suspended, is, that the patients persevere for a long time in an uncom- 
fortable position, and that they allow the urine and feces to escape into 
their beds. 

At the beginning of the second, and very frequently already at the 
end of the first week, the patients complain of a violent buzzing in the 
ears, afterwards they are evidently hard of hearing. Corresponding with 
these changes, the countenances of the patients become altered. Although 
the complexion seems to shine, yet it has a livid hue; the eyes stare, or 
they have a vague and unsteady expression ; when raised in their beds 
the patients at once turn pale and look as if they would faint. The vari- 
ous functions show the following deviations from their normal condition : 
The pulse is seldom below one hundred, nor is it often above one hundred 
and twenty, it is weaker than usual and sometimes dicrotic. The tongue, 
which already showed a good deal of dryness in the first week, now is 
constantly dry; the streaked coating, which had marked it hitherto, now 
vanishes ; it shows a peculiarly red color, and the papillae seem to have 
become effaced; towards the end of the second week the tongue appears 
covered with a brownish incrustation. The appetite is entirely wanting, 
yet the patients will taste of what they are offered to eat. They do not 
seem thirsty, yet they drink greedily the proffered beverage. At this 
stage the abdomen begins to bloat quite considerably ; when the ilioccecal 
region is pressed upon very hard, the patients distort the corners of their 
mouths. Diarrhoea now usually sets in, from four to eight passages tak- 
ing place involuntarily every day. They have a yellowish color, deposit 
a sediment of thick consistence over which floats a watery, opalescent sub- 
stance. The urine is secreted in smaller quantities, it is dark and is fre- 
quently voided involuntarily; sometimes it is retained altogether, so that 



EPIDEMIC AND ENDEMIC INFECTIOUS DISEASES. 550 

the b. adder becomes very much distended. The respiration is still accel- 
erated, yet the peculiar hurried breathing of the first week is scarcely 
yet perceived ; catarrhal symptoms are likewise discovered, although the 
patients scarcely ever cough and only rarely bring: up a tenacious, yel- 
lowish mucus. The spleen continues to enlarge, although owing to dis- 
tention of the bowels, and the consequent displacement of the spleen 
upwards, the enlargement cannot well be discovered by examination. 
Upon the abdomen, thorax and back, roseola-spots break out in greater 
or less number, some of which are usually present at the end of the first 
week. 

About the middle of the second week all these symptoms generally 
show an increase, less frequently a remission ; both the increase and the 
remission are, however, of short duration. 

Third Week. In the third week, especially at the commencement, 
the symptoms continue to increase in intensity. The patients are now 
lying in a state of complete apathy ; in the day-time they are only slight- 
ly delirious, but during the night the nervous exaltation is much worse, 
attended with grasping at flochs. The prostration is so great that the 
patients are no longer able to sit erect; they are constantly lying on their 
backs, and the body, yielding to the law of gravitation, settles from the 
pillow downwards towards the middle of the bed. The tongue is only 
slowly protruded after loud and repeated requests ; it is quite dry, with a 
brownish coating, which is likewise exhibited on the teeth and at the 
nostrils. Deglutition is very difficult, and it is only with a great effort 
that the patient is able to swallow very small quantities of liquid at one 
time. The diarrhoea continues, but the passages are generally less copi- 
ous, and not unfrequently tinged with blood. The urinary secretions 
continue to decrease and paralysis of the bladder is not an unfrequent 
occurrence. The abdomen is greatly distended and is no longer sensitive 
to pressure. The other symptoms continue unchanged, except that the 
roseola-spots pale off and become complicated with miliaria (measle-like) 
and sometimes with ecchymoses (black-like bruised place). Bedsores are 
now very apt to torment the patient. Emaciation proceeds very rapidly, 
and the whole appearance is that of a general collapse. Up to the middle 
of the third week, the fever maintains its intensity. In cases where the 
disease continues during the fourth week no remission of the fever is per- 
ceptible. In most cases, however, the seventeenth day is characterized 
by a sudden abatement of the fever and of most of the other derangement 
of the functions. This improvement at times is only apparent, as in a 
few hours the symptoms again exacerbate; but at other times it is a real 
improvement marking the beginning of recovery If the patients die, it is 
most generally at this period; the remission just alluded to, when followed 
by exacerbation of the symptoms, isgenerally looked upon as a fatal change. 
Death takes place with symptoms of paralysis of the heart and lungs. In 
favorable cases the fever remits every morning on the last days of the 
third week, whereas the evening exacerbations decrease in violence, 
the consciousness returns gradually and with it a desire for food and drink. 
At this stage the fever scarcely shows a sudden and considerable decrease, 
with a correspondingly sudden beginning of convalescence. 

With the third week typhus of a medium grade has reached its inten- 



500 TYPHOID FEVER. 

sity in so far as signs of convalescence now begin to show themselves, 
although very slowly. Every case of tyhus out-lasting the third week, 
may be safely regarded as very severe. Except complications take place, 
no new symptoms develop themselves during the fourth and fifth weeks. 
The remissions of the fever are very distinct and grow more decided in 
character; the pulse, on the contrary, increases in weakness and frequency. 
The patient looks as if he were in a state of terrible collapse ; occa- 
sionally threatening paroxysms of collapse really take place, more partic- 
ulary in the night; in the latter course of the disease, such paroxysms 
are, however, not as dangerous as they seem. In the case of adults the 
consciousness usually returns towards the end of the fourth week ; but, if 
the fever continues, delirium is still very frequent towards evening. The 
diarrhoea is at times less than it was, and at other times more profuse ; in 
some cases it now ceases altogether. The skin looks clean, with the 
exception of miliaria here and there. The bed-sores which are never 
wanting during such a protracted course of the disease, grow rapidly in 
extent and malignancy. 

If the fever runs a course of four weeks, recovery takes place very 
slowly. In very fortunate cases recovery goes on uninterruptedly, bu: 
most frequently its course is disturbed by all sorts of accidental inconve- 
niences, such as vomiting after certain kinds of food, or even after any 
kind ; sudden disappearance of the appetite that had just begun to return; 
return or protracted continuance of the diarrhoea; exacerbations of the 
fever. The decubitus, the nature and conduct of which afford an excel- 
lent criterion by which the amount of progress in the recovery of the 
patient can be measured, sometimes causes a great deal of serious trouble, 
provided the final cure of the fever is very much delayed. Death either 
takes place in consequence of the utter prostration of the patient, from 
exhaustion, or from sudden and complete overpowering of the whole of 
the vital powers of the system. 

ALLOPATHIC TREATMENT. The first requisite for the proper 
treatment of typhoid fever is, that the patient shall be in a large room, 
ventilated by means of several windows, that the air may be constantly 
changed by the free entrance of pure fresh air. Disinfection should also 
be constantly practiced. 

The generation of Ozone (active oxygen) constantly in the sick room, 
is very beneficial. This is best done by a mixture of two parts of Per- 
manganate of Potash and three parts strong Sulphuric Acid in a broad, 
open vessel. An invigorating quality is imparted to the atmosphere of 
the room, and is especially beneficial, when, for any reason, the room 
cannot be freely open. Dry scales of Iodine, in a chip-basket, hung over 
the bed, and placed in saucers in different parts of the room, are valuable 
in removing any unpleasant odor in the atmosphere. A few of the scales 
may be vaporized, occasionly, by sprinkling on a hot shovel. 

Another available disinfectant is Carbolic Acid; a few drops may be 
put on wetted cloths which are hung up in the room. The floor may be 
occasionally sprinkled with Labarraque's Solution (Chlorinated Soda). 

The vessels which are to receive the excretions should always contain 
a little of the Solution of Chlorinated Soda, Permanganate of Potash, or 
Carbolic Acid, five or ten drops in water. 



EPIDEMIC AND ENDEMIC INFECTIOUS DISEASES. 561 

It is needless to remark that carpets, curtains, and all unnecessary 
articles, ought to be removed from the room. 

The proper temperature of the room is sixty degrees. 

The bed linen should be changed daily. As soon as it is determined 
that the patient has typhoid fever, the hair should be shingled. 

The most effectual plan for controlling the temperature is, by the use 
of water. Where there are proper facilities for it, the bath is the surest 
and most efficient method for reducing a high fever. The patient should 
be placed in the bath at a temperature of ninety-eight degrees F., and the 
temperature of the water lowered to eighty degrees, or to sixty degrees, 
by the addition ice or of ice water. 

After a time varying from five minutes to half an hour, a marked 
reduction of the temperature is produced, as shown by a thermometer 
placed in the rectum (bowel,) when the patient is removed from the bath, 
wiped dry and placed in bed. For this, a bath-tub is necessary, large 
enough to receive the body, provided with a discharge pipe to convey off 
the extra water, a strong sheet to lift the patient, a thermometer to test 
the temperature of the bath, and a fever thermometer to ascertain the 
amount of reduction in the heat of the patient. 

The most suitable method of applying water in private practice, and 
in families, is, by the use of the cold wet pack. A sheet is wrung out of 
cold water and placed on the bed. The patient is then laid on the sheet, 
with a proper support for his head. Each side of the sheet is then brought 
over the patient and tucked under the opposite side. The legs are well 
wrapped in, and the patient is well covered with blankets. He may 
remain in the pack from ten minutes to an hour. The pack may be 
repeated several times a day, the frequency being determined by the rise 
of temperature. When taken from the pack, the patient is to be wiped 
dry. 

An agreeable, but less effectual plan, is, cool sponging and having the 
cloths dipped in cold water and laid upon portions of the body. 

When there is any tendency to collapse, wet baths should not be 
given. There can be no doubt of a greatly diminished mortality by the use 
of cold baths, the disease pursuing a milder course under their use. 

If, in the use of water, the circulation becomes feeble, the skin blue 
or the extremities cold, stimulants should be given, and bottles of hot 
water placed at the feet. 

The use of the mineral acids is of marked benefit in this disease by 
aiding the gastric secretion and improving digestion and in increasing 
the mucus secretions, and relieves somewhat the dryness of the tongue. 
The Dilute Hydrochloric (Muriatic) Acid is as applicable as any, given in 
doses of ten drops diluted in water, sweetened with simple Syrup or 
Syrup of Orange Peel. It seems better suited to aid digestion, than any 
other acid. 

If the teeth become set on edge, it is well to wipe them off after each 
dose of the Acid with a cloth wet with a solution of Bicarbonate of Soda. 
This will do much towards preserving the teeth from the injurious effects 
of the Acid. In case of apparent exhaustion of the nervous system the 
Dilute Phosphoric Acid may be given in doses of ten or fifteen drops 
every hour or two, properly diluted and sweetened. It is given habitually 

36 



562 TYPHOID FEVER. 

by some physicians in this disease. It is conclusive that the use of the 
Acids diminish the mortality of the disease very greatly, besides being 
very grateful to the patient. 

The patient may also drink freely of cold water or iced water, barley 
or rice water acidulated with lemon or orange juice; the only limit neces- 
sary to be observed is, that the amount taken does not derange the 
stomach. 

In view of the fact that typhoid fever is a self-limited disease, the 
essential element in the treatment is to support the powers of life and 
keep the patient alive until the disease shall disappear. The means for 
this purpose are food, (nourishment) alcoholic stimulants and tonic doses 
of Quinine. 

Eegarding the nourishment of the patient, it is important that system- 
atic feeding be begun early in the course of the disease and continued 
throughout. In the beginning of the disease, but very little food will pro- 
bably be taken, owing to a repugnance to it, but if liquid food is given cold 
the patient will often take it to relieve his thirst, and in this way enough 
nourishment will be taken to maintain the strength. It should not be 
given to the extent of producing vomiting or a feeling of discomfort from 
over-fullness or indigestion. The forms of food best suited for fever 
patients are milk, strong beef tea or essence, and fresh raw eggs beaten 
with a teaspoonful of sugar and half a cup (four ounces) of water or milk. 
Further on in the disease, there is an indifference to food, but if it is given 
it is digested ; it should be regularly given. If only about four ounces of 
milk, beef tea, or egg and water or milk are taken at a time, it should be 
given every two hours. If an ordinary drinking glass full (eight ounces) 
is taken at a time, four hours should be the intervals of taking food. If 
the patient expresses a desire for any particular kinds of food, the wish 
should be complied with, as far as possible. 

It is a good rule, however, not to give solid food when there is diar- 
rhoea. With the three articles mentioned, sufficient nourishment may be 
given. In making beef tea, a pound of finely chopped lean beef will make 
a pint of strong tea. A pint of cold water is poured upon the beef and 
brought to a temperature not above one hundred and sixty degrees Fah- 
renheit, and kept at that point for four hours, a little water being added 
from time to time to supply the loss from evaporation. (The Hydro- 
chloric Acid, previously directed, can be given in the beef tea.) Mutton 
or chicken can be used instead of beef. Finely divided lean beef pounded 
in a mortar, until the nutritious elements are separated from the fibre, 
may be given. Nothing excels a milk diet. Everything else should, as a 
rule, be supplementary. By early and continuous feeding, the severer 
symptoms of the disease are generally obviated, as they generally depend 
on the exhaustion and prostration, which is prevented by nourishment. 

In the course of the disease, if severe, alcoholic stimulants are almost 
always required. They should be given from an early period in the 
attack, as aid to digestion, a teaspoonful to a dessertspoonful of Whisky or 
Brandy with each half glass (four ounces) of milk or other liquid food, 
but not often er than two hours, greatly aids in the feeding of the patient, 
and so prevents, in many cases, the innutrition and its results, which is 
shown by delirium, a rapid feeble nulse, twitching of the muscles, pick- 



EPIDEMIC AND ENDEMIC INFECTIOUS DISEASES. 563 

ing at the bedclothes, coma, with watchfulness, restlessness, etc. In a 
stage of this fever where there is marked exhaustion, Brandy or Whisky 
should be given freely and to the extent of relieving the symptoms above 
enumerated. I believe life is saved by the free but judicious administra- 
tion of Alcohol in the advanced stage of prostrating diseases in obedience 
to the scriptural injunction, " Give strong drink unto him that is ready 
to perish." The appropriate dose will be from one to two tablespoon fuls 
of Brandy or Whisky, given from one to four hours apart. The stimulant 
is doing good when the weak, rapid pulse becomes stronger, slower, fuller 
(a pulse of one hundred and twenty is generally a weak pulse; one of one 
hundred and thirty, or more, always so,) when the dry tongue becomes 
more moist, the delirium, vigil, restlessness, etc., lessened, and the sleep 
becomes more refreshing, It does harm, if the pulse is quickened, the 
tongue dryer, the delirium greater, the restlessness increased and is being 
given too freely. 

The tonic effect of Quinine is best produced by doses of two or three 
grains four times in the twenty- four hours. 

In the early part, headache may be relieved by cold water, either by 
keeping a thin cloth on the head, which will keep cool by evaporation, 
or by the use of ice-water, vinegar and water, pouring water upon the 
head (douche) or by bladders of ice. 

Vigil (or wakefulness.) sleeplessness, or delirium, should be relieved. 
For this purpose, there is nothing better than ten grains of Dover's Pow- 
der, or a grain of Opium with a grain of the Extract of Hyoscyamus, at 
night, which will produce a refreshing sleep. A condition of semi-coma 
(insensibility) with watchfulness, does not prevent the use of Opium to 
produce sleep. It is, sometimes, better to give at night, especially when 
there is delirium, twenty grains of Hydrate of Chloral with an equal 
quantity of Bromide of Potassium, dissolved in water with syrup. 

Nausea and vomiting are generally relieved by greater care in giving 
food and drink, especially, a more limited amount of the latter. Cold or 
Mustard may be applied over the stomach. Ten grains of Bismuth, Sub- 
Xitrate, with five grains of Oxalate of Cerium, or a drop of Carbolic Acid 
in water, or three to five drops of Dilute Prussic Acid, may be given 
hourly, if needed. 

Diarrhcea is generally present, and may require to be restrained by 
opiates and astringents, directed in the treatment of that disease. Some- 
times a large injection of thin Starch will suffice. Merely a looseness of 
the bowels does not need treatment. 

Cathartics are not to be given ; but if constipation exists, it is to be 
relieved by injections or mild laxatives, as a dessertspoonful of Castor Oil 
in emulsion with Glycerine, flavored with Oil of Wintergreen (Gaulthe- 
ria) or Cinnamon. 

Should ulceration of the intestines occur, a peritonitis or a hemor- 
rhage is almost sure to result. The former result is to be treated by full 
doses of Opium, to relieve the pain, and every means should be used to 
support life. Large, warm poultices should be kept on the abdomen. 
Peritonitis not caused by ulceration, is not so fatal, but is to be met by 
the same means. 

Hemorrhage into the intestines will call for Opium in doses of a grain 



564 TYPHOID FEVER. 

with ten grains of Gallic Acid, in solution, with ten drops of Aromatic 
Sulphuric Acid. 

Nose-bleeding, if excessive, will call for the treatment directed in the 
article on that trouble. 

The distention of the abdomen from gas in the intestines (called tym- 
panites) occasions great discomfort. It may be relieved by a large injec- 
tion of warm water, containing a tablespoonful of Turpentine previously 
mixed with Glycerine. A flannel cloth wrung out of hot water and then 
wet with Turpentine, laid over the abdomen, will afford relief. 

The urine should b« examined frequently, to ascertain whether a defi- 
ciency in the amount of urea may not warn of Uraemia (poisoning by this 
ingredient of the urine remaining in the blood). The smell of Ammonia 
in the expired breath, also, indicates Uraemia. Diuretics (medicines to 
act on the kidneys) are required, as, a half a teaspoonful of Vinegar of 
Squill in a tablespoonful of infusion of Digitalis every four hours until 
urine is passed freely, and if the symptoms are urgent, hot-air baths 
should be given. Profound sleep (coma) will call for these measures for 
relieving the blood of urea, and blisters to the back of the neck, by means 
of Blistering Collodion. 

During convalescence, care is to be exercised against overloading the 
stomach, but, at the same time, the diet should consist largely of well- 
cooked meats, eggs, milk and simple farinaceous articles. Iron should be 
given as a means of enriching the blood. The Tincture of the Chloride of 
Iron, in doses often drops, largely diluted in sweetened water, and given 
after meals, is as appropriate as any. The Pyrophosphate or Soluble Cit- 
rate of Iron, are efficient and pleasant to the taste. A dram may bedis- 
solved in Syrup of Orange and given, in doses of a teaspoonful, after 
meals. The Citrate of Iron and Quinine, given in the same way, and in 
the same doses, is a useful tonic during this stage of the disease. 

Derangements of the stomach will call for the Liquid Pepsin and 
Bismuth, or such other treatment as is directed in the treatment of Dys- 
pepsia. 

HOMCEOPATHIC DIVISION AND TREATMENT. 

It were of no service, as it would, also, be a difficult task, to define, 
exactly, the varieties of complication which may attend disorders of 
this kind. The broad distinction consists in the organs which are, espe- 
cially, affected. 

But, in order to facilitate the discrimination of unprofessional per- 
sons in the treatment of this most difficult species of disorders, we will 
divide their indication, progress, and issue, into three distinct stages, the 
premonitory and incipient, the acute, and the debilitated and convales- 
cent stages. It is not, however, to be assumed that these gradations are 
always clearly defined. They may merge imperceptibly, may be arrested 
by treatment, or may be suspended by fatal results. The incipient stages 
are, however, naturally distinguishable until the positive development of 
the fever becomes evident, and thestageof debility, which isaconsequence 
of the ravages of the fever, differs from the two former in the substance of 
active symptoms, and the accompanying prostration of animal power. In 
the treatment of all alike we must be guided by the symptoms, and select 



EPIDEMIC AND ENDEMIC INFECTIOUS DISEASES. 565 

the most appropriate remedy according to the characteristic indications 
afforded. 

HOMEOPATHIC TREATMENT— During the Premonitory and 
Incipient Stages. Bryonia-alba, Rhus-toxicodendron. These rem- 
edies, either singly (according to the subjoined symptomatic indications 
of each,) or in alternation (where the symptoms of the disease embrace 
the characteristics of both,) have, when seasonably administered in the 
incipient stages of many varieties of these fevers, been found sufficient to 
arrest the progress and development of the malady, altogether, or at all 
events so far as to modify its future course, as to deprive it of much malig- 
nancy. Bryonia and Rhus are, in fact, the medicines whose ascertained 
operation is most closely akin to that of this class of disorders. 

Bryonia. This remedy is especially applicable to cases which mani- 
fest an inflammatory tendency. It should be selected in the incipient 
stage, when the following symptoms are present: — After a slight cold the 
patient complains of aching pains over the whole body, which admit of 
no relief from a change of posture; severe, throbbing, bursting, frontal 
headache (aggravated by opening or turning the eyes) prevails ; the scalp 
is tender to the touch, and the head burning hot, yet the forehead is, 
nevertheless, frequently bathed with cold sweat; the sitting or even the 
recumbent posture is rendered compulsory by the prevalence of debility, 
languor and heaviness of the limbs, and there is an aversion to cold air ; 
the nights are disturbed, more especially the fore part of the night, by 
ebullition or congestion of blood, heat, and anxiety ; the patient sighs 
and groans during sleep, and is often aroused by agonizing or frightful 
dreams, which continue to haunt him even whilst awake. The digestive 
functions are considerably deranged, as exemplified by the presence of 
bitter taste, loathing'of food, nausea, and inclination to vomit, a yellow, 
furred and dry tongue, pressure or weight and pricking in the pit of the 
stomach, with sensation of distention about the lower ribs on both sides, 
and costiveness. 

Dose: If singly, dissolve eight pills in two tablespoonfuls of water, 
and give a teaspoonful of the solution every two hours; if in alter- 
nation with Rhus., dissolve six pills of each remedy separately in 
two tablespoonfuls of water, and give a teaspoonful of the one 
solution four hours after the other, in rotation, until amelioration or 
change. 
Rhns-toxicodendron is especially applicable to the low, nervous 
variety in the premonitory stage of typhus. It should be employed when, 
either after exposure to a thorough wetting, or without any assignable 
reason, the patient is seized with violent relaxation of the bowels, accom- 
panied by colic, and complains of chilliness, even when seated close to the 
fire; further, when aching pains (or pains as if arising from the effects of 
contusions) are experienced in particular parts of the body, or when a 
painful sensation is experienced, as if the flesh had been torn from the 
bones; the tongue is furred white, and giddiness, inclination to vomit, or 
actual vomiting of phlegm, is present ; the patient is tormented by numb- 
ness, creeping and tingling in the parts of the body on which he lies, 
together with lancinations, drawing pains, and stiffness in the nape of 
the neck and in the back, rigidity and feeling of paralysis in the extrem- 
ities, with trembling on holding out the arms; the chief qualifying con- 



666 TYPHOID FEVER. 

dition is, that all the symptoms are, generally speaking, exacerbated dur- 
ing rest and at night. 

Dose: If singly: Of a solution of ten pills to two tablespoon fuls of 
water, give a teaspoon ful every two hours, until amelioration or 
change. If in alternation with Bryonia, dissolve ten pills of each 
remedy separately in two tablespoonfuls of water, and give a tea- 
spoonful of the one solution four hours after the other, in rotation, 
until amelioration or change. 
Ipecacuanha may be selected in the early stage of typhus, when it 
is ushered in by prominent symptoms of derangement in the digestive 
organs, such as headache, giddiness, nausea, vomiting, watery, yellow or 
greenish, slimy evacuations; particularly when these are associated with 
slight chills alternating with heat, or considerable shivering with slight 
heat or marked heat with but little shivering. 

Dose: Eight pills in a teaspoonful of water every three hours until 
amelioration or change. 

Pulsatilla may also be selected in this stage of the disorder, when 
frequent shivering, bitter taste, whitish tongue, loss of appetite, nausea, 
vomiting of phlegm, slimy evacuations, and febrile heat, intermingled 
with chills, prevail ; and more particularly when these symptoms become 
exacerbated towards evening, and occur in mild, temperate, or phlegma- 
tic subjects, or in females, with extreme depression of spirits and tearful- 
ness. 

Dose: Eight pills in a teaspoonful of water every three hours, until 
amelioration or change. 

Digitalis is indicated when nervous fever, or rather typhus, accom- 
panied by bilious derangement, is ushered in by yellow jaundiced hue of 
the skin ; violent, bilious, spasmodic pains in the stomach ; sensibility of 
the upper part of the stomach on the left side, on pressure; frequent 
urging to make water, particularly at night, with scanty urine; burning 
heat of the head and face; anxiety of mind and dread of some imaginary 
impending misfortune ; urination painful and difficult, or entirely sup- 
pressed. 

Dose : Six pills in a tablespoonful of water every three hours, until 
amelioration or change. 

Nux-vomica. — Symptoms of stomacha derangement, constipation, 
with frequent inclination and ineffectual efforts to evacuate. Nux-vomica 
is further indicated when the spasms, which not unfrequently accompany 
this disease, are confined to the stomach and intestines, particularly the 
inferior bowel — a frequent cause of the above-mentioned constipation; 
painful and difficult emission of urine; painful pressure and tension in 
the regions about the stomach and the lower ribs; sensation as if the 
limbs were bruised; general nervous excitability, with great nocturnal 
restlessness and slight delirium; weakness and aggravation of the symp- 
toms in the morning. Temperament, sanguine or billious; disposition, 
irritable and impatient. 

ose: Six pills in a tablespoonful of water every four hours until 
amelioration or change. 

China. — This remedy is frequently of service in the first stage, or 
when paleness of the face, lancinating, rending, aching, or pressive head- 
ache, cloudiness of vision, buzzing or roaring in the ears, dullness of hear- 
ing are present ; yellow or white coating on the tongue, dryness of the 



EPIDEMIC AND ENDEMIC INFECTIOUS DISEASES. 5G7 

mouth, insipid, clammy, or bitter taste ; inclination to vomit; sensibility 
and distention of the belly; thin, yellow, watery motions, occasionally 
intermixed with undigested substance; urine scanty, pale or dark colored 
and cloudy; oppression at the chest; dragging, shooting pains in the 
limbs; anxiety, sleeplessness, and general coldness and shivering. 

Dose: Six pills in a tablespoonful of water every six hours, until 
amelioration or change. 

Aeon it am. Belladonna. These are the best remedies in the 
incipient stage of the disorder, when inflammatory symptoms declare 
themselves from the commencement. The selection between Aconite 
and Belladonna will be gathered from the subjoined symptomatic indi- 
cations, and from the article on the "characteristic symptoms" under 
the head of these remedies respectively. It should be added here, that 
when the disease becomes further developed, and still retains the 
inflammatory character— Bryonia and Rhus respectively, according to 
the symptoms, are generally preferable. Aconitum is indicated in the 
incipient stage by the presence of the following symptoms:— Chill fol- 
lowed by the burning heat, strong, hard, and quick pulse; dry skin, mouth, 
lips, and tongue; the latter being generally, of a bright red, but some- 
times also coated with white; excessive thirst; red and scanty urine; 
hurried breathing; the symptoms being aggravated or modified, according 
to the greater or less irregularity of the pulse. The condition which 
distinctly points to Aconite, as the remedy (when other complications 
are not present,) consists in the aggravation of the above symptoms at 
night, often attended with slight delirium. Should the delirium become 
violent, and considerable cerebral disturbance be otherwise manifested, 
or should this particular symptom not yield rapidly to the action of Acon- 
ite; — when, moreover, the skin continues hot and dry, and the bowels 
relaxed, or the motions are even passed involuntarily, or when there is in- 
flammation of the glands of the throat (tonsils), or red, parched tongue, 
great thirst with disinclination or dread to satisfy it, it will be preferable 
to administer Belladonna until the indicative symptoms yield. 

Dose: Of a solution of six pills to two tablespoonfuls of water, give a 
teaspoonful every three hours, until amelioration or change. In 
mild cases in which the symptoms yield readily to the action of the 
medicine, the repetition may be deferred to intervals extending to 
twelve hours. 

Belladonna is particularly indicated by the following symptoms, 
in addition to those above enumerated: alternate heat and chills, or gen- 
eral heat externally and internally, with redness, burning heat, and 
bloated appearance of the face, or alternations of coldness and paleness, 
and heat and redness of the face, violent throbbing of the large arteries of 
the neck; redness, sparkling, and protrusion of the eyes, with dilation of 
the pupils, extreme sensibility to light, and distortion of the eyes; singing 
or noise in the ears to a greater or less degree; wild expression of the 
countenance, with uneasy glancing around, as if from fear, sometimes 
attended with a marked inclination to run away; violent shooting pains in 
theforehpad; or dull heavy pain, causing the patient to put his hand 
frequently to his head; sopor; furious delirium or loss of consciousness; 
delirium and snatching at the bedclothes, or spasmodic or convulsive at- 
tacks; parched lips, soreness of the corners of the mouth, redness and 



568 TYPHOID FEVER. 

dryness of the tongue, which is also sometimes foul, and covered with a 
yellow coating ; skin hot and dry ; bitter taste in the mouth, intense thirst, 
difficulty of deglutition, especially of liquids; nausea; pressure at the pit of 
the stomach; excessive distention of the bowels, and constipation or 
watery motions; scanty and red or amber-colored urine; rapid respiration; 
pulse full and accelerated, or quick, hard and wiry; inflammation and 
swelling of the glands before and beneath the ears. 

Dose: Dissolve eight pills in three tablespoonfuls of water, and give a 
teaspoonful of the solution every four hours, until amelioration 01 
change. In mild cases, or when the symptoms yield readily to the 
action of the medicine, the repetition may be deferred to a period 
of twelve hours, and repeated at such intervals, until amelioration 
or change. 

Stramonium is indicated by symptoms of the same nature as those 
which indicate Belladonna, with the addition of the following: — twitching 
of the muscles of the face, starting of the tendons, squinting, trembling 
of the extremities, tremulous motion of tongue on protrusion, burning 
heat of the body, suppression of the urine, fantastic gesticulations, and in- 
voluntary spasmodic smiling. 

Dose: Eight pills in a teaspoonful of water every three hours, until 
amelioration or change. 

Hyoscyamus is indicated by the same symptoms as have been stated 
at length under the head of Belladonna, with addition of the following: 
twitching of the tendons, strong, full pulse, fullness of the veins, burning 
heat of the skin, sensation of pricking all over the body, and constant 
delirium; frequent but ineffectual urging to urinate. 

Dose: Three globules in a teaspoonful of water every three hours, 
until the symptoms are distinctly modified or changed. 

Baptisia (Wild Indigo) is especially required when the weak and 
tremulous feeling; the quick (90,) full, and soft pulse; the internal and 
external heat, with thirst; the headache and tendency to delirium; the 
tongue yellowish-brown in the center, and red at the edges ; the consti- 
pation alternating with diarrhoea; all contribute to make up the morbid 
picture; — hot, dry skin, and a quick, full pulse: the tongue is thickly 
coated with a whitey-brown fur; the head aches, and t here is at least, 
nocturnal delirium; no appetite and great thirst; the urine is high colored, 
and generally with constipation. 

Dose: The same as directed for Stramonium. 

Treatment of Abdominal Typhus ; that is, Typhus with tenderness 
and distention of tlie belly, griping, or sometimes dull, continuous pain, 
diarrhoea, etc. 

Mercurius will be found a most efficient medicine, if immediately 
employed when the disorder assumes the low form of abdominal typhus, 
or occurs in persons of sluggish constitution and slow circulation, and is 
attended with pale, yellowish appearance of the face, severe headache, or 
sensation as if a tight band were across the forehead; thickly coated 
tongue; bitter or foul taste; little thirst; sensitiveness of the region about 
the navel and the pit of the stomach, to the touch, and distention of the 
belly; evacuations, copious, watery, floculent, or slimy and even bloody, 
sometimes qualified by straining without evacuation; at first, dry burning 
skin followed by profuse, debilitating sweats ; depressed pulse, and great 



EPIDEMIC AND ENDEMIC INFECTIOUS DISEASES. 569 

prostration ; extreme restlessness and anxiety, with constant tossing 
about in bed; and disturbed and unref resiling sleep with anxious dreams. 
Dose: Six pills in a teaspoonful of water, every two hours, until the 
evacuations become diminished in number, and improved in appear- 
ance, and the tenderness and pain in the lower part of the stomach, 
etc., are relieved. After which, some other remedy^ must be 
selected, in accordance with the remaining symptoms ; consider Ad- 
dam Nitricam, amongst others. 
Hhus-toxicodctidron is especially indicated in abdominal typhus 
characterized by continued heat and dryness of the skin ; violent delirium ; 
oppression of the heart, with sighing and moaning; pains in the limbs ; 
extreme debility ; tongue and lips dry and red, or covered with a brown 
or blackish, tenacious fur; red, burning cheeks; convulsive twitching of 
the tendons, snatching at the bedclothes, drowsiness or stupor, with mut- 
tering, and loud nasal breathing ; weak, accelerated pulse ; anxious 
expression of countenance ; sleep disturbed, or prevented by the frequent 
recurrence of sudden starts ; eyes inflamed, watery and insensible ; features 
collapsed; breath exceedingly offensive; involuntary evacuation of the 
excrement and urine ; coldness of the extremities ; sinking energies ; livid 
spots and miliary eruption. 

Dose; Dissolve twelve pills in three tablespoonfuls of water, and 
give a teaspoonful of the solution every two hours, until three doses 
have been given ; then extend the intervals (or sooner, if distinct 
improvement takes place) to four hours, and continue the adminis- 
tration until the symptoms particularly indicative subside or become 
altered. If no alteration follow the fourth dose, or the aspect of the 
symptoms be as follows, proceed with the next remedy. 
Camphor frequently proves useful after Rhus., particularly when the 
following symptoms prevail; heat of the head, with confusion of ideas, 
or violent delirium; giddiness; throbbing headache; burning heat in the 
forehead; cold and clammy skin ; continuous coldness of the hands and 
feet; debilitating and clammy sweat; tendency to violent relaxation of 
the bowels ; scanty, cloudy urine, which deposits a thick sediment; great 
weakness, and feeble, scarcely perceptible pulse. 

Dose: One drop of the saturated tincture on a small lump of loaf sugar 
every quarter of an hour, until distinct amelioration or change ; or, 
ifthemore urgent symptoms have yielded, and the following remain, 
proceed with the next remedy. 
Cocculus may often follow either Rhus, or Camphor (after the previ- 
ous employment of Rhus.,) especially when the great debility continues, 
and the patient complains of giddiness and headache ; or when there is a 
tendency to swooning or paralysis of the limbs, and when there are 
prominent symptoms of derangement of the digestive functions. 

Dose: Of a solution of six pills to three tablespoonfuls of water, 

give a teaspoonful every two hours, until amelioration or change. 
These remedies, either singly or in alternation, are amongst the most 
important, in cases of a desperate character, and when the most alarming 
symptoms occur. 

Arsenicum. This is decidedly one of the most important remedies 
in abdominal typhus, especially in the second and third stages, sometimes 
restoring the patient when almost beyond the reach of hope, and renova- 
ting the vital spark. The chief indications for its employment are: — 
extreme prostration of strength— falling of the lower jaw, open mouth, dull 



570 TYPHOID FEVER. 

and glassy eyes, bitter taste, inclination to vomit, pressure and aching at 
the pit of the stomach, pain in the right side of the inferior region of the 
belly, bursting headache, giddiness, violent or low delirium, drowsiness, 
flatulent distention of the bowels, burning thirst, dry, hot skin, parched, 
cracked, sometimes blackish-looking clammy tongue, and violent and 
continuous relaxation of the bowels; pulse scarcely perceptible, and inter- 
mittent. 

Dose: If singly, of a solution of six pills to three tablespoonfuls of 
water, give a teaspoon ful every quarter of an hour (in very critical 
cases,) or every hour (in less urgent instances) until amelioration or 
change, doubling the length of the intervals as soon as distinct 
improvement occurs. If in alternation with Veratrum, dissolve 
separately six globules of each remedy in three tablespoonfuls of 
water, and give one teaspoonful of the one, half an hour after a 
similar dose of the other (in very critical cases,) in rotation — or at 
intervals of one hour (in less urgent instances,) until amelioration 
or change. 
Veratrum is occasionally useful after or in alternation with Arseni- 
cum, when the inferior extremities become cold and covered with cold 
sweat. 

Dose: In every respect, singly or in alternation with Arsenicum, as 

directed for the latter remedy. 
Carbo-vegetabilis may also prove serviceable in very critical cases. 
It is indicated where we find drowsiness with rattling respiration, face 
pinched, sunken, and deathlike ; pupils insensible to light, pulse scarcely 
perceptible, and the vital power rapidly sinking; cold perspirations on the 
face and extremities; involuntary and offensive evacuations; deep-red 
urine, with a cloud floating in it, or rising towards the surface. In abdom- 
inal typhus, however, the more particular indication consists in symptoms 
of incipient ulceration, or in signs of so-called putrescency. 

The following symptoms are, also distinctly indicative of this remedy: 
burning, lancinating pains about the region of the stomach, and deep in 
the bowels, which become renewed after partaking of food of any kind, 
and are accompanied by great anxiety, excessive flatulency, and the evac- 
uation of burning, light-colored, fetid, watery, bloody stools, attended with 
painful urging; desire for salt food, and for coffee, with aversion to meat, 
generally, and dread of indulging the craving, lest the sufferings be aggra- 
vated. 

Pose: In every respect, singly or in alternation with Arsenicum, as 

directed for that remedy, above. 
Treatment of the Second or Active Stage in Typhus.— Whether 
of the inflammatory or low variety. Bryonia is more particularly indi- 
cated when the disorder assumes the character of inflammatory nervous 
fever, or typhus especially affecting the brain, with violent, stupefying 
headache, as from a blow, and pain across the forehead and at the temples, 
as if the head would burst; frequent raising of the hands to the head. 
Aggravation of these sensations by movement; continued, violent delir- 
ium, w T ith excessive febrile heats; foul, thickly-coated, yellow tongue, or 
dry, cracked tongue, with pinched mouth and great thirst, and vesicles in 
the mouth or on the tongue ; furred lips; nausea, inclination to vomit, or 
vomiting of mucous and bilious matter; tenderness of the pit of the 
stomach, when touched ; general heat of the whole body, dryness of the 



EPIDEMIC AND ENDEMIC INFECTIOUS DISEASES. 571 

skin, redness of the face, and profuse perspiration during the fever; sensi- 
bility about the region of the stomach ; distention of the belly, oppression 
at the chest, and frequent sighing and moaning, indicative of threatening 
miliary eruption; constipation, or relaxed stools; urine of a deep orange 
color or bright yellow, with yellow sediment; sensation as of a plug in the 
throat, with difficulty of hearing; stitches in the side ; drowsiness or dispo- 
sition to sleep during the day ; sleeplessness, fugitive heat, and excessive 
restlessness, or continued drowsiness or stupor, with startings and 
unpleasant dreams; painful shootings and soreness of the limbs, aggra- 
vated by movement; trembling of the hands; pulse quick, soft, frequent, or 
irregular, small and intermitting; miliary irruption, livid spots ; irrita- 
bility, irascibility, despair of recovery. 

Dose: If singly. Under very favorable circumstances, of a solution 
of six globules to three tablespoonfuls of water, give a teaspoonful 
every twelve hours. In cases which assume the more serious 
features, a similar dose should be repeated every three hours, until 
amelioration or change. If in alternation with Rhus, dissolve 
separately, six globules of each remedy in three tablespoonfuls of 
water, and give a teaspoonful of one solution four hours after the 
like dose of the other, in rotation, until amelioration or change. 
Eupatoinum-perfoliatiini, Pain in the bones, attended with hot, 
dry skin. This remedy has been highly recommended by the most success- 
ful practitioners, as Drs. Williamson, ISTeidhard, and others. 
Dose : The same as directed for Bryonia. 

Hhus-toxicodendron. This medicine is more peculiarly suitable to 
the low form or stage, Bryonia being more applicable to the inflammatory, 
but will frequently be found servicable in all the stages of the disease, 
particularly when there is undue relaxation of the bowels, congestion to 
the head, oppression at the chest, and great weakness. The headache is 
generally of a stupefying nature, with a feeling as if from a bruise, but 
not so severe as that indicating Bryonia; the tongue presents nearly the 
same character, less nausea and inclination to vomit exist; violent pain is 
present about the region of the stomach, especially when touched. Consti- 
pation as named of Bryonia, but more frequently copious, yellowish, or 
loose, bloody evacuations, with severe cutting pains in the belly; the 
symptoms are general heat, and those of the face resemble those mentioned 
under Bryonia, but without the perspiration, or at most, a clammy feeling 
of the skin. The urine is hot, dark colored, or at first clear, and afterwards 
turbid; the symptoms of the ears the same; sleep also the same; difficult 
deglutition of solids, as if from contraction of the throat and the gullet; 
general trembling, debility, and prostration, almost amounting to paralytic 
weakness of the different limbs ; shooting pains in various parts of the 
body, aggravated when at rest or at night, and momentarily relieved by 
moving the part affected ; pulse quick and small or weak and slow ; as 
mental or moral symptoms, we may notice, excessive anguish, anxiety, 
extreme lowness of spirits, and disposition to weep. 

Dose: Whether singly or in alternation with Bryonia, in all respects 

as directed for the latter remedy above. 
Arnica is also of some importance in low or sluggish nervous fever, 
with lethargy, or delirium, and snatching at the bedclothes; or when the 
patient lies in a state of unconciousness, as if he had been stunned by a 
concussion of the brain. 



572 TYPHOID FEVER. 

_Do.se: Three globules in a teaspoonful of water every four hours, 

until amelioration or change. 
Pulsatilla is often of considerable service in the second stage of 
typhus, when slight delirium, tears and lamentations, alternating with 
drowsiness, prevail. 

Dose : Three globules in a teaspoonful of water, repeated, if necessary 
at the expiration of four hours, and so on until amelioration or 
change. But if any of the undermentioned symptoms declare them- 
selves, proceed with the next remedy. 
Acidum-phosphoriciini is frequently required, either when, at the 
commencement of the disease we find great exhaustion and prostration, 
with wandering even while awake ; or in almost hopeless cases (alone or 
still better in alternation with Khus.) when the patient is always found 
lying on th^back in a drowsy state, and either makes no reply when 
spoken to, or- answers incoherently; or in other instances, and especially 
after the previous employment of Pulsatilla, when the following symptoms 
prevail: Constant loquacious delirium or low muttering ; snatching at 
the bedclothes ; fixed looks ; seeming efforts to escape from some alarming 
object; black incrustations on the lips ; dry, hot skin; continual, copious, 
watery discharges from the bowels, the motions, being in general invol- 
untary ; bloody evacuations ; frequent, weak, and occasionally an inter- 
mitting pulse. 

Dose: Three globules in a teaspoonful of water, at first every hour, 
extending the intervals to three hours as soon as the symptoms are 
modified, and continuing the administration until positive amelior- 
ation or change. Or if the under-mentioned symptoms should, in 
particular, continue unmodified, proceed with the next remedy after 
a lapse of three hours from the last dose. 
Acidum-nitricitm, should be administered after or during the course 
of Acidum-phosphoricum, but not within less than three hours of a previ- 
ous dose of the latter, if the bloody evacuations fail to yield readily to the 
previous treatment. Acidum-nitricum is, moreover, particularly useful 
when there are white specks in the mouth and throat ; sensibility of the 
belly on pressure ; relaxation of the bowels, and slimy, acrid, greenish- 
colored stools; straining; intestinal ulcerations ; shooting pains in the 
lower bowel ; scalding when passing water; and tendency to collapse 
In some cases it is necessary to administer this remedy by injec ion or 
enema, as below stated. 

Dose : Three globules in a teaspoonful of water, repeated, if necessary, 
after four hours (or every four hours till the symptoms yield.) return- 
ing to Acidum-phosphoricmn, if requisite or proceeding with the 
next remedy, after a pause of three hours, if the under-mentioned 
symptoms, in particular, supervene. The enema should consist of 
six drops of the tincture at the third dilution to every two table- 
spoonfuls of water. 
Cantharides should be administered after or during the course of 
either of the three foregoing remedies, but not within less than three 
hours of a dose of any other medicine, if painful evacuation of water be 
distinctly manifested. 

Dose: Three globules in a teaspoonful of water, repeated, if neces- 
sary, after an interval of three hours (or continuing at such intervals 
until the indicative symptom is positively subdued,) returning to 
either of the foregoing, or proceeding with other treatment, or sus- 
pending treatment, according to the prevalence of particular symp- 
toms or general improvement be manifested. 



EPIDEMIC AND ENDEMIC INFECTIOUS DISEASES. 573 

China is sometimes of considerable value in the second stage of this 
disease, especially when the attack has become protracted and tedious: — 
nocturnal sweats, obstinate relaxation of the bowels, but unattended with 
pain in the bowels, the tongue at the same time being clean. 

Dose: Three globules in a teaspoon ful of water, every four hours, 
until amelioration or change, unless, after the third dose, the sweats 
remain unmodified, when proceed with the next remedy, after a 
pause of four hours. 

Sulphur should follow the third dose of China, in the event of the 
continuance of the sweating, notwithstanding the previous administra- 
tion of the latter remedy. Sulphur has always been found of considerable 
service — Bryonia, Rhus., or Acidum-phosphoricum having been fruitlessly 
administered, but particularly when the following symptoms were encoun- 
tered : Pale and collapsed countenance, burning, itching eruptions on 
the lips, dryness of the mouth, foul, dry tongue; bitter taste; slimy or 
bilious vomiting ; tenderness of the region about the stomach, and pain as 
from excoriation of the parts above the navel, increased on pressure; flat- 
ulent rumbling in the bowels ; frequent, watery, flocculent, or yellow 
evacuations ; cloudy urine, depositing a reddish sediment ; miliary erup- 
tion ; eruption with a discharge of matter; bleeding at the nose ; stitches 
in the chest, oppressed breathing; dry cough, worse towards evening and 
at night ; sleeplessness, or whining during sleep ; dry heat during the day 
with moderately quick pulse, and profuse sweating at night. 

Dose: Dissolve six globules in three tablespoon fuls of water, and give 
a teaspoonful of the solution everysix hours, unless, after the second 
dose, the following symptoms be present, when proceed with the 
next remedy. 

Acidum-sulphiiricnm should followthe second doseof Sulphurafter 
an interval of six hours, if the sweating be yet very profuse, particularly 
if so when lying still and modified by movement ; or it should even pre- 
cede either or both of the preceding remedies, if the sweating be very pro- 
fuse when lying still and diminished by movement. 

Dose: Three globules in a teaspoonful of water, every four hours 
until amelioration or change. 

Calcarea, 1 Calcarea-c, may sometimes be adminis- 

Hepar-sulphuris. > tered advantageously, alternately with Bella- 
Lycopodium,. ) donna, Arsenicum, or Rhus., according to the 

symptoms ; it is further, occasionally, a most efficient remedy in cases in 
which debilitating relaxations of the bowels, or bleeding of the nose, 
will not yield to such remedies as Acidum-phosph., Rhus., China, etc.; 
lastly. Calcarea-c, may be exhibited with advantage where there are 
symptoms of impending miliary eruption, jerking or twitchings in the 
limbs, particularly in children, tendency to inflammation of the mem- 
branes of the brain, delirium, etc. 

Dose: Of a solution of six globules to three tablespoon fuls of water, 
give a teaspoonful every three hours until amelioration or change. 
Or if the undermentioned symptom should declare itself, or having 
been previously present, should continue unmodified after the third 
dose of Calcarea, proceed with the next remedy, after a pause of 
four hours. 

Hepar-sulphuris should follow the third dose of Calcarea after an 
interval of four hours, if discharge of blood from the nose should supervene 



574 TYPHOID FEVER. 

or, having been previously present, should continue without material 
improvement ; except, indeed, the presence of other symptoms of a more 
urgent character, should require ttie administration of other remedies, 
such as Pulsatilla, Belladonna, Rhus , or Sulphur. 

Dose: Three globules in a teaspoonful of water, repeated, if necessary, 
after an interval of four hours— or continued, at such intervals, if 
requisite, until the distinct modification of the indicative symptom. 
Lycopodimn is often a valuable remedy after Calcarea, with or (with- 
out the intermediate administration of Hepar-s. according to the circum- 
stances,) in the second stage of typhus, when miliary eruption is slowly 
and scantily developed, and the following symptoms occur; drowsiness 
with muttering delirium ; con founding of words ; stammering; twitching 
of the tendons, snatching at the bedclothes, flatulent distention of the 
bowels, with constipation; affections of the bladder; or when there are 
shiverings alternating with heat; circumscribed redness of the cheeks; 
debilitating sweats; excessive debility; complete hanging of the lower 
jaw; half-closed eyes ; slow respiration ; or, state of excitement, without 
heat or congestion in the head or face; redness of the tongue; constipation ; 
burning urine ; tranquil and resigned state of mind, or surliness and 
malevolence, especially on waking. 

Dose: Three globules, in a teaspoonful of water, every three hours, 
until amelioration or change. In case of amelioration, pause until 
the symptoms evidently retrograde, when resume, at intervals of six 
hours, as long as necessary. In the case of change, suspend treat- 
ment for four hours, and continue with the remedy newly indicated. 
JLachesis may prove serviceable in fever analogous to typhus, attended 
with giddiness on rising or sitting up ; mattering ; bitter taste ; delirium] 
hanging of the lower jaw; vacant expression of countenance ; sunken 
features ; yellowish tongue, with bright-red margins ; cracked tongue ; 
smooth, dry tongue, with difficulty of protruding it, and inarticulate speech ; 
seeming paralysis of the eyelids; lethargic sleep, and tendency to lie in 
the prone position; thirst, with disinclination to drink; brownish-red 
copious urine. 

Dose: Three globules, in a teaspoonful of water, as directed for Lyco- 
podium — or if the symptoms be very urgent, begin by administering 
at intervals of two hours— extending the intervals to four hours after 
two doses have been given. 

Phosphorus is of great service where we find great dryness of the 
tongue, heat of the skin, small, hard, quick pulse, painless relaxation of 
the bowels, with excessive flatulent rumblings ; or when the disease 
becomes, as it were, concentrated in the lungs, and there is consequently 
congestion, with extremely laborious breathing, and excessive anxiety, 
dullness on percussion, mucus rattling, stitching during respiration, cough, 
with copious expectoration of phlegm, mixed with blood or even offensive 
matter, more benefit may be looked for from this than from any other 
remedy. Phosphorus, is also, serviceable when, notwithstanding the pneu- 
monic concentration, there is, moreover, sensibility and rumbling on the 
right side of the lower part of the belly, or when there is continued heat 
of skin, with small, hard, accelerated pulse, throbbing of the great arteries 
of the neck, and nocturnal sweats ; sleep disturbed by crowding of ideas, 
weeping, whimpering, sudden cries, and restlessness. The patient awakes 
from sleep complaining of great thirst and dryness of the mouth, excessive 



EPIDEMIC AND ENDEMIC INFECTIOUS DISEASES. 575 

heat, and aching of the whole body. In addition to these symptoms, there 
is a burning- sensation in the belly and fundament, with frequent semi-fluid 
stools, streaked with blood; giddiness, confusion, and throbbing pains in 
the head ; deafness; frequent discharge of blood on blowing the nose, and 
heat in the face ; tongue and lips dry and cracked; bitter taste; copious 
evacuations of urine, which deposits a whitish or reddish sediment,* 
delirium; stupefaction. 

Dose: Dissolve six globules in three tablespoonfuls of water, and give 
a teaspoonf ul of the solution every four hours, until amelioration or 
change. 

Acidum-muriaticuni. Weakness, with a constant tendency to sink 
down in the bed, with groaning during sleep, almost paralytic state of the 
tongue, rendering it nearly impossible for the patient to speak, even when 
in a collected state, and great dryness of the mouth. 

Dose: Of a solution of six globules to three tablespoonfuls of water, 
give a teaspoonf ul every three hours, until amelioration or change. 

Natrum-muriaticum is recommended in nervous fevers with great 
debility, insatiable thirst, dryness of the tongue, and loss of conciousness, 
and particularly, when they follow in the course of antecedent debilitating 
diseases. 

Dose: Of a solution of six globules to three tablespoonfuls of water, 
give a teaspoonl'ul every three hours, until amelioration or change. 

Helleborus has, also, been found of great utility in nervous fever, 
occurring after other febrile affections, such as scarlatina, measles, stom- 
achal fever, worm fever, and cholera, with pain as from contusion, com- 
bined with tumefaction in the integuments of the head; disposition to 
somnolency, with confusion of ideas, and extreme restlessness ; dark, 
cloudy urine; heaviness, or feeling of stiffness and powerlessness in the 
limbs; depression of spirits, and obtuseness of the faculties. 

Dose : A solution of six globules, as directed for Natrwn-muriaticum. 

Secale-corniitum is, in like manner, with Natrum-m. and Helle- 
borus, recommended by many homceopathists who have had frequent 
opportunities of treating nervous fevers, particularly, in cases occurring 
in the wake of other diseases; but is more especially, appropriate where 
the symptoms developed clearly proceed from irritation of spinal nerves 
with wandering, fugitive, spasmodic pains, extending from the base and 
column of the spine into different parts of the body; the spasms which 
affect the face become subsequently of an intermittent nature; whilst 
those that have their seat in the hands and feet partake of a continued 
character. This remedy is, further indicated by dry heat of the skin, 
insatiable thirst, accelerated pulse, great restlessness and sleeplessness; 
excessive languor, and aversion to food. Should the spasmodic affections 
readily yield to the employment of this remedy, but if the febrile symp- 
toms continue, some other remedy appropriate thereto must be pre- 
scribed. 

Dose: Dissolve six globules in three tablespoonfuls of water, and give 
a teaspoonful of the solution every three hours, until amelioration or 
change. 

Arsenicum. ) These remedies are of signal importance, either 

Veratrum, > singly, in succession, or in alternation according to the 

Carbo-veg. ) individuality, succession, or combination, of the symp- 
toms present, in the second stage of typhus, in all desperate cases in which 



576 TYPHOID FEVER. 

vitality becomes nearly extinct. For distinctive indications, the reader is 
referred to the foregoing prescription of these remedies, under the head of 
Abdominal Typhus. 

Dose : If singly, of either remedy : dissolve six globules in three 
tablespoonfuls of water, and give one teaspoonful of the solution 
every quarter of an hour (in ver> critical cases,) or every hour (in 
less urgent instances,) until amelioration or change, doubling the 
length of the intervals as soon as distinct improvement ensues If in 
alternation, dissolve, separately, six globules of the remedies to 
be used alternately in three tablespoonfuls of water, and give a tea- 
spoonful of one, half an hour after a similar dose of the other (in 
very critical cases), in rotation, or at intervals of an hour (in less 
urgent instances), until positive amelioration or change, doubling 
the length of the intervals as soon as a degree of improvement is 
evident. 
Carbo-veg. . In addition to the indications given for this remedy, 
under the head of Abdominal Tyhpus, the following symptoms are 
characteristic of its employment in the second stage: excessive anxiety, 
and burning heat of the skin, arising from congestions to the head and 
chest; the eyelids agglutinated during the night; deafness and ringing in 
the ears; bleeding from the nose, and obstruction of the nose from incrusta- 
tions, eruption around the nose, and brown or blackish, cracked lips; the 
legs drawn up during sleep, and the sleep restless, and disturbed by 
frequent waking. 

Dose: Three globules in a teaspoonful of water, every three hours, 
until amelioration or change, when thus specially indicated; when, 
as above, singly, or in alternation, the dose should be as directed 
under the last head. 
Treatment of Typhus Characterized by Stupor. In treating 
of this variety of the malady, it will be unnecessary to recapitulate the 
remedies already enumerated, in relation to the various stages and vari- 
eties hereinbefore described. Suffice it to say, that the same features and 
conditions would indicate their employment in this variety, and that the 
method of administration should be, in every respect, similar. But the 
symptoms which more particularly distinguish this species of typhus, 
especially indicate, by assimilating most closely to the specific opera- 
tion of. 

Opium, This remedy should accordingly be given when the follow- 
ing group of symptoms prevail : great drowsiness or lethargy, with 
stertorous breathing, open mouth, half-closed eyes or fixed look; slight 
delirium or muttering, snatching at the bedclothes; the patient being 
in a continual state of stupor, from which it is extremely difficult 
to rouse him, and from which he is scarcely aroused before he relapses 
into his former state; furious delirium, and incessant restlessness; 
dry, offensive stools, with involuntary evacuations of excrement and 
urine. 

Dose: Of a solution of six globules to three teaspoonfuls of water, 
give a teaspoonful every three hours, until amelioration or change. 
Treatment of the Stages of Debitity and Convalescence 
After Typhus. Mhus-toxicodendron, This remedy retains its 
importance in the treatment of typhus throughout all the stages of the 
malady, and is amongst the best appliances during the period of debility, 
which generally supervenes after the issue of this fever. Rhus, is more 



EPIDEMIC AND ENDEMIC INFECTIOUS DISEASES. 577 

especially indicated in this stage, when the progress towards recovery is 
sluggish, the pulse retaining a febrile character, the appetite, although 
improved, being capricious, the bowels predisposed to relaxation, and 
the chest not yet exempt from feelings of oppression. 

Dose: Three globules, in a teaspoonful of water, night and morning, 

until distinct amelioration or change. Upon evident improvement 

taking place under this treatment, it will be sufficient to repeat the 

dose every night. 

China is frequently of great use in this stage, against the debility 

resulting from the effects of the malady, more especially when the patient 

has suffered much from violent relaxation of the bowels during the 

previous course of the disease; or if there be a tendency to continuance in 

this symptom. China is, also, particularly useful when debilitating 

sweats supervene. In this case it should be followed by Sulphur, if that 

symptom has not yielded distinctly, after the second dose. 

Dose: In the case first described, three globules, in a teaspoonful of 

water, repeated, at intervals of twelve hours, until three doses have 

been taken. Under the last-stated circumstances, a similar dose, 

night and morning, and if the symptom does not distinctly yield 

within twelve hours after the second dose, proceed with the next 

remedy . 

Sulphur should follow, twelve hours after the second dose of China, 

in case of the obstinate continuance of the sweats, or of the presence of 

dry cough at night. 

Dose: Three globules, in a teaspoonful of water, every twelve hours, 

until amelioration or change. 
Ferrum-metallicnm is a preferable remedy when the pulse contin- 
ues weak or frequent, after a profuse discharge of blood, particularly in 
the case of females affected with green sickness, or who have previously 
suffered from it. 

Dose: Three globules, in a teaspoonful of water morning and 
evening, for a week. 

ACCESSORY MEASURES DURING THE PERIOD OF DEBILITY. 

The fever having subsided, and the patient being able to sit up, 
should first be removed to another apartment, free ventilation and a 
moderate degree of warmness being simultaneously secured. By degrees, 
and as soon as possible, passive motion, and from thence, if possible, 
walking exercise (not sufficient to exhaust the patient), should be daily 
sought in the open air, in fine weather, with, however, particular 
precautions against damp or chill. Nothing will conduce to restore 
the patient to health and strength more rapidly and thoroughly than 
such accessory treatment, with proper precautions in respect of diet, as 
stated below. 

AFTER EFFECTS OF TYPHUS. 

Bed-sores, Abscesses, Boils, Swelling of the Feet, Weakness of Digestion, 
and General Derangements. These are more or less frequently the results 
of very severe or protracted cases, especially when the reactionary process 
is sluggish, and require simultaneous local and constitutional treatment, 
with this reservation : that when the local application is unmeditated, 
(such as pure spirits), we may select the constitutional remedy, irrespec- 
tive of such application, according to the particular features of the case, 

37 



578 YELLOW FEVER. 

by consulting the symptoms present, and the article on "Boils" and 
"Abscesses,'' as regards those particular affections. 

External Treatment of Bed-sores. Spirits of Wine, Col- 
lodion or Glycerine will, in general, suffice to remove this trouble- 
some affection. 

Application : To one part of the Spirit, add two parts of pure water, 
and saturate with this solution a linen pad, which must be applied 
to the parts and kept moist. 
Arnica (tincture) should be employed, if the diluted Spirit has proved 
insufficient and inflammation has not supervened. 

Application: To one part of the Tincture, add twenty parts of water, 

and proceed as directed for Spirits of Wine. 
Tincture of Carbo-veg., \ When mortification 

Tincture of Arsenicum, I supervenes we may suc- 

Tincture of Cinchona (concentrated.; j cessfully employ either 
of these remedies (according to symptomatic indications,) simultaneously 
with the internal administration of the same medicine, as stated below. 
Application-. To a wine-glassful of water, add five drops (of the Tinct- 
ure of Arsenicum,) or ten drops (of either of the others,) and saturate 
with this solution a linen pad, which apply to the parts and keep 
moist. 



YELLOW FEVER. 

In this article we have quoted freely from the report of that commis- 
sion of eminent physicians, appointed in 1878 by the oldest National 
Medical Association in America. This commission was composed of 
eleven of the most thoroughly educated physicians in the United States, 
seven of whom were experts in this disease in all its phases. 

Causes and Prevention. Yellow fever is a specific disease, 
entirely independent of malaria, occurring rarely a second time in the 
same person. It is infectious and capable of transmission to any distance 
by means of fomites or infected material. 

The yellow fever germs, for we accept provisionally the germ theory 
of the disease, are indigenous to the West Indies, and, perhaps, to the west 
coast of Africa, and have been thoroughly naturalized in many localities 
in the southern portion of the United States. They were imported into 
New Orleans during the last quarter of the eighteenth century, and have 
existed in the soil or atmosphere of that place ever since, either in a latent 
or an active condition. They may lie dormant for many years consecu- 
tively, and they require a concurrence of causes to develop them into a 
state of disease-producing activity. 

Some of the factors which seem to be favorable to the excitation of the 
yellow fever germ, are the following: 

Low, swampy ground, near the level of a tropical sea. 

Long continuance of very high temperature, following heavy rains. 

Long continuance of south and east winds. 

Aggregations of human beings, with the excreta of their bodies in a 
small space. A crowded and dirty ship may be a nidus for yellow fever, 
as well as a crowded and dirty city. 

Long continuance of calm weather, unbroken by thunder-storms. 



EPIDEMIC AND ENDEMIC INFECTIOUS DISEASES. 579 

Exposure of decaying vegetable and animal matter to a burning sun. 

Inefficient drainage and the general accumulation of filth, especially 
the city garbage. 

Deficiency of ozone in the atmosphere. 

Pestilential exhalations from an upturned soil. 

When the yellow fever germ has been waked into activity by these 
causes, it may be transported to places where none of them exist. It 
seems that a certain concurrence of several of the above factors is neces- 
sary to the generation of yellow fever. There is probably one combina- 
tion in one epidemic, and a somewhat different combination in the next 
epidemic. An epidemic may be mild or severe according to the number 
and force of the concurring causes. There may, also, be other unknown 
but discoverable factors, which may be necessary at one time to produce 
an epidemic, and not necessary another. No one of the above suggested 
causes could excite an epidemic by itself, and it is not probable that they 
all ever concurred equally to the formation of the disease. The most 
extensive collections and comparison of facts are necessary to illumine 
the very great darkness which lies upon these complex questions. 

The naturalized yellow fever germs may receive 'so slight a stimulus 
as to produce only a few sporadic cases. Or they may be vitalized in 
certain localities to such a degree as to occasion quite an outbreak in 
those localities, not easily communicated to other quarters. Or thirdly, 
the disseminated germs may be vivified in all directions, and a general 
epidemic excited. Or lastly, the naturalized germs may lie entirely 
quiescent, until fresh and active germs are brought in from foreign ports, 
which then act as sparks to ignite the inflammable material already 
existing. We thus have four shades or degrees of yellow fever visitation : 
sporadic cases ; local and limited outbursts; epidemics from naturalized 
germs ; and epidemics from importation. 

In sporadic cases and limited outbreaks the specific nature of the 
fever is not clearly brought to light, and it is sometimes difficult to diag- 
nose it from the dominant malarial or bilious diseases. The imported 
epidemic, whether from Havana to New Orleans or from New Orleans to 
Memphis, etc., etc., is always a more quick-spreading and malignant 
disease than that arising from our naturalized germs. The comparative 
mildness of the late epidemic in New Orleans, is one out of several reasons 
for believing that the disease was of local origin. 

The yellow fever of domestic origin can only be prevented by local 
sanitary measures. So long as the public authorities ignore the crying 
evils at home, and watch only for the enemy at the seaside, we shall 
continue to be scourged with repeated epidemics of yellow fever. Quar- 
antine may or may not keep out the tropical foe, but our utmost energies 
should be concentrated against the enemy which has been domiciliated 
in our households for nearly a century. 

Is there any personal prophylatic against yellow fever? None which 
has the least scientific value. Quinine is probably serviceable when 
malarial fevers are simultaneously prevailing, not because it has any 
power against yellow fever, but because an attack of malarial fever, pre- 
ventable by Quinine, might, if allowed to occur, precipitate an attack of 
yellow fever. 



580 YELLOW FEVER. 

Quinine for intermittents, Belladonna for scarlet fever, and vaccina- 
tion for smallpox, are the only prophylactics which have commanded 
even the partial belief of the profession. They are all confessedly homoe- 
opathic in their actions, and we confidently believe, if prophylactics for 
yellow fever or any other disease exist, that they will be found only by 
study and experiment in that direction. 

" To prevent the development of yellow fever we recommend: 

1st. The thorough drainage of the city. This mighty work can only 
be efficiently achieved by the general government. Whether that would 
be constitutional or not we need not pause to inquire. An intelligent 
people will some time or other so modify their government, that it shall 
recognize the superior claims of the health and lives of its population over 
those of railroad companies and harbor improvements. As is well known 
the topography of New Orleans presents very considerable difficulties in 
the way of a perfect system of drainage, but not such as to be insuperable 
to engineering skill. 

2d. The constant irrigation or flushing of the street gutters and canals 
by fresh water pumped in daily by steam apparatus. Allied to this meas- 
ure is a perfect system of water works, which shall give an abundant 
supply of river water for drinking, bathing and cleansing purposes, so as 
to supersede the use of cistern water almost altogether. In this connec- 
tion we may mention a curious fact communicated to the Commission by 
Mr. Harry Hammersly, who keeps a floating bathing establishment in 
the Mississippi river. One hundred and fifty boys under twelve years 
of age took one, and some of them two baths a day during the whole sea- 
son, and not one of them had the yellow fever, although it prevailed ex- 
tensively among their families, and children of that age were peculiarly 
liable to it. 

3d. The consumption of all the city garbage by cremation. This new 
process has been extensively experimented upon during the last six 
months in the city of New York, and with extraordinary success. The 
plan has been described to us by Dr. George F. Foote, of Stamford, Con- 
necticut, a brother of the inventor. A single large furnace has been so 
constructed as to consume 1,000 loads in twenty -four hours. The garbage 
is not handled, but dumped immediately from the carts into the furnace. 
The combustible material mingled with it — old rags, paper, straw, vege- 
table debris, unburnt coal in ashes, the sweepings of stores, factories, 
streets, etc., is about a sufficient supply of fuel for the whole work, when 
the fire is once started under a full blast. The gases from the combustion 
— carbonic oxide and carburetted hydrogen — are brought under the boiler 
and again burned to generate steam to drive the blowing engine. The 
expense for fuel is light ; there is no escaping odor, and the residue or 
slag, about eight per cent, by weight, can be made available for useful 
purposes. 

One such furnace in each district of New Orleans would consume 
daily every atom of its garbage, deliver it from every pestilential emana- 
tion and odor, and give its atmosphere something like the sweetness and 
purity of mountain air. Nor will it be many years, in our opinion, before 
the people of New Orleans, who are compelled by the nature of the soil to 
bury their dead above ground, will discover that in their case, at least, 



EPIDEMIC AND ENDEMIC INFECTIOUS DISEASES, 581 

cremation is the very best disposition to make of the human body, when 
the principle of life has abandoned its tissues. 

4th. The generation of ozone to supply its deficiency in the atmos- 
phere when detected by the proper instruments. This should be made 
one of the most special and important duties of the Sanitary Commission. 
Ozone is a peculiar gas, a modified form of oxygen, generated by electri- 
cal storms and violent concussions of the atmosphere. It is so powerful 
as a disinfectant, that one part of it will purify three million parts of at- 
mospheric air. Ozone is thus nature's great disinfector and purifier, more 
subtle, powerful and ubiquitous than all others, and we must learn to 
utilize this splendid gift of the Creator for our own sanitary blessing. 
When it is deficient, deleterious gases accumulate and produce diseases of 
various kinds, and when the other factors of yellow fever productions are 
present, the deficiency of ozone may be t'he determining element for the 
manifestation of the disease. The scientists of the Sanitary Commission 
will be provided with the instruments and chemical means for detecting 
its slightest variation, and for restoring it in suitable quantity to the air, 
where, by the law of the equitable diffusion of gases, it will be almost in- 
stantly distributed many miles around. 

There are many measures of great sanitary importance over which 
the Commission would exercise a strict supervision. It would enforce 
the frequent emptying and disinfection of water-closets, sewers and all 
places containing putrescent matters, vegetable or animal. It would see 
that no sacks of decaying coffee, or chaff in rice pits, or dead animals, or 
any offensive matter was left exposed so as to poison the atmosphere. It 
would prevent, so far as possible, the destruction of trees, and in every 
way encourage their planting and growth. Above all, it would forbid 
the upturning of the soil during the spring and summer months, as epi- 
demics of yellow fever have followed such upturning at New Orleans, 
Natchez and Vicksburg, in such a manner as very strongly to suggest that 
the relation of cause and effect existed between this exposure of the earth 
and the development of the disease. 

YELLOW FEVER — ITS SYMPTOMS. 

This fever is a disease of warm climates, and has obtained the name 
of yellow fever from the hue which the skin of those affected by it very 
frequently acquires. The more constant symptoms of the disease are : 
violent vomiting, first of bilious and subsequently of brownish-black 
matter, which is also passed by stool; great anxiety and prostration, 
intense fever. Remarkable remissions take place in the course of the 
fever, succeeded in a few hours by exacerbations. The outbreak of the 
malady is generally preceded by sudden debility and restlessness, which 
are soon followed by headache, giddiness, faintness, and slight chilliness, 
to which are added precordial oppression, want of appetite and deranged 
digestion. 

In other cases, the seizure is sudden and unattended with premoni- 
tory symptoms; and the course of the disease exceedingly rapid, and a 
fatal termination not unfrequent within thirty-six hours from the acces- 
sion of the attack. The more usual form which the disease takes is, 
however, as follows: Immediately after the fit of chilliness and horror, 
violent reaction sets in, announced by a high degree of fever, with 



582 YELLOW FEVER. 

great heat of skin, strong throbbing of all the arteries of the body, and 
determination of blood to the head. The respiration is hurried and often 
laborious, attended with deep sighing and gasping for air. The face is 
flushed, the eyes heavy, sensitive to light, and affected with burning 
pain, the tongue white, furred, and sometimes red, but soon becomes 
parched and dark-colored, and tinged with yellow after the vomitings 
come on ; the thirst is excessive. A burning pain is sometimes experi- 
enced in the pit of the stomach ; an excessive sensibility to the touch in the 
right side; and the stomach, irritabie from the first, is rendered so 
much so as the disease advances, that everything which is taken into it is 
almost immediately rejected, along with a quantity of bilious matter. 
Severe darting pains traverse the head, the small of the back, and even 
extend down the thighs. The pulse is subject to variations, being in 
some cases quick and strong, in others quick, low and irregular ; in pleth- 
oric individuals, who have not been long exposed to the relaxing effects of 
the warm climate, it is accelerated, full and bounding, for some hours 
after the development of the reaction ; the urine is suppressed, or scanty 
and offensive; the stools, likewise, have a most disagreeable fetor; the 
patient is excessively restless, tormented with spasms in the abdomen 
and legs, and tosses about with anguish. These symptoms constitute the 
first or inflammatory stage of the fever, and may continue from twenty- 
four to sixty hours, and upwards, according to the severity or mildness of 
the attack. 

The second stage commences with the abatement of several of the 
preceding symptoms, and the increase or substitution of others. The skin 
and eyes present a yellow tinge; the head is confused, or delirium super- 
venes, and the eyes look glassy. The fits of vomiting are more violent, 
and the matter ejected becomes thicker and darker; the patient occasion- 
ally drops asleep, but instantly awakes in a fright, and sometimes he 
springs out of bed in a state of furious delirium, but instantly sinks to the 
ground in a state of tremor and exhaustion; the pulse flags, but is some- 
times soft, at others high ; the tongue is generally parched, harsh, and 
discolored, but sometimes moist, and covered with a dark fur; there is 
frequent hiccup, and the skin is soft and clammy. The duration of this 
stage is also variable ; rarely, if ever, longer than forty-eight hours, some- 
times only twelve. 

The first and second stages terminate by a remission of the more 
alarming symptoms, and a hope of recovery is entertained, but it is too 
often doomed to disappointment by insidious degeneration of the disease 
into the third stage, in which the pulse sinks, becomes irregular and 
intermittent, yet sometimes increases in frequency; the vomiting becomes 
incessant, and is attended with great straining and noise, from the violent 
belching of flatus; the matter vomited is grumous, resembling coffee 
grounds, and is named the black vomit. The breathing becomes more 
labored; the tongue black, or shrunk, dry, and red; the eyes hollow and 
sunk, and the features shortened. A gradual aggravation of the symp- 
toms then ensues, attended with startings or twitchings of the tendons, 
the limbs become deadly cold, and the hiccup distressingly constant. 
Hemorrhage, or oozing of the blood takes place from different parts of the 
body ; the urine is deep-colored, the stools black or sanguineous; the abdo- 



EPIDEMIC AND ENDEMIC INFECTIOUS DISEASES. 583 

men often tense and tympanitic; varices make their appearance, and 
death slowly or suddenly terminates the scene. 

ALLOPATHIC TREATMENT. This disease is one in which the 
treatment must be directed to guiding the patient through it, as in 
typhoid fever. The fever is self-limited, and will run its course. 

The room should be managed as directed for typhoid fever. Disin- 
fectants should be used as directed for that disease. 

A very essential point in all cases, whether mild or not, is to keep the 
patient in bed. This cannot be too strongly insisted on, from the first 
slightest indisposition. 

During the first stage, the use of water should be resorted to, t< 
moderate the intensity of the fever. Preference should be given to the 
wet sheet or cold sponging. They should be managed in the same way 
as directed for typhoid fever. If there is perspiration, (sweating,) bathing 
is not to be followed at all. 

It is recommended by good authority to give three grains of Quinine, 
three grains of Dover's Powder, and three grains of Calomel, every two 
or three hours, while this stage of the fever lasts. (The writer would 
omit the Calomel.) 

It is also recommended, if the skin continues hot and the fever high, 
to produce its reduction with Aconite. Sixteen drops of the Tincture in 
four ounces of water in doses of a teaspoonful, every half-hour, may be 
given until a reduction in the fever is produced. It may then be given 
every hour or two to maintain its effect. It certainly is appropriate, if 
the treatment with water is not satisfactory. 

Purgatives are generally given in the beginning of the disease, but 
they seem uncalled for, except for the relief of constipation, for which 
Castor Oil is to be preferred, in doses of a desertspoonful to a tablespoonful, 
mixed well with an equal quantity of Glycerine and flavored with Oil of 
Cinnamon (or Gaultheria,) or recourse should be had to injections. 

Regarding the use of Calomel or other mercurials, it is difficult to see 
what benefit can accrue from them, further than their action as cathar- 
tics, the use of which has just been discussed. 

Emetics are not to be given, but all stomach troubles should be met by 
proper palliatives. The nausea and vomiting, by the use of Opium to the 
extent of relieving the pain, when, if the vomiting continue, the addition 
of Carbolic Acid, or Creosote, in doses of one drop, or ten to twenty grains 
of Sub-Xitrate of Bismuth, or five-drop doses of Dilute Hydrocyanic Acid 
may be given every hour or two, until the vomiting is relieved. Small 
lumps of ice may be swallowed. Mustard plasters, dry cups, or small 
blisters, two inches square, may be applied over the stomach. Warm 
poultices over the stomach often relieve the nausea and pain. 

Probably as appropriate a way to administer Opium as any, is by the 
hypodermic injection of a sixth of a grain doses of Morphine, or injec- 
tion of a teaspoonful (dram) of Laudanum in an ounce of thin starch, in- 
to the bowel. The drug should be given .at any time when necessary to 
relieve suffering. The ordinary dose may be given by the mouth, as one- 
fourth of a grain of Morphine. 

Any coldness of the extremities should be met by the application of 
heat by the hot foot-bath, made stimulating by adding Mustard or Cay- 



584 YELLOW FEVER. 

enne pepper, and Mustard plasters. The bath should be given under the 
bedclothes. In this way the tendency to internal congestion, upon which 
may depend the tendency to hemorrhage, is relieved. 

Cold to the head, by means of cold water, the ice cap, or bladders of 
pounded ice, may be used to relieve headache. 

As soon as the amelioration of the symptoms (usually temporary) 
occur at the close of the second or third day, particular attention must be 
given to nourishing the patient and keeping him quiet in bed — perfectly 
quiet, and carefully covered with blankets. Bathing and all other means 
of reducing the fever should cease. 

Food and alcoholic stimulants must be given, as directed in the treat- 
ment of typhoid fever throughout the course of the disease. By this 
means alone life may be saved. 

Beginning at the period of amelioration in the symptoms, tonic doses 
of Quinine, from two to three grains four times a day, should be given. 

The mineral acids are indicated the same as in typhoid fever, prefer- 
ence being for the Aromatic Sulphuric Acid, on account of the tendency 
to black (hemorrhagic) vomit. The dose is ten drops largely diluted with 
water. It can be given at intervals of two hours or more. The teeth 
should be wiped with a cloth dipped in a solution of Bicarbonate of Scda 
after giving the acid to prevent injury to them from the Acid. 

To prevent hemorrhage into the stomach, and consequent black vomit 
ten or fifteen-drop doses of the tincture of the Chloride of Iron should be 
given four to six times a day, largely diluted in sweetened water. If 
hemorrhage occurs ten-grain doses of Gallic Acid should be given in the 
Acid mixture, until that symptom disappears. 

Difficulty in the secretion of urine should be met by diuretics, as the 
infusion of Digitalis in doses of a tablespoonful, or the Tincture in doses of 
half a teaspoonful with half a teaspoonful of the Vinegar of Squill, given 
four to eight times a day. 

If diuretics are inoperative, and especially if there are symptoms of 
uremia, (poisoning by retention of urea, an ingredient of the urine, in the 
blood,) the smell of Ammonia in the breath, or insensibility, the hot air 
bath should be used to produce copious sweating. If this does not relieve, 
a cathartic of one or two drops of Croton Oil or a quarter of a grain of 
Elaterium in Glycerine may be given. 

When the symptoms of remittent or intermittent fever are associated 
with yellow fever the first remission or intermission should be seized upon 
for giving thirty grains of Quinine at a dose. Subsequent treatment of 
these complications should be as directed for these diseases. 

Salycilic Acid has been used by Dr. Buenz, of Savannah, in the epi- 
demic of 1876, in a single dose of a dram and a half in capsules, or rubbed 
up with sugar ; if the stomach rejected it, twice the quantity (three drams) 
was given by the rectum (injections into the bowel.) Out of one hundred 
and seventy-nine patients only four died. The disease during that epi- 
demic was of intermittent and remittent type. Whether this treatment 
is generally applicable is a question as yet undecided. 

During the severe epidemic of 1878, in the Southern states, Dr. Mar- 
shall of Burlington, Iowa, who was then at Jackson, Miss., states while 
the disease was almost universally fatal, wonderful results were obtained 



EPIDEMIC AND ENDEMIC INFECTIOUS DISEASES. 585 

by treating patients on the general principles appropriate to fevers which 
must run their course, which we have just sketched. The bowels were 
kept open and the kidneys active by the use, from the beginning to the 
end, of the Hyposulphate of Soda. An ounce of this salt was dissolved in 
eight ounces of water and a tablespoonful given every four hours. The 
patient was kept well covered with blankets and a gentle sweating encour- 
aged by the use of Orange Leaf or Horse-mint tea. Besides this, keeping 
the patient in bed during the stage of calm, and giving liquid nourishment 
and stimulants and tonic doses of Quinine, constitute the treatment. An 
almost universal fatality was reduced to a fatality of one in ten in whites, 
two in fifteen in mulattoes, and one in thirty-six in negroes. Getting up, 
or eating solid food of any kind during the disease, which patients desire 
to do during the stage of calm, is almost always fatal. 

HOMCEOPATHIC TREATMENT. All through this work numerical 
comparisons have been steadily avoided, but on account of the thorough 
reliability and the broad extent of country covered, we think we may be 
excused for thus presenting these statistics, when it is so evident that it will 
be the means of saving very many valuable lives. The treatment here fol- 
lowing has been thus proven, and if these remedies are given in time (as 
they will be where this work is owned) and the full directions followed 
the deaths from this terrible destroyer and foul plague of all hot climates 
will, we confidently believe, be reduced below three per cent of all persons 
attacked with the disease. We quote again from the before-mentioned 
report: 

On analyzing the reports handed to us, we ascertained the following 
facts : 

We have here 1.945 cases of yellow fever treated homceopathically in 
the city of New Orleans, with a loss of 110 patients, a mortality of 5 6-10 
per cent. 

We have 1,969 cases of yellow fever treated in cities and towns outside 
of New Orleans, with a loss of 151 patients, a mortality of 7 7-10 per 
cent. 

This makes a total of 3,914 cases of yellow fever, treated homceopath- 
ically, during the epidemic of 1878, with a loss of 261 patients, a mortality 
of 6 6-10 per cent. 

We have, moreover, reports of 555 cases treated homceopathically in 
the great epidemic of 1853, with a loss of 33 patients, a mortality of 6 per 
cent. 

Also, reports of 2,100 cases treated during the several minor and much 
milder epidemics which occurred between 1S53 and 187S, with a loss of 66 
patients, a mortality of 3 7-10 per cent. 

Making a grand total of 6,569 treated by homoeopathic physicians, 
with a loss of 360 patients, a mortality of 5 4-10 per cent. 

The number of cases reported as occurring in 1S78, among negroes, 
including mulattoes, was exactly 900 — with a loss of 27 patients, a mor- 
tality of 3 per cent. 

Some physicians did not distinguish between their patients as to race 
or color. The number distinctly reported as white, was 2,299, of whom 
194 died, a mortality of 8 4-10 per cent. This includes the returns from 
points like Memphis or Chattanooga, where the fever was very malignant, 



586 YELLOW FEVER. 

and the mortality very great. In four of the New Orleans reports, 1,076 
patients are described as being white, of whom 66 died, a mortality of 6 
1-10 per cent. 

The number of cases distinctly reported as colored in the city of New 
Orleans, was 107, of whom 3 died, a mortality of a little less than 3 per 
cent. 

The total number of cases reported as being under 15 years of age, is 
1,089, of whom 48 died, a mortality of 4 4-10 per cent. 

The total number of recoveries after black vomit, was 125. This 
dreaded symptom, formerly considered so fatal, has been growing less and 
less so since the epidemic of 1853, and a great many recoveries have been 
recorded during the great visitation by gentlemen of both Schools. Chil- 
dren seemed to have it more frequently in proportion to numbers, and to 
recover from it more readily than adults. We must not forget that there 
are various shades and degrees of black vomit. Blood more or less black- 
ened by the acids in the stomach, may have been quite healthy when 
exuded from the mucous membrane of that organ, and be far less prog- 
nostic of danger than that sooty, coffee-ground substance, the genuine 
black vomit, which shows under the microscope a chemical destruction 
and disintegration of the blood-globules. 

Among these returns are nine papers to which we attach especial 
value. These comply fully with the request of the circular letter, to give 
not only cases and deaths, but the name, age and address of every patient 
attended, so that with these documents in our hands, we can verify every 
statement, and challenge comparison with any member of the Allopathic 
School who can furnish us with similar acurate data. 

These returns exhibit an attendance upon 2,010 cases of yellow fever, 
with a loss of 129 patients, a mortality of 6 4-10 per cent. There were 64 
recoveries after black vomit. The number of children under 15 years of 
age amounted to 828, of whom, only 40 died, a mortality of 4 6-19 per cent. 
HOM(EOFATIIIC TREATMENT. Aconitum has been named as the 
most direct and positive remedial agent in the early stage of yellow fever; 
and, indeed, its specific effect upon the human economy in a healthy state, 
especially under conditions of temperature provocative of the generation of 
fevers of this kind, tends greatly to confirm this opinion. In case of an 
attack of fever of an inflammatory character, whether it be apprehended 
that it may resolve itself into this form or not, the prompt administration 
of Aconitum can only have been productive of benefit. 

Dose: Six pills in a teaspoonful of water, or dry on the tongue, 
repeated, after the lapse of one or two hours, and subsequently, at 
intervals of one, two, three and four hours, until the fever symp- 
toms abate, the breathing becomes less laborious, and the pulse more 
regular, or less quick and frequent. But if symptoms of severe 
exacerbation should threaten to succeed, notwithstanding the admin- 
istration of Aconitum, proceed promptly with such of the following 
medicines as may offer the closest analogy to the case. 
Belladonna may prove of much service after the previous adminis- 
tration of one or two doses of Aconitum, for the treatment of those cases, 
(during the first stage) which attack young, full-habited subjects, with very 
marked and predominant brain-symptoms. It is useful in the first or 
second stages. 

Dose : As directed for Aconitum. 



EPIDEMIC AND ENDEMIC INFECTIOUS DISEASES. 587 

Bryonia may be called for in the first, or even in the second stages, 
where Aconite or Belladonna have not sufficed to allay the symptoms. It 
is more particularly indicated when the pains assume a rheumatic charac- 
ter, and all the symptoms are aggravated by motion. 

Dose : As directed for Aconitum. 

Arsenicum, Faintness, depression, nausea with intense burning in 
the region of the stomach, increased by pressure ; violent vomiting of 
brown turbid matter, mixed with mucus, and sometimes stained with 
blood. Pulse small, frequent and irregular ; skin cold and clammy in the 
stage of collapse, at other times it is very hot; breathing feeble and accom- 
panied with sighing; great nervous irritability ; intolerable pain in the 
bowels, w T ith dark, or bloody stools; great emaciation; want of sleep, 
urine scanty, high-colored, and passed with an effort; delirium; jerking; 
coma; convulsions; thirst frequent, but usually for the moment satisfied 
with a small quantity of water. 

Dose: Six pills in a little water, or dry, every one to three hours, or in 
severe cases, every ten or fifteen minutes. 

Crotalus has been employed in some cases with very marked success, 
all danger having been subdued after a few hours, even in cases which had 
reached the fully developed third stage. It is more especially indicated by 
the hemorrhages occurring from the oyes, nose, mouth, ears, stomach and 
bowels. 

Dose : As directed for Arsenicum. 

Agentum Nitricum has been employed in some cases, with good 
effect, where the patient is sinking, the vomiting becomes worse, with 
brownish stains in the matter ejected, or other evidence is given of effu- 
sion of blood upon the mucous lining of the stomach. 

Dose: As directed for Arsenicum. 

Pulsatilla. Mercurius, Nux-vomica, Acid-nitricum, and China 
may prove of service in the first or second stages, more particularly, and 
Cantharis, Digitalis, Carbo-veg.,Croton-tiglum, Rhus-tox., and Veratrum- 
album, in the second and third stages, more particularly. The selection 
should be guided, in each case, by the analogy existing between the 
symptoms of the disease, and those which are specific to each of these 
medicines, as found by the appended " RepertoPwY." 



ASIATIC CHOLERA— MALIGNANT CHOLERA— EPI- 
DEMIC CHOLERA. 

This virulent disease generally commences with giddiness, headache, 
singing in the ears, and uneasiness, a sensation of flatulence in the 
stomach, (rumbling of wind), or griping pains, rapid loss of strength, and 
a feeling of weight and oppression in the region of the heart. In the 
severest forms of the malady, the patient suddenly falls senseless to the 
ground, as if struck by electric fluid. But in many instances, diarrhoea 
is the first symptom, which, if neglected, soon becomes associated with 
vomiting, severe colic, cramps, or convulsions, anxiety, and dread of disso- 
lution, which appears to be inevitable. 

In some, though not all, cases of Asiatic Cholera, we find the lips, 
nails, and sometimes the whole skin, of a blue color, but, in almost every 



588 EPIDEMIC CHOLERA. 

instance, the frame loses its power of generating heat, the pulse and pulsa- 
tion of the heart are almost unfelt, and the circulation of the blood 
becomes stagnant. 

Patients who have outlived the second stage sometimes fall victims 
to a secondary typhoid fever in the third. 

Predisposing Causes.— The predisposing influences are: intemper- 
ance in eating and drinking, insufficient of or cold, indigestible fruit 
and crude vegetables, cold drinks, when the body is overheated; exposure 
to exhalations from decayed vegetable or animal matter, residence in 
low, damp, dark, ill-ventilated dwellings; excessive fatigue, suddenly 
suppressed perspiration, sudden mental shocks, or moral emotions, as 
fright, fear, grief, and especially passion; neglect of cleanliness, both 
personal and domestic ; constitutional debility, serious derangement of 
the digestive organs, weakness of the bowels, etc. As any, or, at all 
events, several of these in conjunction, tend to favor the invasion of the 
disease, they ought, when practicable, to be carefully guarded against or 
removed. 

Exciting Causes.— These are generally said to depend upon some 
peculiar atmospheric conditions. But it is to be remarked, that such 
atmospheric conditions, (properly so called, in contra-distinction to the 
many other immediate causes of disease, with which the atmosphere 
may be impregnated), do not appear, necessarily, to involve whole 
regions, or even extensive tracts of country. Cases are not wanting, 
especially in tropical climates, in which this disease, in all its distinctive 
features, has occurred, almost in isolated instances, or has been confined 
to particular spots. 

ALLOPATHIC TREATMENT. In the treatment of epidemic, or 
Asiatic cholera, this much appears to be settled, that upon the appearance 
of the diarrhoea, (cholerine,) which is preliminary to the disease, the 
patient should take to his bed, and remain there; this is essential to 
success. The remedy which is best suited to control the preliminary 
diarrhoea, is Opium. Strychnine, Sulphuric Acid, Chloroform, and 
Camphor, have been found useful. The following formula is found 
useful during this stage: Take a fourth of a grain of the Sulphate of 
Strychnine, Aromatic Sulphuric Acid half an ounce, Sulphate of Morphine 
two grains, Camphor Water three and a half ounces. Mix; a teaspoon ful, 
well diluted, may be given every one, two or three hours, according to the 
severity of the diarrhaza. The plan of checking the diarrhoea by a full 
dose of Opium, varying from a quarter of a grain, to one grain of 
Morphine, according to the severity of the diarrhoea, is a good one. The 
continued use of the above mixture would then be appropriate. But a 
return or increase of this symptom, (diarrhoea,) should be met with 
another full dose of Opium after an interval of not less than an hour. 
The bowels should move in a bed-pan, the patient not being allowed to 
rise to stool. The stools should be buried, and the vessels thoroughly 
washed and disinfected by keeping a solution of Permanganate of 
Potash, or Carbolic Acid, in them. The floor may be sprinkled with 
Labarraque's Solution, or a solution of Carbolic Acid, one part to forty 
of water. 



EPIDEMIC AND ENDEMIC INFECTIOUS DISEASES. 589 

The food, when there is diarrhoea, should be composed of farinaceous 
articles, milk, and beef tea. 

The drink may be Sulphuric Acid Lemonade, using for a change, and 
to gratify the taste, plain water, cold tea, or milk and water. 

Hot poultices, or mustard plasters, may be applied to the abdomen to 
relieve pain. 

When vomiting and purging occur, there appears to be no remedy 
more generally useful than Chloroform, given in doses of five to ten drops 
every half hour, or hour. It relieves the vomiting, pain, and spasms. 
Lint, saturated with Chloroform, laid over the stomach, and covered 
with oiled muslin, will aid in controlling the vomiting. 

The use of Chloroform may be continued in five to ten drop doses, or 
teaspoonful doses, of Spirits of Chloroform, (Chloroform one part to Alco- 
hol twelve parts.) every half hour, or hour, may be continued, either of 
which may be given in teaspoonful doses of Camphor Water, which will 
give the beneficial effect of the Camphor. The benefit of that variable 
mixture called Chlorodyne depends largely upon the Chloroform it 
contains. 

Brandy, or Whisky and water, should be given as freely as the 
stomach will retain them, in small quantities at a time. 

The thirst may be relieved by water, rendered slightly sour by the 
addition of ten to thirty drops of Aromatic Sulphuric Acid to a glass of 
water. Ice water may be taken in small quantities, or simple water may 
be used. Water is not harmful, if it does not provoke vomiting. Small 
lumps of ice may be given. 

Concentrated nourishment as milk and meat essences should be fre- 
quently given in small amounts (with whisky or brandy, or without) if 
the stomach does not reject it. 

When collapse occurs the Opium and Strychnine before appropriate 
are not to be given, because they may not be absorbed, and when the pa- 
tient rallies from the collapse (if he does,) there is danger from an over 
dose by accumulation in the stomach. 

The remedy which has yielded the best results in the stage of collapse, 
or when it was approaching, is the Hydrate of Chloral given by hypoder- 
mic injection, from five to ten grains in solution in water being the dose 
given at intervals of half an hour to an hour or two. It is often advan- 
tageously given with Morphine in doses of from an eighth to a quarter of 
a grain. 

The surface of the body should be kept warm, if possible, by dry heat, 
such as hot flannels, bottles of hot water, etc. It is not desired to occasion 
sweating, but perspiration should be wiped off with warm dry cloths. 

Injections of warm water or injections of whisky with warm beef tea 
are permissible. The latter has been known to avert an approaching col- 
lapse and arrest the diarrhoea. 

If the patient rally from the collapse the cautious use of nourishment 
and stimulants as directed for typhoid fever are indicated. If the kidneys 
do not act freely they should be'stimulated by the use of half teaspoonful 
doses of the Vinegar of Squills in a dessert or tablespoonful of Infusion of 
Digitalis four times a day, and bland drinks such as flaxseed tea or barley 
water. If coma (insensibility) occurs, the hot air bath should be resorted 



590 EPIDEMIC CHOLERA. 

to, to throw off the urea by sweating. The danger of ursemic poisoning 
is averted by getting the kidneys to acting freely. Tonics should be given 
For this purpose there is none better than two or three grains of Quinine 
given four times a day. 

Thorough cleansing and disinfection of buildings and surroundings, 
having privy vaults, drains, and vessels which receive excretions, house 
waste, etc., contain disinfectants, no filth of any kind being allowed to 
accumulate, the severe ravages of the disease may be prevented. 

HOMOEOPATHIC TREATMENT. The success of treatment much 
depends upon the promptness with which remedial resources are exhib- 
ited, upon the earliest recognition of the attack. 

Tincture of Camphor, if administered upon the earliest premoni- 
tory indications of the attack, will often avail to prevent the further 
development of the disease, and will, at all events, in the great majority 
of cases, avert fatal consequences. The following are the particular indi- 
cations in the early stage — chilliness, shivering, giddiness, headache, 
singing in the ears, pain, weight, pressure, or a distressing sensation in 
the pit of the stomach, cramps with protracted rigidity in the calves of 
the legs, sensation of general uneasiness, sudden loss of strength; sunken, 
blue-encircled eyes ; diminution of the senses; slow, or scarcely percep- 
tible pulse; blueness and icy coldness of the face and hands, and greatly 
diminished temperature of the whole body ; burning heat in the throat 
and region of the stomach ; distended bowels ; much flatulent rumbling; 
nausea and even vomiting, and diarrhoea; diminished or suppressed urine 
(an almost constant symptom in cholera;) hoarse voice; countenance 
expressive of excessive anguish ; suffocating oppression. After taking 
Camphor, sweat soon breaks out as a sure sign that an improvement has 
commenced. Then the remedy must be given less frequently and in 
smaller doses, or it may give rise to congestion of the brain. 

Dose : Take of the purest loar sugar, or of Sugar of Milk finely powdered 
just a sufficiency, upon which deposit a drop of the tincture, thus 
administering the dose, and repeating such dose, at first every five 
minutes, extending the intervals according to the duration of the 
intermissions between the spasmodic attacks, only repeating the 
administration as the attack returns, and continuing this course 
until positive amelioration or change. Decided improvement is 
readily distinguishable: first, by increased warmth, and, shortly, by 
diminution of anxiety, by comparatively healthy perspiration, and 
by an inclination to sleep. After sleeping an hour or two the 
patient awakes with a sensation of ease, which he can scarcely 
believe. 
Veratrum (especially under the particular circumstances just enu- 
merated) should be employed without a moment's delay, when cholera 
sets in, in its worst and characteristic form, with sudden and violent fits 
of vomiting and purging, the evacuations resembling starch or rice-water, 
after several paroxysms ; flatulent rumblings, excruciating gripes, severe 
cramps (either with protracted rigidity, or with rapid alternations of con- 
traction—particularly the letter) in the calves of the legs, etc., (second 
stage,) ice-like coldness of the entire body, even of the tongue, cold, clam- 
my sweat, suppressed respiration, feeble pulse, great thirst— the patient, 
if permitted, drinking large quantities of water— excessive weakness, 
terrified look, weak, hollow voice, groaning and yawning. 



EPIDEMIC AND ENDEMIC INFECTIOUS DISEASES. o91 

Dose: Six globules in a teaspoonful of water, every quarter of an 
hour, (in extreme cases) or every half hour (in less urgent circum- 
stances,) or even in some very desperate cases, and when a fatal issue 
seems imminent, every five minutes, until the extreme severity of 
the symptoms becomes somewhat abated ; and, subsequently, every 
time'the paroxysms return, and so on until the symptoms yield or 
change. 
Arson icum-album displays its curative action in those terribly 
rapid cases where cholera algida at once sets in without any premonitory 
symptoms. The most essential indications for Arsenicum are : Sudden 
and complete exhaustion, vanishing of the pulse, together with violent 
palpitations of the heart, great dyspnoea, inexpressible anguish, constant 
tossing about, horrid thirst, yet the least quantity of liquid is vomited up 
again immediately ; burning distress in the region of the stomach and 
upper portion of the bowels; complete suppression of urine. In such 
cases Arsenicum should be given at once, without any other medicine 
being resorted to in the first place. After the exhibition of Arsenic the 
urine is often secreted in large quantity, a very favorable change. 

Dose: Six pills in a teaspoonful of water, every quarter of an hour 
(in urgent cases,) or even every five minutes (when a fatal issue 
appears imminent.) or only every half hour (in cases of a less desper- 
ate character,) until the symptoms are modified, and the sufferings 
are not so incessant : then extending the intervals according to the 
duration of the periods of remission between the paroxysms and so on, 
until positive change. 
Aconite is a splendid remedy if, in the beginning, or after the blue 
cold stage, there is heat of the skin, quickness of the pulse, headache, 
noise in the ears, dryness of the tongue with craving thirst, this remedy 
should be given in small doses — six pills every ten to thirty minutes. 

On the other hand, when the skin is cold, clammy and livid, the pulse 
not perceptible at the wrist, the action of the heart quite feeble and 
irregular, the head cold, the pupils of the eyes dilated very much, and not 
sensitive to the effects of light, involuntary discharge from the bowels 
of a thin stool resembling rice-water, vomiting of a similar substance, the 
dose should be large— twenty drops of the Tincture of Aconite, in a glass- 
ful of water, to be given one teaspoonful every fifteen to sixty minutes. 

Carbo-veg may often be advantageously employed after the previous 
administration of one or more of the preceding medicines, or even in 
alternation with Arsenicum (in some cases) when the patient is reduced to 
the last extremity, animation being all but completely suspended, and the 
pulse scarcely perceptible; or when, on the cessation of vomiting, purging, 
and cramps or convulsions, determination of blood to the head and chest 
ensues, attended with oppressed breathing, coldness of the breath, redness 
or livid hue of the face (which is covered with clammy sweat) and lethargy 
— the patient seeming as if seized with an appoplectic fit. Also, when 
every sign of reaction has been extinct from the beginning. 

Dose : Six pills in a teaspoonful of water (or,— if there be difficulty in 
ensuring its being swallowed thus— dry on the tongue,) at intervals 
of five, ten, and fifteen minutes successively, and then (if the pulse 
become stronger) every half hour until positive change. But if, 
upon the development of stronger pulse, and the subsidence of the 
lethargic symptoms, the pain, vomiting, cramps, etc., should return, 
at once, resume the administration of Veratrum, as before. 
Additional Partictlars. Ipecacuanha, Nux-vo?n,ica, These 



592 EPIDEMIC CHOLERA. 

remedies (the first either singly or followed by Nux-v.) have been found 
efficacious either before or after the previous administration of the other 
medicines, (generally when more urgent/symptoms had been overcome,) or 
at the onset of the attack (in milder cases,) when such indications as the 
following could positively be identified. 

Ipecacuanha may be administered under circumstances such as 
those just stated, either after previous treatment, when the vomiting 
becomes a prominent symptom, and the discharge attending it is more 
copious, or at the onset of the attack, when the vomiting (being copious, 
and attended with much nausea) predominates, so as to characterize the 
case distinctly. Further indications for this remedy, are such as the fol- 
lowing:— sensation of weakness (or of internal sinking,) coldness of the face 
and limbs, sensation of shivering in the belly, slight cramps in the calves of 
the legs, and in the fingers and toes ; or sometimes, again, vomiting, alter- 
nated with watery diarrhoea, accompanied with, or preceded by griping, 
colicky pains ; or even yellowish diarrhoea in some cases in which the 
vomiting does not occur; or loose evacuations of excremental matter, 
mingled with slime (at the commencement of the attack,) or evacuations 
of a greenish or brownish character. 

Dose: Of a solution of twelve pills to four tablespoonfuls of water, 
give a teaspoonful every hour, until change. But if, after the more 
violent symptoms (the vomiting especially) have yielded in a degree 
to the action of Ipecacuanha, pause three hours, and proceed with the 
next medicine, if the subjoined symptoms remain. 
Nusc-vomica may be employed with great advantage three hours 
after the last dose of Ipecacuanha, when the vomiting has subsided under 
the influence of the last-named medicine, but symptoms of spasm of the 
stomach remain, such as weight and constriction in the region of the 
stomach; or again, when anxiety, great debility, griping, frequent, small 
evacuations with much straining, frontal headache, or aching pain at the 
back of the head, and shuddering, with predominant internal chill, con- 
tinue to prevail. 

Dose: Of a solution of six pills to two tablespoonfuls of water, give a 
teaspoonful every hour, until the symptoms abate ; and then every 
three hours, until positive change. 
Cicuta-virosa has proved an appropriate remedy, when there are 
spasms in the muscles of the chest, continuous vomiting, and a little diar- 
rhoea, when the eyes are turned upwards, and the patient is in a drowsy 
state. 

Dose : Six pills in a teaspoonful of water, (or, if there be difficulty in 
this method, dry on the tongue,) every ten minutes, until the symp- 
toms abate, and then every half hour, until positive amelioration or 
change. 
Treatment of the After-effects of Cholera. Carbo-veg. is of 
much service in the stage of convalescence, when flatulent rumblings, and 
colic with diarrhoea and excessive flatulence during stool remain. 

Dose : Four pills in a teaspoonful of water every hour, or after every 
intestinal evacuation, until a degree of improvement becomes appar- 
ent, and then every twelve hours. 
Phosphorus is very useful when debilitating diarrhoea remains after 
the removal of the more urgent symptoms, and particularly when the 
stools are watery, and sometimes productive of an acrid, pungent sensa- 
tion in the last intestine, and attended with belching, weight or oppression 



EPIDEMIC AND ENDEMIC INFECTIOUS DISEASES. ^3 

at the pit of the stomach, and lateral regions (without the heat or burning 
which accompanies this symptom in the cases that call for the employ- 
ment of Arsenicum,) and pain in the region of the navel, rumbling noise 
in the bowels, either at other times or on pressing the hand against the 
belly, pricking or shooting pains in the left side of the chest, etc. Phos- 
phorus is also useful when a tendency to vomit remains, but with the 
distinctive indication that it only occurs about a quarter of an hour or so 
after drinking, or when the cold fluid drank has become warm in the 
stomach. Again, it is a remedy of much importance in the event of con 
gestion in the chest, with oppressed and laborious breathing, in addition 
to the before-mentioned symptoms during the course of the disease. 

Dose: Four pills in a teaspoonful or water, every three hours (or 
every hour in more urgent cases) until the symptoms abate, and 
then every six hours. 

Aeidum-phosphoricum should be administered, either after the : 
previous use of Phosphorus, or even before it, in the event of the tongue 
becoming exceedingly clammy, or slimy ; or, again, if colliquative diar- 
rhoea should ensue, with or without the typhoid or congestive symptoms, 
hereafter described; or when the dullness of the head, and pallor of the 
face, occur; or the evacuations are watery or slimy, or exhibit a greenish- 
white hue, and there is inadequate discharge of urine. 

Dose: Of a solution of six pills to two tablespoon fuls of water, give a 
teaspoonful every two hours. 

Accessory Treatment. The patient should be kept in a room 
of a warm temperature, the bed should be heated by artificial means,; 
bottles of hot water applied to the feet, if necessary, and hot flannels to 
other parts of the body. The observance of this rule greatly facilitates 
the action of the medicine employed. Enveloping the patient in a damp 
sheet, (one which has previously been soaked in warm water.) and then 
wrapping him in blankets, is another useful auxiliary mode of treatment. 
Frictions with woolen cloths, and the act of rubbing and pinching, under 
the bedclothes, the parts affected with spasms, have also been recommend- 
ed; but if these auxiliary measures prove distressing to the patient, he 
should be left quietly under the action of the medicine. Anything which 
might disturb the equanimity of the sufferer, such as noise or contra- 
diction, should be carefully avoided, and his spirits should be sustained 
as much as possible. 

Food and Drink. Cold water is the best drink, but the patient 
should not be allowed to take too much at a time ; the occasional adminis- 
tration of a small piece of ice, if possible, or of iced water in teaspoonfuls 
is often attended with benefit; and injections of iced water are sometimes 
serviceable in relieving the colic and cramps in the intestines, or of starch- 
water in the case of straining. When cold water, in lieu of diminishing, 
increases the vomiting orother sufferings, and the patient expresses a wish 
for a little nourishment, tepid emulsion of sweet almonds, thin gruel, 
barley water, toast water, milk and water, (all warm and given a 
teaspoonful at a time,) may be administered. 

During the convalescence following this disease, we must be careful 
not to indulge the patient to the full extent of his desires. It is, there- 
fore, advisable, when the appetite returns, to commence with Semolina, 
Sago, Arrowroot, and such like, as also Cocoa, chicken broth, or beef tea; 

38 



594 RHEUMATISM OF THE JOINTS. 

but great caution must be observed, in order to avoid the risk of a relapse 
from an undue amount of nutriment. This is best accomplished by the 
administration of a tablespoonful every hour, or only every two or three 
hours, diminishing, or gradually augmenting, and varying the quantity 
and quality of the food, according to the effects produced. 

General Accessory Precautions.— Care ought to be taken to 
avoid excesses of all kinds, late hours, exposure to night air, melancholy 
thoughts, or fear, which are all predisposing causes to the attacks of this 
malady. 

Pure air, and thorough ventilation, are indispensable, and the 
precaution of providing a free current of water through all drains, etc., is 
not to be neglected. If it be known that stagnant, or obstructed drains, 
cesspools, and the like, are distributing noxious exhalations about a 
dwelling, the safest course is, (if possible,) to remove to another locality; 
the next, to endeavor to neutralize the poison which is given out by 
these decomposed deposits, by means of chloride of lime, or peat, 
charcoal, etc. It is, however, very hazardous to set about removing such 
nuisances during the prevalence of the epidemic; this should have been 
done before, or should generally be left until afterwards, when there is no 
longer reason to apprehend the distribution of additional causes of 
disease; a keen frost may render the cleansing of foul places comparatively 
safe. 

Kegular exercise should be taken during the best part of the day (in 
fine weather) in the open air, but excessive fatigue should be avoided. 
preservative measures during the prevalence of cholera. 

Accurate observance of the Homoeopathic Preventive Regulations 
will, in a very great number of cases, avert the attack altogether. 
But, even if this should not be the case, the disease will, in general, 
be developed in a very modified form, and such as will usually be 
readily subdued by the employment of Camphor, (as heretofore directed 
at page 590.) In some few cases, further treatment may become neces- 
sary, according to the directions stated in the foregoing portions of this 
article, but there will rarely be reason to apprehend a serious issue. See, 
also, Veratrum. 



RHEUMATISM OF THE JOINTS. 

MUSCLES OF THE FOOT. 



m 




A. Os Calcis. B and F. Flexor brevis digitorium. C. Abductor 
pullicis. D. Abductor minimi digiti. E. Flexor longus digitorium. 

CHAPTER XXIX. 

CONSTITUTIONAL DISEASES WITHOUT DEFINITE INFECTION. 

ACUTE ARTICULAR RHEUMATISM — RHEUMATISM 
OF THE JOINTS. 

This form of rheumatism often arises from a cold, and from exposure to 
the atmospheric influences; it not unfrequeutly assumes an epidemic type, 
and, in such a case, breaks out most commonly in the fall and winter. 



596 CONSTITUTIONAL DISEASES WITHOUT INFECTION. 

The disease commences very gradually, with a vague feeling of fatigue, 
accompanied with slight catarrhal symptoms; it may break out after 
severe attacks of angina, very seldom suddenly, and scarcely ever with a 
chill, but with alternate chills and heat. Simultaneously with the fever, 
very seldom after, and still less seldom before, one or more joints become 
painful; the pain rapidly increases, and the joint swells, sometimes with, 
and at other times without, redness ; at this period, the least motion, and 
the least pressure, cause pain, so that the patients remain perfectly quiet, 
for fear of hurting themselves. Generally, several joints are attacked at 
once, very seldom only one at a time, never all the joints at once from the 
start. The disease progresses in a very characteristic manner. While the 
joint that was first attacked, is getting better in three to five days, 
sometimes with a complete cessation of the pain, as well as the swelling, 
other joints are attacked in the same manner ; in this manner most of the 
other joints are invaded, after which the rheumatism frequently breaks 
out again in the joint whence it had originally proceeded. At times the 
swelling is quite considerable, at other times scarcely perceptible; some- 
times it is confined to the joint alone, at other times the surrounding 
parts are very extensively involved ; not unfrequently the articular 
extremities feel enlarged. The constitutional symptoms are at times very 
violent, at other times very slight ; this depends a good deal upon the 
number of joints involved. The fever runs pretty high, remitting very 
irregularly ; the temperature is not much raised above the normal 
level ; pulse about one hundred, in very acute cases increasing very sel- 
dom to one hundred and twenty and upwards, small and changeable ; a 
copious perspiration, having a musty, sour smell, continues during the 
whole course of the disease, corresponding with which the patients are 
tormented by a distressing thirst. The urine is very scanty, saturated, 
and, on cooling, deposits a copious sediment. The digestion is slow, the 
appetite impaired, but very seldom entirely suspended. 

The course of uncomplicated rheumatism is never very rapid, gener- 
ally more or less wavering; recovery takes place gradually; single joints 
may remain painful and swollen for a long time, the pulse remains obsti- 
nately accelerated, the perspiration continues, the weakness abates very 
slowly. A favorable change takes place very seldom after the first week, 
a little more frequently after the second, but most commonly only after 
the third and fourth week. Very often we have noticed that, before the 
disease terminates, every joint is attacked twice, and that the second 
attack only lasts half as long as the first. In violent cases all the joints 
are affected together at the termination of the attack, some, however, are 
more acutely inflamed than others. 

With proper management and care this form of rheumatism ends in 
recovery in one week at the latest. However, by neglecting to guard 
against relapses, an acute attack may very easily terminate in a chronic 
form, and contractions and paralytic conditions may arise which can only 
be removed with great difficulty. 

CHRONIC ARTICULAR RHEUMATISM. 

It most frequently develops itself out of the acute form, of which it 
constitutes a rest, as it were; it likewise arises from the continued action 
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598 RHEUMATISM OF THE JOINTS. 

Chronic rheumatism is less frequently located in the external integu- 
ments of the joints where acute articular rheumatism is generally seated 
than in the synovial (inner) membrane lining, the ligaments and articular 
cartilages. Little by little these grow thicker and rough. The disease sel- 
dom involves a number of joints ; generally it is limited to one or a few 
only. Neither the swelling nor the pain is very considerable ; to some ex- 
tent the power of motion remains, yet the patients may be entirely de- 
prived of the use of the affected limb, while the rest of the body is per- 
fectly sound. The rheumatism has remissions followed by exacerbations, 
each of which leaves the joints somewhat worse. These exacerbations 
often look like an attack of acute rheumatism, with fever and slight in- 
flammation of the affected part ; sometimes, however, they are without 
fever and distinguished only by pain and loss of mobility. Chronic 
rheumatism sometimes remains after repeated attacks of acute rheu- 
matism, of which it seems to constitute the ultimate stage. 

The joint is not greatly distorted by the disease. A complete cure is 
very much impeded by the extreme obstinacy of the trouble, and likewise 
by the impossibility of preventing the joint from being acted upon by 
influences that never cease, by their presence, to perpetuate the dis- 
ease. 

DEFORMING RHEUMATISM. ARTHRITIC RHEUMATISM. 

This form of articular rheumatism always runs an exceedingly chro- 
nic course; it does not develop itself out of the acute form, occurs very 
rarely previous to the thirty-fifth year of age, and is most frequent after 
the fortieth year. It breaks out among all classes, especially, however, 
the lower; on this account it is very difficult to determine the degree of 
influence exerted by bad food or damp dwellings over this disease. Ar- 
thritic rheumatism affects more particularly the female sex; the critical 
age undoubtedly favors an outbreak of this disease, for we meet with it 
most frequently about this time. 

This may attack any joint in the body, but it is mostly limited to the 
joints of the hand and feet, affecting both sides of the body at the same 
time. It generally commences in the hand, whose joints become more or 
less painful, especially when they are moved or pressed upon laterally. 
Sometimes the pain is principally felt in bed. The joint swells very 
slowly ; at times long intervals occur in the further continuance of the 
swelling, after which the arthritic process resumes its course amid renewed 
paroxysms of pain. Towards the end the shape of the joints is very 
much altered, especially the shape of the finger joints. They look bulbous 
and are especially enlarged in breadth ; they feel hard ; their integumen- 
tous covering has a natural color. The power of motion is not entirely 
suspended, but motion is very painful ; in the very highest grades of the 
disease the joints are entirely immovable. Life is not endangered by this 
condition, but its curability is very doubtful. The swelling never disap- 
pears entirely ; all that can be properly aimed at by treatment, is to arrest 
the further progress of the disease. 

ALLOPATHIC TREATMENT. In the treatment of inflammatory rheu- 
matism or rheumatic fever, no active single remedy has afforded such 
good results as Salicylic Acid. Its effectiveness in this disease, above all 
others has caused the repute of the drug. The fever is not unfrequently 



CONSTITUTIONAL DISEASES WITHOUT INFECTION. 59£ 

corrected in forty eight hours. While not every case is so favorably 
influenced, yet it exerts a remarkable power in greatly modifying the dis- 
ease, lessening the fever, pain, and swelling. 

Fifteen to thirty grains may be given in medicine wafers or capsules 
every hour until the fever and pain abate, when the medicine may be 
continued in doses of ten to fifteen grains every three or four hours for 
several days. It is claimed, that in some instances, these large closes cause 
sickness of the stomach, and prostration like collapse, which may be 
avoided by combining the acid with one-fourth its quantity, each of 
Bicarbonate of Soda and Carbonate of Ammonia. The formula of 
Brideaux is; Take of Bicarbonate of Soda, Carbonate of Ammonia, each five 
grains i Salicylic Acid twenty grains. Water one ounce. Mix. For one dose. 
Much the pleasanter way to take the Acid, is in capsule, or wrapped in 
medicine wafers. 

Fifteen grains of Salicine (active principle of Willow Bark) every three 
hours, will often give relief within forty-eight hours. It can be given in 
capsule or wafer, or mixed in water. It should be used, provided Salicylic 
Acid is not given. 

A well tested, and beneficial plan of treatment, is known as the alka- 
line treatment, A solution of a teaspoonful of Bicarbonate of Potash 
should be made in a quarter of a glass of water; to this is added a table- 
spoonful of a solution of half an ounce of Citric Acid, in four ounces of 
water, and drank during effervescence. More water may be used if 
desired. This should be repeated every three hours, until the urine has 
become alkaline, (as ascertained by testing freshly voided urine with lit- 
mus paper) or the fever has abated, then once in six hours, and after three 
or four days, twice a day will be sufficiently often to keep the urine alka- 
line. After the violence of the symptoms has subsided, if anaemia (impov- 
erished blood and feebleness) exist, the Bicarbonate of Potash should be 
discontinued, and twenty to thirty drops of Muriatic Tincture of Iron, 
largely diluted in water, and ten grains of Iodide of Potash, at different 
times, should be given six hours apart. 

It is only fair to add, that the benefit of the alkaline treatment, which 
has such earnest advocates, is, also, seriously questioned by some who 
claim better results by some of the other methods of treatment, such as 
blisters, cold baths, and Quinine. 

The Chloride of Trimethylamine in doses of two grains every three 
hours, is claimed to moderate the fever and pain immediately, and moder- 
ate and shorten the disease. Take of Chloride of Trimethylamine sixty- 
four grains. Peppermint Water thirty two drams. Mix. 

Dose: A teaspoonful. This drug, if used, should be given alone. 

Prof. Da Costa recommends ten grains of the Bromide of Ammonium 
every three hours. It can be given in water flavored with Tincture of 
Orange peel. 

Quinine is useful in maintaining the reduction of heat produced by a 
cold bath, if given in a dose of twenty grains upon taking the patient from 
the bath, but it seems to the writer, that a more effectual plan, is the 
repeated application of the wet sheet and the use of Aconite. There is no 
doubt of the benefit of Quinine, or some other preparation of bark as a 
tonic in doses of two or three grains four times a day, after a few days 



600 RHEUMATISM OF THE JOINTS. 

have passed. Large doses of Quinine have been thought to be curative. 
It has not proved so in the common experience of the profession. 

In patients having a high fever and a strong pulse, the Tincture of 
Aconite may be given in doses of half a drop every hour or two to main- 
tain an impression on the fever, and to moderate the pulse, until such a 
time as the fever spontaneously subsides, or is prevented raising by the 
effect of one of the curative remedies before mentioned, viz: Salicylic 
Acid, Salicine, or Alkalies, etc. 

In those cases having a sudden rise of temperature, to one hundred 
and five degrees or one hundred and seven degrees or more, (above which 
a fatal result is to be expected,) the most effectual and speedy method of 
reducing the fever, is by the cold bath, as directed in typhoid fever. By 
promptly reducing the fever in these extreme cases life may be saved. 
While this danger seldom occurs in this disease, it should promptly be 
resorted to, if required. 

Blisters are often applied around the affected joints, followed by poul- 
tices to keep up the discharge, or a small blister one or two inches square, 
which is allowed to heal, and another one immediately applied. This is 
called the flying blister. The preferable local application seems to the 
writer, and used in his practice, is hot packing of the affected joints, wrap- 
ping them with flannels wrung out of hot water, and thickly covered in. 
Cloths saturated with an Alkaline and Opium Solution, similar to 
that recommended by Fuller, may be wrapped about the joint with benefit. 
Take of Carbonate of Potash six drams, Laudanum one ounce, Glycerine 
two ounces, Water nine ounces. Rubbing the affected joints carefully with 
a liniment of one part each, of Chloroform and Tincture of Aconite, and 
two parts Soap Liniment, will afford relief. 

Through the whole course of the disease, Opium given to the extent 
of relieving pain, is most happy in its effects. Two grains of the solid 
Extract, with a third of a grain of the Extract of Belladonna in pills may 
be given at night, if the pain is very severe, and repeated during the day 
in doses of half this amount, at such intervals (three to six hours) as will 
make the pain tolerable, until it disappears in the course of the disease, or 
under the effect of one of the three curative remedies mentioned above. 

Constipation should be relieved by half teaspoonf ul doses of Wine of 
Colchicum six hours apart, until the bowels are moved ; Cathartics are not 
needed. 

The appetite should be gratified, and encouraged by nutritious diet. 

The patient ought to lie between blankets, and wear flannel garments, 
if any, next to the skin, during the whole course of the disease. 

During the latter part of the disease, tonic doses of Quinine, three 
grains four times a day, or equivalent doses of some other preparation of 
Cinchona bark are advantageous. 

The Salicylic Acid, Saline, and Alkaline treatments, are said to pre- 
vent heart complications, hence, in part, is the prompt and bold manner 
with which they are recommended to be given. 

Should violent and irregular action of the heart, friction sounds, pain 
in the region of the heart, enlargement of the area of dullness on percus- 
sion, difficulty of breathing, and increase of fever occur in the course of 
the disease, the dangerous complication, pericarditis, has occurred. Full 
doses of Opium are to be given. 



CONSTITUTIONAL DISEASES WITHOUT INFECTION. 001 

The treatment before recommended for the rheumatism should be 
continued. Large, hot poultices of flaxseed meal and mustard, should be 
kept over the region of the heart. 

If the action of the skin and kidneys is not sufficient, the hot air 
bath should be given. 

Particular attention should be given to nourishing the patient. Milk, 
raw eggs, beaten with milk or water, and strong beef tea, or essence, 
should be freely given. 

When symptoms of weakness occur, stimulants should be given as 
are directed in the treatment of typhoid fever. 

The treatment of pericarditis has been more fully considered else- 
where. 

CHRONIC RHEUMATISM OF THE JOINTS. 

In chronic rheumatism of the joints, attention should be given to the 
general health, and measures employed to restore it to its fullest vigor. 
To this end, good food should be taken, avoiding sugar and starchy food, 
while milk, cream, eggs, and fruits, may be freely taken. 

The Citrate of Iron and Quinine, in solution, in doses of three to five 
grains, will be serviceable. 

It is claimed by good authority that the Tincture of Chloride of Iron 
is curative in acute rheumatism, and other equally high authority claims 
it to be a preventive of rheumatism. It is equally worthy of a trial in the 
sub-acute, or chronic form. The dose is twenty to thirty drops, largely 
diluted in water, every six hours, (four times a day.) It will be especially 
serviceable if the svstem is debilitated. 

Iodide of Potassium, in doses of ten grains, dissolved in water, 
(Peppermint or Sarsaparilla, covers the taste,) three times a day, frequently 
is very beneficial. A better effect is sometimes produced by giving five 
drops of Fowler's Solution, with the Iodide of Potassium. 

The remedies so useful in acute rheumatism, are not so appropriate in 
this, though they may be tried. 

Alkalies are required, if the urine is acid, but they should be given 
more moderately. While Salicylic Acid has succeeded in my hands, it 
has often failed. 

The Hydrochlorate of Ammonia often succeeds admirably in doses of 
fifteen to twenty grains. It is best given in Elixir of Cinchonia, and given 
four times a day. 

Tincture of Guaiac, or the Ammoniated Tincture, in doses of one or 
two teaspoonfuls, three times a day, is one of the most successful remedies. 
It may be given in milk, or the gum prescribed in other mixtures. 

Prickly Ash, (Xanthoxylum,) has a deserved reputation in this 
disease ; the dose of the Tincture is one or two teaspoonfuls. In domestic 
use, a tea is generally made, (an ounce of bark to a pint of tea,) and two to 
four tablespoon fuls taken at a time. 

Poke root, (Phytolacca Decandra.) cures some cases of chronic rheu- 
matism. The dose is ten or twenty drops of the Tincture. A tea made, in 
domestic practice, from half an ounce of the root to a pint of tea,) could be 
given in doses of a tables poo n/ul. 

The waters from Sulphur springs are helpful in very old cases. 

Warm bathing, alkaline bathings, vapor baths, Turkish baths, and 



602 RHEUMATISM OF THE JOINTS. 

the wet pack, are each in their turn useful means of treatment, and should 
be given a thorough trial in obstinate cases. 

The relief of pain is called for in some instances, and should be met, 
when not afforded by local applications, with Opium, given in half the 
doses recommended in the acute variety. 

Local applications are highly useful. Flying blisters, from one to two 
inches square, and allowed to heal at once, following each other over 
different parts of the joint, so that a fresh blister always exists on some 
part of the surface, is one of the best plans of local treatment. 

Stimulating liniments are frequently beneficial, as the following: 
Take of Ammonia Liniment an ounce and a half, Chloroform half an ounce, 
Soap Liniment two ounces; rubbing the joint well with it. If the pain is 
very great: Take of Chloroform, and Tincture of Aconite, each an ounce, 
Soap Liniment two ounces; mix. Wet a flannel with the Liniment, apply 
it round the joint, and cover with oiled muslin. Turpentine, or 
Petroleum, well rubbed into the part, or a flannel, saturated with them, 
and wrapped round the part, are sometimes useful. 

Other useful Liniments: Take of Oil of Cajuput and Laudanum each 
two drams, Turpentine four drams, Ammonia Liniment an ounce ; mix. Or 
Aqua Ammonia a dram, Laudanum four drams, Tincture of Cantharides 
three drams, Soap Liniment ten drams; mix. 

Iodine is one of the best local agents in overcoming inflammation, 
and removing its products. The Tincture may be used, but the following 
ointment is believed to be preferable, because, after a few applications of 
the Tincture, a dead scarf skin prevents the penetration of the remedy: 
Take of Iodine thirty grains, Iodide of Potassium a dram, Water a dram, 
Lard an ounce ; mix. If this irritates too much, it can be made weaker 
with Lard. 

A certain amount of stiffness, tenderness, and inability to use the 
joints, or limbs, is met with, in many cases, after the inflammation has 
subsided. This is removed by regular passive motion, i. e., motion by the 
hands of others, systematic shampooing, kneading and slapping with the 
hands, (called massage.) So-called cures of rheumatism are effected at 
this stage by "rubbing," "slapping," and "mesmeric " quacks. 

Liniments are largely useful in this stage, partly because they neces- 
sitate a certain amount of rubbing. 

Flannel ought always to be worn by those who suffer from chronic 
rheumatism. 

The general treatment of muscular rheumatism is not essentially 
different from that of chronic rheumatism affecting the joints, and it is 
unnecessary to describe it here. Absolute rest of the affected muscles is 
necessary. Pain should be relieved by the hypodermic injection, oyer the 
affected muscle, of a quarter of a grain of Sulphate of Morphine, with a 
fiftieth of a grain of Sulphate of Atrophine, in the acute stage, or of Atro- 
pine alone, in the chronic disease. Strong mustard plasters should be 
applied over the painful muscles, and immediately upon their removal, a 
hot poultice of Flaxseed meal, with Laudanum poured over the surface, or 
hot fomentations of flannel wrung out of hot water and well covered, to 
retain the heat. 

Rubbing the part and the use of liniments as in chronic rheumatism 



CONSTITUTIONAL DISEASES WITHOUT INFECTION. 603 

of the joints, is useful. Sometimes the daily use of the wet pack has 
proved curative. Aside from tonic remedies probably Iodide of Potassium 
and Guiacum, as recommended for chronic rheumatism of the joints, and 
live grain doses of Quinine three or four times a day, are the most fre- 
quently curative, especially if the pain is periodical. 

Persons subject to this affection should wear flannel the year round. 
The daily use of the cold sponge bath will invigorate the system against 
liability to cold, while an over quantity of clothing, night or day, is to be 
avoided. Invigoration of the system, especially by an out of door life.i s 
to be sought for. 

H0M(E0PATHIC TREATMENT. Aconitnm is the main remedy in 
acute articular rheumatism, if the pulse is not only frequent, but likewise 
full and hard, the temperature is considerably higher, the joint is red and 
exceedingly sensitive to contact ; it is suitable for nervous, irritable, ple- 
thoric individuals; or when heart troubles have set in. Further indica- 
tions may be gathered from the Repertory. Aconite has been less fre- 
quently used in chronic cases, where it sometimes acts with great efficacy. 
Aconite is less adapted to chronic articular, than to muscular rheumatism, 
especially when the disease is located in the upper extremities. 

Bryonia alba is a leading remedy for acute and chronic rheuma- 
tism, except the arthritic form. It is most suitable for rheumatism caused 
by exposure to cold and dampness after a severe muscular effort ; the vio- 
lent fever soon weakens the patient; the swelling of the joint is dark-red 
and exceedingly painful ; the respiratory organsshow symptoms of inflam- 
mation ; the perspiration has a sour smell. In muscular rheumatism, 
Bryonia is indicated by the following symptoms : The muscles of the 
trunk are the seat of the disease, especially the muscles belonging to the 
chest ; the patient feels much better during rest ; the pains are severe tear- 
ing pains, and incline to shift from one place to another. 

Mercurius. Mercurius is not so much adapted to chronic as to most 
forms of acute and sub-acute rheumatism, with the following general indi- 
cations: The fever runs high ; the pulse is remarkably quick and hard, 
the perspiration very copious and having a musty smell, the thirst is 
exceedingly tormenting. The local swelling is not very great, but painful, 
intensely red, giving rise to the apprehension of pus forming in the joints 
it is not apt to shift about; even if other joints are affected, yet the origi- 
nal joint remains swollen and painful ; the breath is foul, the tongue has 
a thick, yellow coating, the appetite is gone, every kind of food causes 
nausea. The pains are worse every night, towards midnight, aggravated 
by severe cold and ameliorated by external warmth. The more frequently 
relapses set in, the more specially Mercurius is indicated. In muscular 
rheumatism, Mercurius is indicated by the following circumstances; the 
pains exacerbate at night, they are deep-seated as if the bone were attacked 
with great sensitiveness to gentle as well as firm pressure. 

Rhus-toxicodendron is adapted to every kind of rheumatism, 
except arthritic. In acute articular rheumatism, it is indicated by the 
following symptoms: Violent fever, with tendency to the adynamic type, 
delirium and excessive restlessness; the swelling is inconsiderable, admits 
of some motion, is instantly re/1 and somewhat sensitive to contact. The 
perspiration is not considerable. The patients are constantly changing 



C04 RHEUMATISM OF THE JOINTS. 

their position, for even after lying for a short time in the same position, 
the pains are very much increased. Feather beds are intolerable, so is 
external artificial warmth. For muscular rheumatism, Rhus-tox. is the 
best remedy, if the attack is caused by exposure to wet; if the above men- 
tioned circumstances either improve or aggravate the symptoms; if the 
pains at once become associated with paralysis and contraction; if the 
muscles of the lower extremities are the seat of the disease. Rheumatic 
paralysis particularly points to Rhus. In chronic articular rheumatism, 
Rhus, is of little, if any'use. 

Pulsatilla is indicated in mild, sub-acute rheumatism of the joints 
and muscles; the affection shifts about frequently and speedily ; the pain 
exacerbates in the evening and at night; they are violent, tearing, draw- 
ing and jerking pains, increased by warmth, improved by cold, at least for 
a short time. 

Pulsatilla is seldom appropriate in chronic rheumatism, but more so in 
the rheumatism of muscles and of joints. 

Tartar-emet. deserves to be used more than it has so far been 
*— it is one of those remedies that have a good effect in exceedingly painful 
local muscular rheumatism, for instance, rheumatism of the muscles of 
the back, contracted after a cold, during the performance of a fatiguing 
muscular effort. In such a case, Tartar emetic very soon brings relief. In 
acute articular rheumatism, Tartar emetic is indicated by the follow- 
ing symptoms: marked swelling of a number of joints, the pains are not 
very great during rest, but this rest is frequently interrupted by sponta- 
neous spasmodic, very painful contractions of single bundles of muscles 
There is not much fever; the symptoms of digestive derangement, on the 
contrary, are very prominent. A condition marked by such symptoms, 
sometimes occurs during the subsequent course of articular rheumatism, 
scarcely ever at the commencement. 

Digit alis-purpurea is, in our opinion, a most important remedy in 
acute articular rheumatism; in the last few years we have often seen this 
remedy produce a striking effect, and shorten the course of the disease. 
Hurried, small pulse, easily affected by motion; increased strength of the 
beating of the heart, but the sounds are muffled and indistinct, mingled 
with arterial murmurs; hurried respiration, with ability to draw along 
breath; hurried, abrupt speech; almost complete suspension of the urin- 
ary secretion; shining-white swelling of the joints, not very sensitive to 
pressure; a number of joints are attacked at once; the whole body is very pale. 
During the whole course of the disease we have given this medicine 
without any other drug, and in spite of the violence of the symptoms, we 
have never been able to discover any but the best results. 

In conclusion, we desire to state that Digitalis holds a high rank as a 
remedy for rheumatism among the rational physicians ; there is, undoubt- 
edly, a reason for this. 

Sulphur bears almost a specific relation to the rheumatic process. 
In an acute attack, we would not think of giving Sulphur ; on the other 
hand, Sulphur is indispensable to remove the remaining traces of acute rheu- 
matism, upon which the extraordinary disposition to relapse generally 
depends. What this remedy is capable of accomplishing in chronic rheu- 
matism, is shown by the numerous cures which are every year wrought by 
the use of Sulphur-springs, and which it is impossible to doubt. 



CONSTITUTIONAL DISEASES WITHOUT INFECTION. 005 

Sulphur exerts a curative power over arthritic rheumatism ; it arrests 
the progress of the disease, and materially reduces the swelling of the 
joints, but must be given in large doses. 

Although Sulphur-springs are the most effective remedy for constitu- 
tional rheumatism, yet there are other means calculated either to heal or 
prevent new attacks; some of these means are often sufficient to perform 
a cure. In this class we rank the cold-water treatment, sea-bathing, the 
Turkish and Russian baths. The two last-mentioned have to be employed 
with great care ; if they help at all, the favorable effect is seen after a few 
baths. 

It is a matter of course that the cause should be removed as much as 
may be. 

The diet in acute rheumatism is easily managed ; the patients either do 
not crave any nourishment, or their appetite is very much impaired. Fat 
and greasy articles of diet are decidedly injurious; acid substances, espe- 
cially stewed fruit, have a very good effect ; raw fruit may be partaken of, 
but moderately. 

HOME TREATMENT. In the treatment of acute rheumatism, the 
first thing to be affected, is the production of a copious perspiration ; for 
this purpose, a warm vapor bath may be used, or the patient may be 
placed in a well warmed bed, with bottles of hot water, or ears of boiled 
corn placed around him. Warm drinks, such as Pennyroyal, Catnip, Sage, 
and Flaxseed tea should be freely administered over the painful and swol- 
len joints ; apply warm or cold fomentation of Hops, or Hops and Stra- 
monium (Jimson) leaves, or poultices of Flaxseed meal, or bran or rye 
meal may be used. 

Equal parts of vinegar and whisky made warm and rubbed on the 
principal joints, will sometimes relieve the pain. One of the best applica- 
tions, however, is fresh leaves of Stramonium, (Jimson Weed) which 
should be bruised, and moistened with a little water, and applied over the 
parts, and renewed three or four times a day. After the hot applications 
have been used, the parts should be covered with cotton batting, about a 
quarter of an inch thick, and a piece of flannel spread over it so as to 
retain the heat and moisture. 

Lemon juice, a tablespoonful every two or three hours, or warm lem- 
onade will be found beneficial. A free use of lemons, in any form, is bene- 
ficial. 

Celery is a cure for rheumatism ; indeed, the disease seems almost 
impossible, if the vegetable be cooked and freely eaten. The celery should 
be cut into bits, and boiled in water until soft, and the water drank by the 
patient. Put new milk, with a little flour and nutmeg into a saucepan 
with the boiled celery, serve it warm with pieces of toast, and the painful 
ailment will soon yield. 



RHEUMATISM OF THE SCIATIC NERVE. 

This constitutes one of the most frequent, and, at the same time, one 
of the most painful forms of rheumatism. Its causes are generally 
involved in uncertainty ; a cold, excessive exertions, abdominal affections, 
stagnation of habitual hemorrhages, etc., are mentioned as such causes, 



606 . RHEUMATISM OF THE SCIATIC NERVE. 

but it is difficult to trace a distinct connection between these two orders 
of phenomena as cause and effect. 

At times the affection commences very suddenly, at other times the 
pain arises gradually from sensations that resemble a slight attack of ordi- 
nary rheumatism. The pain is generally located between the hip and knee, 
so that the course of the nerve can be determined very exactly by the pain. 
It is very seldom that the pain runs upwards, but more generally down- 
wards below the knee, and as far as the foot, on the internal or external 
surface of the leg. We distinguish two kinds of pain; either the pain is 
constant, somewhat remittent, but never entirely intermittent, and 
usually following very exactly the tract of the nerve without the patient 
being able to define the quality of the pain ; or else peculiar tearing-darting 
pains may supervene, resembling electric shocks, setting in paroxysmally 
and being excited by motion or making a wrong step, sneezing or coughing. 
At the same time one or more places in the course of the nerve are gener- 
ally sensitive to pressure. Although the pain does not seem to be worse at 
definite periods, yet all patients complain that it is worse in bed, and that 
this exacerbation is sometimes so great, that they dare not go to bed. Inas- 
much as the pains are very much increased by an extension of the leg, by 
pressure or by the nerve being put on the stretch, the patients generally 
keep the limb slightly flexed, using it as little as possible during a w«lk or 
for the performance of any other motion . This is generally the cause why 
the diseased limb, after the rheumatism has lasted for some time, grows 
thin, although the emaciation may likewise be caused by a gradually devel- 
oping paralysis. The diagnosis being sometimes extremely difficult, it is 
important to know that it always attacks only one limb. 

This disorder runs a chronic course. A spontaneous cure only takes 
plaee with a gradual abatement of the pains, but not till months have 
elapsed. The general health is very much disturbed by the constancy of 
the severe pains and by the-sleeplessness; the appetite becomes impaired 
and the bowels are inactive. 

ALLOPATHIC TREATMENT. This affection is a form of neuralgia, 
but not unfrequently of a rheumatic origin. The remedy which gives 
the most speedy relief is Morphine, by hypodermic injection. A prompt 
and complete relief of the pain by this means is not unfrequently 
curative. The injection should be made in the neighborhood of the 
nerve. The dose to be preferred is a quarter of a grain, which can be 
repeated in twenty or thirty minutes, if the pain is not relieved. 

If the Morphine should not succeed, the hypodermic injection of a 
fiftieth of a grain of Atropine should be made. Relief from it is more apt 
to be permanent than the same degree of relief from Morphine, but this 
injection cannot generally soon be repeated, but if the pain is not relieved 
nor excessive dryness of the throat, nor other inconvenience experienced; 
a second injection will be made, but generally, if the pain is not relieved 
by the first injection of Atropine, it is best, as a rule, to resort to Morphine. 
The injection, under the skin, of fifteen or twenty drops of Ether behind 
the great trochanter is often followed by quick relief. 

Electricity is often beneficial. The direct current should be passed 
down the nerve. In old cases, a needle, such as is used in acupuncture, 
insulated to near its point, should be introduced to near the nerve, and 



CONSTIUTIONAL DISEASES WITHOUT INFECTION. COT 

attached to the positive pole. The negative pole is then passed down the 
course of the nerve. A daily sitting of five to ten minutes is appropriate. 
The neuralgic form of the disease is more often benefited by Electricity 
than the rheumatic. 

Acupuncture, in old cases, especially in the form originated by 
Baudenscheid, is sometimes particularly beneficial. 

The general treatment is that given for chronic rheumatism or 
neuralgia, as the affection is of a neuralgic or rheumatic origin. It is not 
necessary to repeat these directions here. 

Iodide of Potassium, in doses often to thirty grains, three times a day; 
Alkalies; Salicine, in doses of fifteen grains, four times a day; Quinine 
five grains, and tincture of Nux Vomica five drops, three or four times a 
day ; or ten to twenty drops of Turpentine, with Honey, three or four times 
a day, are particularly recommended in rheumatic sciatica. 

The same local measures given for neuralgic and chronic rheumatism 
are appropriate. In addition may be mentioned as especially applicable: 
A strip of flannel wet with Chloroform, laid over the course of the nerve, 
and covered with oiled silk, (or muslin,) or the whole limb covered with 
new flannel, which has been thickly sprinkled with sulphur and covered 
with oiled muslin, are recommended by Fuller. Enveloping the limb is 
claimed by Trosseau to have cured after blister and Morphine failed. 
Great relief is sometimes given by blistering the head. Flying blisters, 
as directed in neuralgia, are generally beneficial. The actual cautery is 
recommended. 



CONS UMPTION—TUBERC ULOSIS—PHTHISIS. 

Tuberculosis is not only the most frequent of all constitutional 
diseases, but likewise the most common of all diseases. It is character- 
ized by deposits into all sorts of tissues and organs, of a small lump or 
granule, the size of a millet seed; of a pale yellowish, or gray color; of a 
soft, cheesy consistency. 

The formation of these deposits or tubercles, depends, in most cases, 
upon the peculiar conditions of the organism. In almost every case, 
tuberculosis can be demonstrated as developing itself under the following 
circumstances : It may result from a deficient supply, or the bad quality 
of the food, in the same manner as scrofula; in this manner consumption, 
tuberculosis,) often succeeds the latter, so that when, at the age of 
pubescence, twelve to sixteen years,- scrofula disappears, tubercles take 
the place. It may likewise be occasioned by a deficient activity of the 
respiratory (breathing) organs, as may occur during certain trades, which 
will be named by and by, or as may result from tight dressing, or from 
a sedentary mode of life. Whether a pre-existing germ is excited or 
created by such causes, is uncertain : the former, however, seems to us 
more probable It may, likewise, be inherited like scrofula. 

The consumptive constitution does not manifest itself by ar.y positive 
symptoms, and the so-called consumptive habit consists of nothing else than 
the symptoms of general debility and imperfect digestion or nutrition. 
There die as many persons without as with this habit. The only point that 




608 



CONSUMPTION 009 

enables us to be tolerably sure of its existence, is the fact that the person 
was affected with scrofula when young. 

Consumption is found equally distributed in both sexes, perhaps a little 
more among women. It breaks out chiefly between the ages of eighteen 
and thirty years. 

The deposit of tubercles, and hence the tubercular disease generally; 
perhaps, likewise, in many cases, the origin of the peculiar consumptive 
habit, are founded in the following circumstances : 

A scanty supply and a bad quality of food, damp dwellings, deficient 
exercise in the open air— on this account the disease is chiefly met with in 
the lower walks of life, and likewise occurs more frequently in cities than 
in the country ; among individuals whose business confines them to a room ; 
and among prisoners. 

Too rapid growth, more particularly if the growing persons are fed on 
improper nourishment, for this will occasion a condition of great debility 

Continued depressing emotions, especially sorrow and grief, home- 
sickness. The connection of cause and effect between these influences and 
the disease is not clearly made out; but that this connection exists, can 
be shown by a number of cases ; tubercles are often very properly desig- 
nated as tears shed inwardlv. 

Circumstances incident to pregnancy, confinement, nursing, the more 
certainly, the more rapidly one confinement follows another, and the longer 
the infant is nursed at the breast. Women with consumptive dispositions 
generally pass very well through their first confinement ; they keep up nurs- 
ing for a year, without losing much strength, but after that, they complain 
of feeling exhausted. During the next pregnancy they apparently feel 
better in every respect, but immediately after confinement the symptoms 
of an approaching consumption multiply; while nursing her child, the 
mother experiences all sorts of inconveniences ; the next pregnancy again 
brings an improvement, until phthisis suddenly breaks out in all its might, 
usually during the first weeks after a new confinement, and very often runs 
a very rapid course to a fatal termination. 

A sudden change in the mode of living; if an occupation requiring 
constant exercise in the open air, is exchanged for a sedentary business; a 
luxurious mode of living is suddenly replaced by a mode of living full of 
privations; if the climate is suddenly changed, if persons move all at once 
from a warm into a cold climate. 

Circumstances and conditions that permanently interfere with the 
breathing; tight dresses preventing a free expansion of the chest ; occupa- 
tions that render constant stooping necessary, as in the carpenters' and 
tailors' trade, etc. ; or trades in consequence of which the lungs become 
filled with fine dust. 

Diseases of the respiratory organs. Frequent attacks of acute bronchial 
catarrh, pneumonia, pleuritis; above all, measles, whooping cough and 
influenza are very common exciting causes of tubercular deposits. 

Most diseases that cause a rapid decline in the assimilative functions 
such as: Typhus, dysentery, cholera, chlorosis, diabetes, inveterate syph- 
ilis, chronic eruptions. 

Influences which greatly debilitate the nervous system, such as long- 
continued mental labor, venereal excess, self-abuse. 

What causes are chiefly instrumental in exciting the first outbreak of 

39 



610 CONSTITUTIONAL DISEASES WITHOUT INFECTION 

the disease, is hard to decide. If the germ is present, the most trivial event 
may kindle the spark into a flame. 

Certain conditions of system afford a certain immunity from tubercu- 
losis. It is certain that mid-mountain air diminishes the chances of tuber- 
culosis becoming a fully developed disease. 

Symptoms and Course. In describing this disease, we shall adhere 
to the most common form, namely: chronic miliary tuberculosis, 
(consumption.) 

It is very difficult to say, with anything like certainty, when the 
disease really commences. The deposit of the first tubercles, especially if 
not very numerous, is accompanied by symptoms that seem too insignifi- 
cant to a patient to complain of to a physician. When a physician is 
consulted, the disease is already sufficiently advanced to be discoverable 
by the usual means of exploration ; at its first beginning, no such result 
can be obtained. That the disease is beginning to set in, can almost 
positively be inferred if individuals who were afflicted with scrofula when 
young, or persons with a tubercular, (consumptive,) habit, show the 
following symptoms : disposition to pulmonary hyperaemia, with palpi- 
tation of the heart; disposition to catarrh of the air passages, the attacks 
being very obstinate, with bloody sputa, long-lasting hoarseness; general 
nervous irritability, irritability and increased frequency of the pulse. 

Repeated attacks of catarrh ought especially to excite suspicion, 
for they evidently indicate the period when the first tubercles are 
deposited. Very often, however, the deposition may be going on for a 
long time without any apparent symptoms, in which case the supervention 
of a severe bronchial catarrh, which gets worse all the time, shows the 
sudden outbreak of phthisis, or, in other words, of the purulent dissolution 
of the tubercles. In young women the disease not unfrequently sets in 
with all the symptoms of chlorosis, (green sickness) which may lead to very 
injurious mistakes. The older the patients, the less distinctly is the 
beginning of the disease recognizable. Yery seldom, however, the 
disease breaks out suddenly in»such a manner that an apparent ful- 
ness of health is suddenly followed by a state of illuess, with all 
the characteristics of consumption; a more or less sickly condition almost 
always precedes the outbreak. It would be of great importance if the 
first deposit of tubercles could be clearly made out by a physical explor- 
ation of the lungs. We only know of two tolerably reliable indications, 
early attention to which may be of the most decided importance to the 
treatment. One is a prolonged, although not very much louder expira- 
tory murmur, which is particularly important if it is heard during a slow 
expiration with closed mouth. The second is the so-called "respiration 
saccadee" jerking, wavy, cogged-wheeled respiration, which is most dis« 
tinctly perceived during an inspiration. These sounds can be easily heard 
when present by placing the ear close against the patient's naked breast 01 
back. In the place of an uniform blowing murmur, we hear an inspira- 
tory murmur at intervals, but not otherwise altered in any respect. 
Another reliable sign is if, during a slight catarrhal attack, the apices of 
the lungs exhibit symptoms of catarrhal irritation. Another sign is, when 
the expectoration looks like soaked sago, or is transparent, having the 
shape of fine, firm threads; this is a symptom of chronic catarrh of the 
finest bronchial ramifications. 



CONSUMPTION 611 

The existence cf a tolerably severe, protracted, acute bronchial 
catarrh, or a more or less violent spitting of blood, (hsemoytisis) generally, 
is an evident, and very seldom doubtful sign, that the phthisis has set in. 
At the same time, the patients complain of unusual debility, stitches, or 
a peculiar drawing pain in the upper lobes of the lungs, peculiar rheu- 
matic pains in the arm of the affected side ; the respiration is accelerated 
the pulse very frequent ; this acceleration is very much increased by the 
least motion ; the existing fever very soon shows typical increase, setting 
in in the morning between nine and eleven, or in the evening between 
five and seven o'clock, or at both these periods, and sometimes attended 
with such complete remissions, that the fever has very much the appear- 
ance of an intermittent disease. 

From this beginning, the symptoms can be easily observed further 
in their character of tubercular phthisis, with various modifications during 
their course, to which we will first call attention before describing the 
various local symptoms. 

The course of the disease, especially among individuals of a more 
advanced age, is marked by stages. After the first evidently tubercular 
catarrh has slowly disappeared, a feeling of almost perfect health is again 
enjoyed by the patient, who is at most reminded of the slumbering danger 
by a dry cough, or a disposition to shortness of breath after an unusual 
bodily exertion, or after talking. In the course of months, and sometimes 
not till years have elapsed, another catarrh breaks out, which likewise, 
ends without any untoward symptoms, and these changes continue until 
finally an acute attack of marked intensity terminates in fully developed 
phthisis. At the same time, nutrition may remain perfect for years, the 
patient may retain his flesh and healthy complexion, or else he may lose 
his flesh gradually, and acquire a more or less anaemic (bloodless) appear- 
ance. 

A chronic, uniform course of phthisis occurs much less frequently 
after an acute catarrh. On the contrary, it sets in with very trifling 
symptoms, a slight, hacking cough, loss of flesh, palpitation of the heart, 
shortness of breath, etc., and the patient already presents a complete pic- 
ture of phthisis, when all at once an acute catarrh sets in, which is sud- 
denly transformed into the actual disease, or else no acute catarrh ever 
takes place. The patients continue to fail almost imperceptibly, hectic 
fever supervenes, a tuberculous diarrhoea and oedema (swelling of the 
extremities) make their appearance, and death takes place amid symp- 
toms of complete exhaustion. 

A subacute course of the disease, quick consumption (phthisis florada) 
succeeds the initial catarrh sometimes immediately, especially in the case 
of young individuals, and after confinement, likewise, after severe acute 
diseases; very frequently it forms the conclusion of the more chronic 
forms of phthisis. This subacute course is particularly distinguished by 
intense hectic fever, tuberculous diarrhoea, disposition to pulmonary 
hemorrhage. The most vigorous patients fail within eight or ten weeks, 
nor is it at all possible to arrest the course of the disease in the least 
degree. 

The cough of consumptive persons varies exceedingly. At the begin- 
ning, a constant short and hacking cough is very usually present, some- 



612 CONSTITUTIONAL DISEASES WITHOUT INFECTION. 

times interrupted by severe paroxysms, resulting in the expectoration of 
a light-colored, scanty mucus; or else, the cough sets in in irregular 
paroxysms, which are generally excited by marked changes in the 
temperature, and by pulmonary efforts ; these paroxysms often last for 
several hours, and end with retching; the sago-like expectoration follows 
in a few hours. A cough that at once sets in, with a copious expectora- 
tion, is a rare occurrence. After suppuration has taken place, the cough 
becomes much less wearing and spasmodic; the coughing fit readily 
results in copious expectoration. Between the more violent paroxysms, 
a constant hacking takes place, during which the mucus rale (rattle) is 
distinctly heard. In very rare cases there is no cough during the whole 
course of the disease. 

Previous to the deposition of numerous tubercles and their purulent 
dissolution, the expectoration is without any characteristic features. 
Nevertheless, a continual expectoration of clear mucus is always a suspi- 
cious symptom ; but such an expectoration acquires significance when it 
is traversed by fine streaks of a yellowish color, and when, moreover, it 
frequently appears streaked with blood. Still more characteristic is the 
presence of sago-like, firm little lumps and fibres. Much less frequently 
hard, yellowish or greenish, cheesy little lumps are coughed up at an 
early period; they generally taste very badly, and frequently have an 
offensive odor. Sometimes the expectoration contains small lumps of 
calcareous matter, (chalk-like) tubercles, seldom however, previous to 
suppuration having fully set in ; usually after caverns have formed. The 
cavernous expectoration has a yellow-gray color, less frequently a greenish 
color, is firmly coherent; in the water it forms irregular, shaggy balls, 
which slowly sink to the bottom ; it is surrounded by a quantity of clear 
bronchial mucus, with whieh, however it does not mix. 

The larynx and trachea seldom remain intact during the whole 
course of the disease; they show more or less marked symptoms of 
catarrhal irritation. At an early period of the disease, the voice becomes 
husky, or loses its clearness and firmness of tone; at a later period, 
these organs become painful, according as the above described ulcers 
are located, and not unfrequently complete loss of voice sets in. 

The tendency to sudden changes of color is a striking phenomenon 
only at the commencement of the disease. Very soon the pulse becomes 
frequent, and feebler than usual, it is accelerated by every movement. In 
the last stage it almost always exceeds one hundred, sometimes rising 
to one hundred and forty. It is only exceptionally that the pulse 
of consumptive patients is retarded, and then only occasionally, alternat- 
ing with a frequent pulse. As a rule, the pulse affords the best means of 
; udging how far the patient's strength has already been consumed by the 
disease. 

The digestive functions are generally very much impaired. Usually 
at an early period of the disease the appetite grows poorly, or cardialgic 
pains are experienced after eating, which are not unfrequently followed 
by distressing vomiting. The appetite seldom remains natural; some- 
times, generally shortly previous to the patient's death, he experiences a 
morbidly increased hunger. Except in quick consumption, the stools 
generally remain natural for a long time; diarrhoea only sets in after the 



CONSUMPTION. 613 

symptoms of extensive suppuration of the intestinal tubercles have become 
manifest. These diarrhceic stools are peculiar, partly papescent and part- 
ly watery, resembling mustard in color, and appearance ; most commonly 
the passages are accompanied by a quantity of gas, they frequently contain 
blood and pus, and are seldom colorless. They are not frequent, from 
three to six a day, generally two in the morning in quick succession ; in 
the daytime they occur after the patient has partaken of nourishment. 
Sometimes they are preceded by slight colicky pains, at other times they 
are quite painless. They are always a bad symptom, for the longer the 
diarrhoea postpones, the longer is the patient's strength preserved. In 
the first period of the disease, the patient is sometimes troubled with 
diarrhceic stools, but they generally abate in proportion as the pulmonary 
symptoms decrease in intensity; if the tendency to diarrhoea has once 
become established, the course of the disease is generally very rapid. 

The skin does not show any special symptoms; it is pale and some- 
times exhibits a yellowish tint. At an early period of the disease the 
muscles begin to show symptoms of wasting away. A characteristic sign 
of phthisis is the bulbous thickening of the ends of the fingers; most like- 
ly this change takes place because the ends of the fingers do not partici- 
pate in the general emaciation. 

What is peculiar, is, that in most consumptives the sexual passion is 
very much excited, especially in the case of men, and that the virile 
power continues so long unimpaired, in spite of the general emaciation. 
The menses remain natural for a long time ; if they cease, death may posi- 
tively be expected within a few months. The urinary secretions do not 
undergo any abnormal changes ; if sweats break out, the urine is of course 
diminished. 

Home and General Treatment and Prognosis. Although the 
prognosis in consumption is absolutely unfavorable, although the pros- 
pect of a case that had been diagnosed with positive certainty, is very 
slim, yet the labor of a family or physician in this direction is not without 
reward, since it may be in our power to postpone the fatal termination. 
Professional aid becomes still more important, if it is tendered at a period 
when the tubercular disease was still hidden, or had emerged into light 
with sufficient distinctness to be recognized in its true character with a 
tolerably reliable degree of certainty. Although success cannot be posi- 
tively promised at this period, yet it is our opinion that the formation of 
tubercles can either be prevented, or that their further development can 
be stayed. After all, the case may perhaps be the same as that of other 
acute or chronic diseases, which only become incurable after they are too 
far advanced. Unfortunately the aid of the physician or proper means is 
not sought until thesuppurative process has already set in, in other words, 
in the stage of phthisis, when help is exceedingly doubtful. 

It cannot be denied that consumption is curable at any period during 
its course, although such a result happens very seldom after hectic fever 
basset in, and more particularly after the consumptiveprocess has invaded 
the intestines and the larynx. For this reason no case should at once 
be abandoned as beyond the reach of successful treatment. A complete 
cure, that is, a complete reabsorption of the tubercular deposits, indeed, 



614 CONSTITUTIONAL DISEASES WITHOUT INFECTION. 

cannot be expected ; remnants of the disease will remain, and a new 
outbreak may take place at any time. 

What we have said, shows that the treatment must aim at three 
objects: preventive treatment, the treatment of consumption as a consti- 
tutional disease, and the treatment of the acute intercurrent exacerbations 
and their most prominent symptoms. 

The preventive treatment has to embrace a vast range, if it is to be of 
any use. As mistakes in the first education and care of children may 
promote, if not originate, scrofula, and as scrofula may easily terminate 
in consumption, the means of prevention must necessarily go back to the 
first years of childhood. A correct mode of living from the earliest 
infancy is an excellent preventive against this dreaded disease; every 
parent should see to it that physical laws are properly obeyed in 
the rearing of children, for this will at the same time prevent a legion of 
other diseases. A parent's duties in this respect are so much more sacred 
as so many false customs and wrong maxims have been grafted upon the 
education of the young by the present age. Unfortunately it cannot 
be denied that parents and physicians pay too little attention to the first 
development of childhood, and that they confine their solicitude much 
more to the treatment of existing diseases than to their prevention. Of 
course, preventing diseases does not pay the physician. TVe have not 
space to exhaust the whole subject of prevention ; hence we have to limit 
ourselves to a statement of the most essential points. 

The diet should be regulated in accordance with the principles which 
are more and more universally recognized as correct. Above all, during 
the first two years the nourishmentshould principally be milk; afterwards, 
other easily digested articles of diet may be added in suitable quantity 
and order. Potatoes should not by any means constitute the chief nour- 
ishment of children. But not only the quality, also the quantity of the 
food, which should be supplied at regular intervals, should have our care- 
ful attention. It may seem a small matter to bother about such trifles 
w.hen the children are robust and healthy, but it is not a small matter ; on 
the contrary, it is a subject of great importance. Besides proper diet, a 
salubrious home, fresh air, exercise, and cleanliness must likewise be 
provided for the little ones. The mental culture is likewise of the utmost 
importance. Daily experience shows that precocious development and 
continued mental exertions render children irritable, make them look 
pale, deprive them of their appetite, and predispose them for all sorts of 
bodily sufferings. These symptoms show themselves already, in the 
seventh year, but still more at the age of pubescence, particularly among 
females. How many individuals fall victims at an early age to an 
unreasonable and precocious mania for acquiring knowledge! The only 
means of counteracting the absurd claims of our schools is gymnastics in 
all its forms, especially if it lays particular stress upon the cultivation of 
the respiratory muscles, but not by imitating the modern plan of practising 
neck-breaking tours de force, and straining the muscles to their utmost 
limits. A proper system of hardening children should likewise be 
pursued, with a view of rendering them capable, at an early period, of 
bearing abrupt changes of temperature, without being made sick by the 
exposure. 

If it is proper that all these rules should be enforced in the education 



CONSUMPTION. 61o 

of every child, it is still more important that they should be strictly carried 
out in the case of scrofulous children, or children born of consumptive 
parents. 

At the age of pubescence all the signs denoting the accession of tuber- 
culosis, become more apparent, and the tuberculous habit frequently shows 
its peculiar characteristics at an early age. To the above-stated rules a 
tew other important rules may be added. In the first place, the young 
people must be taught to breathe properly, not merely with one portion of 
the respiratory muscles. Nothing is more conducive to this end than 
early singing lessons, taking care to pay particular attention to a correct 
practice of the middle notes. 

It is during this period of development that gymnastics perform real 
miracles ; chamber-gymnastics in particular becomes an invaluable aid iu 
the harmonious development of the muscles. However, in practising 
with the arms, heavy weights must not be used. The dress, likewise, 
deserves our attention ; it should be of such a style as not to interfere with 
the freedom of respiration. If a catarrh occurs, it must not be neglected; 
chlorosis (green-sickness) should likewise be carefully attended to. In 
selecting a trade or profession, male individuals should avoid such as are 
known to favor the development of consumption. Women should be 
cautioned against reckless dancing and the continued application to work 
that requires constant sitting. 

A rigid preventive treatment is likewise necessary, if symptoms of 
tubercles have broken out, and if the tendency to catarrh has at the same 
time become very prominent. Whatever involves an increased activity 
on the part of the lungs, such as running, dancing, continued talking in 
large crowds, hurried going upstairs or ascending an eminence, should be 
strictly avoided at this stage; so should anything that interferes with the 
action of the lungs, such as continued stooping in a sitting posture, tight 
clothing, etc. The patient now ought to practice deep inspirations; a 
substantial, but simple diet, without any artificial stimulants, is likewise 
indispensable It being of essential importance that the patient should 
avoid all opportunities of being attacked with acute catarrh, he will have 
to avoid keen and cold winds, and provide himself with a respirator, (a 
piece of sponge fastened over the mouth when out on cold days will do) 
the usefulness of which has not yet been sufficiently recognized. The 
damper the atmosphere of the place where the patient resides, the more 
important it is that he should wear flannel undershirts ; this rule applies 
more particularly to the female sex. A sojourn in crowded rooms that 
are lighted with gas, and in damp and musty churches is exceedingly 
prejudicial. Proper ventilation and a moderate heating of the rooms 
should not escape our attention. At this period the food should be more 
simple and of a more digestible quality than ever; animal food deserves 
a decided preference. Milk now commends itself as an excellent nourish- 
ment, provided the patients are able to bear it, which is unfortunately not 
always the case. We must insist, that a woman suspected of consumption 
should never nurse her children at the breast. It behooves us likewise to 
direct attention to the circumstance that the mental labor and the mood 
and disposition of the patient are of the utmost importance to the course 
of the disease. We doubt whether grief and care can cause tubercles, but 



616 CONSTITUTIONAL DISEASES WITHOUT INFECTION, 

what is absolutely certain is, that depression of spirits, sorrow and care, 
and continued chagrin accelerate the course of tuberculosis, and that a 
good deal of mental excitement likewise exerts a pernicious influence. 
Even a change for a few weeks only from their usual surroundings to a 
quiet and pleasant retreat, affects the patients beneficially. 

What we have said shows how much importance we attach to a cor- 
rectly-understood preventive treatment. Various medicines are likewise 
of importance during the course of consumption. 

HOMEOPATHIC TREATMENT. In the first stage of the malady, 
when the tubercles are in a crude, unsoftened state, or when they are 
inflamed, and commencing to soften, the remedies by means of which the 
malady may be retarded, if not arrested, and, with due collateral precau- 
tions, kept harmless for years, are, chiefly, Aconitum, Bryonia, Belladonna, 
LachesiF, Hepar, Spongia, Phosphorus, Dulcamara, Pulsatilla, Arsenicum, 
!Nux-v., Hyoscyamus, Silicea, Calcarea c, Carbo v., Acidum nitricum, and 
Sulphur. These must be selected according to the aggravated symptoms of 
the case under treatment. Their leading indications may be gleaned from 
the chapters on "Cough," "Pleuritis," "Pneumonia," " Hemoptysis,' 7 and 
" Repertory." 

In the second stage, with more free, copious, and somewhat purulent 
expectoration, the most important remedies are: Acidum nitricum, Silicea, 
Kali-c, Sulphur, Calcarea, Natrum-m., Mercurius, Lachesis, Phosphorus, 
Lycopodium, Carbo-v., Sambucus, Hepar sulphuris, Spongia, Cinchona, 
Perrum, Conium, Zincum, Ammon-c, Laurocerasus, Graphites, Nitrum, 
Iodium, Drosera, Plumbum, etc. 

In the third, or ulcerative stage, the same remedies as the foregoing, 
together with Guaiacum, Sepia, Stannum, Staphysagria, Acidum phos- 
phoricum, Sanguinaria canadensis, are those by means of which the 
symptoms may be materially mitigated, and the fatal issue of the disease 
postponed. A few general indications for most of these will be found in 
the chapter on "Cough." When the colliquative sweats are particularly 
distressing, Sambucus, Stannum, Cinchona, Phosphorus, Arsenicum, 
Carbo v. et al., Silicea, Mercurius, Nitrum, Lachesis, Sulphur, and Lyco- 
podium, are the medicines which are of the greatest service. The 
remaining morbid symptoms must regulate their selection. When colli- 
quative diarrhoea predominates: China, Ferrum, Arsenicum, Phos- 
phorus, Acid, Phosphoricum, and Sepia, are the most useful. (See 
"Diarrhoea.") 

While conducting the treatment of consumption, the state of the 
digestive functions, and in females the condition of the uterine system, 
likewise, must be strictly attended to. This is, however, a superfluous 
precaution to the homoeopathic practitioner, as he is ever careful to 
pay due regard to every symptom, not only in this, but in every other 
disease. 

Should none of the remedies, above quoted, correspond to the 
derangements alluded to in particular cases, although they may be other- 
wise indicated, an intercurrent remedy may be selected from amongst 
those we have mentioned in the articles on "Dyspepsia," "Chlorosis," 
etc. The temperament and constitution of the patient ought also to claim 
attention in the selection of the remedies. 



SCROFULA. 617 

t 

In conclusion, it must be remarked, that as the irritation which is so 
repeatedly created in the lungs by the vicisitudes of climate, so constantly 
occurring in most parts of this country, forms a great drawback to the 
more or less successful treatment of pulmonary consumption, it is of 
great moment that every possible means be taken to avoid that pernicious 
influence. It has been much in vogue with many medical men to 
recommend warm climates, or well-sheltered situations, even although 
the atmosphere might be of humid and relaxing nature. But we confess 
that we are inclined to side with those who do not object to a somewhat 
bracing and cold atmosphere, provided it be dry, and not of variable 
temperature. 

Much, however, depends upon the peculiarity of the case — the air, as 
well as the food, which may be adapted to one patient, being often 
perfectly inappropriate, and, therefore, injurious to another. 



SCBOFULA—SCBOFULOSIS. 

This is a constitutional anomaly which it is as difficult to define as 
rheumatism, perhaps more so. 

Scrofula may be inherited from scrofulous parents, whose disease is 
not necessarily, but in a majority of cases, reproduced in the children. It 
may likewise be regarded as an inherited disease, if the parents were 
affected with some chronic disorder, (more especially the mother during 
pregnancy,) such as consumption, constitutional syphilis, fever and ague, 
mercurialism. Finally, there is every reason why scrofula should be 
regarded as inherited, when the disease breaks out among the offspring 
of marriages between near relatives, and after such marriages had been 
continued for several generations. 

Scrofula may likewise be acquired by exposure to influences that con- 
tinually impair the process of nutrition. Above all, it is a deficient sup- 
ply of food, or improper food generally, that develops scrofula in children, 
the more certainly the sooner the child was exposed to such an influence. 
This is the reason why children that are chiefly fed on farinaceous soups, 
bread, potatoes, easily become scrofulous, the more certainly the smaller 
the quantity of milk they were allowed at the same time. Potatoes, and 
next to them, farinaceous food, are the articles of diet to which scrofula is 
chiefly attributed. Children who are nursed by healthy mothers, can 
likewise become scrofulous if they are fed too often, or if they are kept too 
long at the breast, which is so often done in the country by women who 
are anxious to prevent another conception. Scrofula is not perhaps directly 
caused, but decidedly promoted, not only by improper food, but likewise 
by an insufficient supply of fresh air, want of exercise, living in damp 
dwellings, inattention to the skin. 

If hereditary scrofula and the last-mentioned circumstances meet, 
scrofula reaches the acme of its development. In our opinion, improper 
nutrition is a much more frequent cause of scrofulosis than hereditary 
descent. Parents generally bring up their children as they had been 
brought up themselves ; the absurdities of their own parents have become 
engrafted upon them with the mother's milk, and the grandmother gener- 



618 CONSTITUTIONAL DISEASES WITHOUT INFECTION. 

ally stands by the cradle as a faithful watch-dog to prevent the old rou- 
tine from being departed from in the least particular. In this point of 
view it is often proper to say, not that scrofula has been inherited, but 
that absurd views concerning the bringing up of children have been 
transmitted from one generation to another. As an evidence of the truth 
of this statement, we mention the circumstance that the first-born in a 
family is apt to have a feeble and sickly constitution, whereas children 
born at a subsequent period, are healthy ; or that some children who were 
brought up on improper food, become scrofulous, whereas no sign of scro- 
fula is manifested in children with whom more rational maxims are 
pursued. 

Scrofulosis always breaks out in childhood. It seldom manifests 
itself before the second year. Children that are very large and bloated in 
the first two years, almost always become scrofulous at a later period; 
children with firm muscles and slender forms are scarcely ever attacked 
with the disease. Scrofulosis scarcely ever breaks out after the second 
dentition, still less frequently after the age of pubescence. 

Symptoms and Course. It is very difficult to furnish a complete 
picture of the scrofulous disease, for the reason that it manifests itself in 
so many different localities and diversified forms; hence a few general 
statements will have to suffice. Scrofula chiefly locates itself in the 

Lymphatic Glandular System. Either we find a more or less exten- 
sive hardened and thickened degeneration, or else a swelling tending to 
suppuration, the surrounding soft parts being more or less involved in 
this process. In the former case, the swollen glands may remain un- 
changed for many years, until they gradually disappear, most commonly 
at the age of pubescence, leaving only a few trifling remnants of diseased 
structure. The inflammatory exudation is seldom deposited in an acute 
form; generally the glands swell slowly and without pain, the swelling 
sometimes even remains stationary, or else retrogrades, until gradually 
one portion of the gland becomes injected, fluctuates and breaks. The 
suppuration generally takes place very slowly, because the decomposition 
of the pus goes forward step by step. In other cases, especially in indi- 
viduals with sickly constitutions, a complete decomposition of the exuda- 
tion takes place before the swelling discharges ; in such a case the discharge 
indeed takes place very rapidly, but other glands are attacked so much 
more speedily, one after the other, and the patient's strength is under- 
mined by hectic fever. The cervical and posterior cervical glands are 
generally attacked first and most extensively; but the morbid process 
may likewise be transmitted to every other part of the body. It becomes 
most threatening, if the glands in contact with the bowels (mesenteric) or 
bronchial glands are invaded ; in such a case obstinate and severe catarrhal 
irritations may set in, which are often followed by hectic fever and 
death. If scrofula can be suspected, every chronic intestinal catarrh, or 
every chronic bronchitis, is not necessarily traceable to a scrofulous 
origin. 

The skin is very often the first organ that shows symptoms of the 
scrofulous taint. It is but too often the case that children who, up to the 
time when they were weaned, look fleshy and solid, after they are weaned 
are attacked by skin diseases ; the scabs are generally accompanied by 



SCROFULA. 619 

obstinate ulcers, which constitute characteristic symptoms of scrofula. 
While the exantheni, which is most commonly confined to the head, is 
still out, or soon after its disappearance, the glands become affected. 

The localization in the bones and joints is one of the most dangerous 
signs of scrofulosis. The inflammatory forms run a very protracted course, 
and it is only when the patient's constitution is in a very bad state, that 
those forms terminate in hectic fever and death, but, on the other hand, 
leave the affected joints with an impaired mobility, stiffened and de- 
formed. Scrofulous inflammation of the vertebra? is the most threatening, 
for it either leads to curvature of the spine, or develops hectic fever by the 
origination of congestive abscesses. 

Another symptom of scrofula is the sore eyes (ophthalmia) which we 
have already described in a previous chapter. It is either confined to the 
margins of the lids, or involves the whole conjunctiva. The ears of scro- 
fulous children have a peculiar inclination to discharge, with small sores 
(eczema) breaking out at the same time round the ears. 

The mucous membranes do not show any particular morbid symp- 
toms, but an extraordinary susceptibility to catarrhs, especially the mucous 
membrane of the nose and throat. In the nose, the copious secre- 
tion is associated with soreness and ulceration, and a swelling of the 
whole nose, in which the upper lip generally participates in a manner 
that is exclusively peculiar to scrofula. In the mouth we notice 
frequent attacks of sore throat, with disposition to swelling of the 
tonsils. 

These various localizations manifest themselves in most diversified 
combinations and successions, sometimes one at a time, and at other times 
all together. Their course is always slow and dragging, subject to many 
oscillations between remissions and exacerbations, but generally termin- 
ates in recovery, as long as the vital organs remain unaffected by the 
disease, always, however, leaving some remnants of the disease behind. 
Even suppuration of the bones of the back (vertebrae) sometimes termin- 
ates in recovery with surprising rapidity. 

The general state of the organism is of importance, both to the course 
of the disease, as well as to the treatment. There are two kinds of scrof- 
ulous constitutions. The one active is distinguished by a lively circula- 
tion and a marked tendency to febrile affections. Such children have a 
fine, transparent skin, (lushed cheeks, with great tendency to sudden 
changes of color in the face, an extreme nervous irritability, increased 
mental activity, melting, languishing eyes, delicate bones, and slightly- 
developed muscles. The torpid scrofulous constitution, on the contrary, 
is characterized by a diminished activity of the circulation and repro- 
duction, and great tendency to fat. The whole body of such a person 
looks bloated, especially the face, the features are coarse, the nose and 
upper lip are swollen, the bones, especially the skull, are large, and the 
limbs coarsely-shaped; other characteristics are: a distended abdomen 
flabby muscles, mental and bodily indolence, a dingy looking, yellowish- 
gray skin, disposition to canine voracity From such general symptoms 
the speedy outbreak of local scrofulous affections can be predicted with 
tolerable certainty ; frequently, however, especially if a proper mode of 
living is pursued from an early period, the scrofulous habit disappears 



620 



CONSTITUTIONAL DISEASES WITHOUT INFECTION. 



entirely, sometimes at the age of seven years, without having occasioned 
any local diseases. 

The treatment of the various local scrofulous diseases has been 
discussed in other articles, and all that remains for us to do here, is 
to consider the disease in its totality. According to what we have said 
when treating of the causes of the disease, it is evident the casual indica- 
tion in scrofulosis occupies the first rank. Before any medical treatment 
can be thought of, the mode of living has to be thoroughly changed. This 
change refers mostly to diet, habitation," exercise in the open air, attention 
to the skin, etc. ; in cases of scrofulosis of active persons, it has likewise 
to take into special account the mental development of the patient, which 
should never be forced and premature, and should always go hand in 
hand with an abundance of bodily exercise. In this respect it is difficult 
to lay down specific rules which might be adapted to one child, and decid- 
edly contrary to the constitution of another. The physician should care- 
fully investigate, and afterwards remedy the defects of education, but 
definite laws cannot be laid down to such a result. The casual indication 
likewise includes measures having reference to a true and useful preventive 
treatment ; hence, a parent or physician should make it his duty to watch 
over the education of his children, in every possible direction and aspect 
of the case. How much trouble will a parent save himself by such a 
course, and how much care, anxietv, and suffering to others. For 

TREATMENT see: Ophthalmia, Otorrhcea, Nasal Catarrh, Diseases 
of the Liver, Diarrhoea, Tardiness in Learning to Walk, Cough, Teething, 
Diseases of the Glands and Bones, Rickets, and the general article on 
Preventive Treatment, which has been prepared to meet the wants of such 
cases. 




DIAGRAM OF THE FEMALE PELVIS AND ITS ORGANS. 



PART THIRTEENTH 

^ **. 

DISEASES PECULIAR TO WOMEN. 

CHAPTER XXX. 



DISEASES OF THE FEMALE SEXUAL ORGANS. 

MEXSTR UATION. 

By menstruation we understand a flow of blood from the female sex- 
ual organs recurring at regular intervals. It is a sign that the female 
organism has attained the faculty of conceiving, and depends upon the fol- 
lowing processes: The gradual maturing of an ovum (egg) in the ova- 
ries determines an increased afflux of blood to those organs. If this 
congestion has reached its acme, the other organs of the sexual system 
participate in this hyperemia (congestion) to such an extent that the 
blood-vessels become ruptured and a more or less considerable, discharge 
of blood takes place, accompanied by a sometimes more extensive and at 
other times more local detachment of the epithelial lining of the sexual 
organs. While the discharge of blood lasts, the matured ovum {egg) 
enters the fallopian tubes, which renders its fecundation possible. A 
discharge of blood need not necessarily accompany the passage of the 
ovule into the tubes; otherwise bow could a woman who is nursing her 
baby and does not see the least sign of a menstrual show, conceive again 
at such a time? That this has happened, is a fact established beyond the 
possibility of a doubt. 

According to circumstances the menses appear at times sooner, and at 
other times later. They are influenced by climate ; the nearer to the equa- 
tor, the sooner the menstrual period appears; they are likewise influenced 
by the mode of living; in cities the menses appear sooner than among 
country-girls; by the mental capacities; the more advanced the mental 
development, the earlier the menstrual functions make their appearance. 
The constitution exerts no particular influence; very robust girls some- 
times menstruate very late, whereas feeble ones often menstruate prema- 
turely. According to the circumstance the menses may set in between the 
ages of ten and twenty years; in our climate they appear in cities between 
the ages of fourteen and sixteen, and in the country between the ages of 
sixteen and twenty years. 

The quantity of the menstrual blood is likewise variable and cannot 
be determined a priori; stout women sometimes lose a small quantity of 

621 



622 DISEASES OF THE FEMALE SEXUAL ORGANS. 

blood, whereas feeble and spare-built women lose a great deal. The quan- 
tity is from two to eight ounces. 

Nor is the duration of the menstrual flow the same in all cases. It 
generally averages five days, but, without being considered abnormal, may 
last only two, or may be extended to eight or nine days. Sometimes the 
bleeding stops for a short time and then reappears again. 

The periodicity of the bleeding likewise varies. By far in the majority 
of cases it returns again every twenty-eighth day. In many cases there is 
an interval of four weeks between the periods ; in a few cases we notice an 
interval of twenty-one to thirty days. Four weeks may be considered the 
normal length of the interval between each two successive turns. 

The influence of the menses upon the general health is sometimes 
considerable, and at other times none at all. AVe notice hyperemia 
of the vagina and of the external pudendum, sometimes with increased 
secretion of mucus; tumefaction of the breasts with painful, knotty 
swelling of single milk ducts. During the menstrual flow the ner- 
vous system is much more sensitive and excitable, whence the follow- 
ing phenomena ; chilliness alternating with flashes of heat; headache; 
hemicrania, vertigo, languor, drowsiness without any ability to sleep; 
irritated, whining mood; loss of appetite, palpitation of the heart. In 
addition to these derangements, we often see a sickly, gray complexion, 
efflorescences in the face, margins around the eyes; vomiting or nausea; 
altered voice. These phenomena usually occur only during the first 
twenty-four hours of the flow, after which they cease either suddenly or 
gradually. 

The total cessation of the menses take place indefinitely, some women 
mensturating regularly until the age of fifty-five, whereas others cease to 
menstruate when they are thirty years old. These differences do not 
depend upon the time of the first appearance of menses, or upon the vigor 
of the individual, upon the number of times a woman has conceived, 
nor even upon other morbid conditions. The final cessation is 
not bound by any rule, and may take place quite normally, 
betwen the ages of forty and fifty years. It may occur suddenly 
and completely, or in paroxysms; some periods, even to the 
number of ten or twelve, being skipped, after which the menses may 
occur again regularly for months, or a sort of hemorrhage may set in, 
which is again followed by a stoppage of the menses. As a rule the quan- 
tity of the menstrua'l flow is larger, as the period of a final cessation draws 
near, than in the preceding years. 

In the previous paragraphs we have only briefly alluded to the most 
important points. But they show satisfactorily the importance of the 
menstrual function to the female organism. Hence, it is that menstrual 
irregularities have, at all times, excited a lively interest among physi- 
cians, as well as lay-persons, to such an extent that they have been class- 
ified under special heads, although, in reality, they constitute a symp- 
tomatic manifestation of one and the same general or local disease. The 
question now is, when, in a general sense, menstruation may be said to be 
abnormal. The menses are abnormal in the first place, if they do not 
harmonize with one of the previously indicated periods; they are likewise 
abnormal, if, for some cause or other, the usual duration of the menstrual 



MENSTRUATION. 623 

flow in a given case is either shortened or lengthened. A woman who 
menstruates every twenty-first day, is not considered sick; but we 
consider a return of the menses every twenty-first day abnormal, if here- 
tofore they had occurred every twenty-eighth day. Finally, whether 
the menstrual flow is to be considered abnormal, may depend upon the 
influence which it exerts upon the general organism. A supension of the 
menses in the case of a young girl who, after being relieved from the 
prejudicial influences of school and city home, goes into the country, 
and there regains her blooming health, cannot be regarded as a morbid 
condition. 

Every attention should be given to the mind and feelings of the 
young woman ; her excited fancy should be controlled, and her nervous 
sensitiveness, and excitable temperament, which are so apt to cause 
disease, should be quieted. For this reason, a woman should be treated 
with kindness and attention, especially during pregnancy and the 
menstrual period. Every depressing emotion, chagrin, fright, anger, acts 
prejudicially upon persons in health, much more upon those who are 
diseased. We refer the reader to our article on hysteria, and to our 
subsequent article on chlorosis, where we shall show that a premature 
development of the mental faculties, and more particularly of the fancy, 
exerts a pernicious influence upon the constitution of the growing woman 
generally, and upon the normal functions of the sexual system in partic- 
ular. 

Woman's material mode of living deserves a closer attention. A 
wrong system has, in this respect, become a second nature to such an 
extent, that a physician is expected to allow his patients to indulge in 
their accustomed violations of a proper diet, on which account we invite 
him to pay particular attention to the following points in the treatment 
of female diseases. 

1. Women who lead a sedentary life, should be induced to take more 
exercise than usual, and to rouse themselves from their phlegmatic 
torpor. This is one of the first requisites of health; frequent exercise in 
the open air, cleanliness, frequent bathing and washing, and frequent 
changes of linen. During the menses, every heating exercise, and every 
exposure to a cold should be avoided; likewise heavy farinaceous food, 
freshly baked bread; violent emotions, sexual intercourse, emetics, purga- 
tives, baths. This caution need not be carried so far as to compel healthy 
and robust women to lie down the first two days, and even to give up 
their accustomed walk. 

2. A bad habit, that is indulged in by many ladies, is eating at any 
hour of the day. This practice is decidedly injurious to the success of 
any good treatment, and should be abolished. Order is useful in all 
things, and likewise in our meals, and patients should be given to under- 
stand that they must partake every day of a warm dinner, at a fixed 
hour; breakfast and supper may consist of cold articles of food. 

3. Too much sleep, and sleeping too often within twenty-four hours, 
can only be approved of if the patients are very weak and anaemic ; during 
sleep the body has to be kept perfectly unrestrained and easy, without 
the least inconvenience from the pressure of the ordinary clothing; 
otherwise, sleep will not exert the quickening influence that is expected 



624 DISEASES OF THE FEMALE SEXUAL ORGANS. 

from it. Females, especially, have the bad habit of lying down with a 
mass of clothing on. This practice not only prevents the body from 
getting warm, but interferes with the free circulation of the blood, and 
thus gives rise to other troubles, in addition to those already existing. 
Tight lacing is another censurable practice, which is often the sole cause 
of menstrual irregularities. By going without corsets for a time, the 
woman will soon learn to keep her back straight, without any articial 
support. If corsets are worn too tightly, they compel the wearer tobreathe 
with the upper portion of the thorax, the lower ribs not being allowed 
freely to expand, on account of the compression exerted upon them. 
This gives rise to an incomplete respiration, an imperfect introduction of 
oxygen, and a diminution of the elasticity of the plumonary vessels. 
Thus it is that corsets become a co-operating cause of many of the blood 
diseases of females. When speaking of chlorosis and tuberculosis, we 
shall revert to this subject. 

4. Regarding the function of the bowels, it is of importance that our 
female patients should never suppress an urging to stool, and that they 
should at least have one evacuation from the bowels every day. Women 
are much more afflicted with constipation than men ; in most cases they 
are the authors of this exceedingly prejudicial state of the bowels, some- 
times on account of neglect, at other times from sheer laziness, again on 
account of sedentary habits, and finally, because they are ashamed of 
satisfying the call .of nature. 

5. Women should make it a rule to wash their parts, especially if 
affected with leucorrhoea, or other diseases, several times a day with cold 
water, and during the menstrual flow, with tepid water. More recently 
the Sitz-baths and the vaginal syringe are now in almost general use. 
These are not only excellent means of relief in many morbid conditions, 
but likewise, excellent means of prevention, and should be found in every 
lady's bed-chamber. Cold water is indeed the most reliable nervine at our 
disposal. 

DERANGEMENTS ATTENDANT UPON THE APPEARANCE OF THE MENSES. 

It must be self-evident, that the awakening of the sexual life, which is 
the greatest revolution which the female organism can undergo, is accom- 
panied by phenomena which very often partake of the nature of a morbid 
process. The normal conditions under which the menses should first appear 
have been explained in a previous paragraph. A premature appearance 
of the menses always implies a feeble constitution and powerful sexual 
instinct. Hence, it is of the utmost importance not to accelerate this 
period because all the ailments which sometimes befall young girls at this 
age, are supposed to originate in the tardy appearance of the catamenial 
discharge. Of course, where the delay is evidently of a morbid character, 
nature should be assisted by such remedial means as will promote the men- 
strual flow. 

Such morbid phenomena are the more striking, the more sensitive and 
delicate the young woman who had been reared in the bosom of luxury and 
ease. Although these ailments may not be very considerable, yet their 
removal often requires the interference of art. Sometimes a judicious diet 
is sufficient for this purpose, but in many cases medical agents have to be 
used. Such cases are characterized by the following symptoms : Conges 
tion of blood to the head, as indicated by heaviness of the head; rush of 



MENSTRUATION. 625 

blood to the chest, with palpitation of the heart, and sometimes attended 
with oppression of breathing; sensation of warmth and repletion in the 
abdomen; feeling of indolence through the whole body; occasional flashes 
of heat and red flushes in the face; languid feeling in the legs and feet; 
pain in the small of the back and pelvic region ; drawing in the thighs, 
frequent urging to urinate. These symptoms may be regarded as menstrual 
distresses, which are very speedily succeeded by an actual appearance of 
the menses and disappear with them. If these symptoms continue for a 
longer time without any menstrual show taking place, the patient will 
have to take a good deal of exercise in the open air, use more vegetable 
than animal diet, more liquids than usual, and spend her time as much as 
possible in cheerful company. 

If the above mentioned symptoms become more severe and continuous ; 
if the rush of blood is more violent, causing anxiety, palpitation of the 
heart, constant heat, a restless sleep full of dreams and interrupted by 
sudden starts; if the face looks bright-red, and the signs of cerebral hyper- 
emia and congestion of the organs of the chest becomes manifest; we resort 
to remedies that have been indicated for such conditions in their respect- 
ive chapters. One of the leading remedies is undoubtedly Pulsatilla, 
especially if the congestive symptoms of the head and chest are accompa- 
nied by signs of abdominal and uterine congestion, as if a stone were 
oppressing the uterus, and the patient complains of chilliness, stretching of 
the extremities; yawning and other febrile symptoms may likewise be 
indicated by a certain train of symptoms. The above-mentioned dietetic 
rules should not be neglected while this medicine is used. Belladonna may 
be added to this group of remedies as one of its most prominent members, 
whereas Chamomilla is very seldom indicated, Veratrum and Belladonna 
will often be required, the former, if the functional activity of the heart 
is very much impaired, as indicated by paleness of the countenance, great 
chilliness or constant alternation of chilliness and heat, anxious feelings; 
the latter if symptoms of cerebral congestion prevail, with bright redness 
of the face. 

If the young woman has reached the age of pubescence and feels other- 
wise quite well, although the menses do not show the least sign of making 
their appearance, you would commit a great wrong to drench the organism 
with medicines; your duty will be to leave nature alone in determining 
the period for the appearance of the menses, more particularly if the organ- 
ism shows signs of being backward in its development. It is only if the 
organism is sufficiently developed and the young woman's age justifies the 
expectation that the menses ought to appear, that it is proper to hasten 
this process by the emplo3 r ment of suitable remedies. We give Pulsatilla, 
and if the indications are satisfactory, repeat the dose rather frequently, 
more particularly in cases where the non-appearance of the menses causes, 
without any other bodily ailments, an excessive nervous irritability, whin- 
ing, peevish, timorous disposition, paleness of the face and great nabbiness 
of the muscular tissue. Nux-vomica, on the contrary, will be found appro- 
priate in persons of an opposite temperament, an irascible, choleric dispo- 
sition, a full habit without any decided congestions, redness of the cheeks 
and turgescence of the body. 

Dose: For any of the remedies, (homoeopathic) six pills, once in each 
day, dissolved in a teaspoonful of water. 

40 



626 DISEASES OF THE FEMALE SEXUAL ORGANS. 

CHLOROSIS OB GREEN SIC KXESS--EMANSIO MENSIUM. 

Chlorosis is a disease which occurs exclusively among females, chiefly 
between the ages of thirteen and twenty-four, seldom at a later period ; if 
it does, it can be traced to secondary disturbances, such as confinements 
of young women, coming rapidly one after another, more epecially if the 
women nurse their own children. 

The disease sometimes breaks out previous to the first appearance of 
the menses, more frequently after several menstrual periods ; as an 
entirely primary disease, it only breaks out among unmarried women. 
It is, in some degree, hereditary; females of a pale complexion are more 
liable to be attacked with it ; though no constitution is exempt from the 
disease, although delicate individuals with irritable nerves are more 
susceptible to it. Among other causes, we may mention : insufficient ex- 
ercise, mental exertions, without corresponding muscularactivity ; excite- 
ment of the fancy, especially when caused by novel-reading; excitement 
of the sexual instinct by onanism, improper converse with the 
other sex ; deprivation of the open air, and interference with the free 
expansion of the chest by tight dresses. Chlorosis is very commonly met 
with among daughters of a tuberculous mother. 

Symptoms and Course. — This disease generally comes on very slowly, 
the patients become more irritable, they are apt to get tired after every 
little effort, they are liable to changes of color, the skin soon loses its 
bright lustre, and the patient complains of feeling chilly at an early 
period of the disease. Inasmuch as the disease may be characterized by 
a variety of symptoms, we will describe the derangemento as they appear 
in each special organ and system. 

The skin at times has the color of wax ; at other times it is rather 
yellowish, or of a dingy white, the veins being either not at all percept- 
ible, or but indistinctly so, the color of the cheeks may change quite 
often, within a very brief period of time. The visible mucous membranes 
are more or less without color. Swelling of the feet and limbs sometimes 
occur, but only in the highest grades of the disease. 

The following symptoms occur in the digestive range : impaired 
appetite, aversion to meat, longing for strange articles of diet, such 
as vinegar, chalk, coffee, beans ; bloating of the stomach after every 
meal, sourness of the stomach, and generally the bowels are very 
torpid. 

In the nervous system we discover excessive irritability, neuralgia, 
hysteric symptoms, fitful mood. The breathing is accelerated, the least 
physical exertion causes dyspnoea (shortness of breath,) sometimes to a 
very high degree. The circulation is accelerated, very seldom retarded ; 
disposition to palpitations of the heart, which are easily excited by a 
physical effort. The menses are irregular, sometimes entirely suppressed, 
or very tardy, sometimes more profuse than usual, but always of a lighter 
color, or even quite colorless. 

Accompanying these symptoms, are pains of themost diversified kind, 
very generally uterine catarrh. The urine has a strikingly pale color. 
The patients generally sleep very soundly, and have to sleep a long time, 
* hough sleep never refreshes them. 

One or the other of these derangements is generally wanting. 




UTEJRUS AXB ATVENBAGES. 

The Uterus is the organ of gestation, situated in the 
cavity of the pelvis between the bladder and the rectum, a. 
The body of the Uterus. 6. The cervix, in the lower end of 
which isa transverse aperture, the OS uteri ; around the uter- 
us and a little above its lower extremity the vagina,c— which 
i< here shown cut open and spread out— is attached to the 
uterus walls. The ovaries </ d are placed one on either 
side of the womb below and behind the Fallopian tubes e e, 
and each month for a number of years, during the life ot 
a woman, the ova— egg— bursting from the ovary is caught 




by the fringed finger-like end of the Fallopian tube called fimbrinse, 
and by them placed in the outer end of the tube, and by it carried 
forward into the uterus//. The broad ligaments extend from the 
uterus to the walls of the pelvic cavity, dividing that into two por- 
tions; g r/ the round ligaments extending from the upper back part 
of the womb to the labia rnajora, h h blood-vessels. 



GREEN SICKNESS. 627 

The one characteristic symptom is never absent : dyspnoea and palpi- 
tation of the heart from the least unusual effort, especially after going 
up stairs. 

The course of chlorosis is always more or less protracted, sometimes 
very chronic. If no particular disturbances take place, the affection can 
sometimes be cured in a few weeks; whereas, if the mode of living which 
had acted as the exciting cause is persevered in, the trouble may continue 
for years. The disease is most commonly more violent in summer than 
in the winter season. Uncomplicated chlorosis always terminates in 
recovery. 

Among the complications, the simultaneous presence of consumption 
and scrofula are most threatening. We generally find that scrofulous 
girls who are attacked with chlorosis recover their health to some extent 
for a year or two, after which they die of consumption, or phthisis may 
set in as a direct development of a protracted chlorosis. 

HOM(EOPATHIC TREAT3IENT. The leading remedies which have 
been found most useful in this affection are Pulsatilla, Sepia, Bryonia, 
Sulphur, Calcarea carb., Ferrum, Lycopodium, and Plumbum. 

Pulsatilla is peculiarly useful in chlorosis, when the derangement 
seems to have been excited by, or is connected with, indigestion ; and 
it is accompanied with headache, particularly in the side of the head, 
with shooting pains extending to the head and teeth, sometimes shifting 
suddenly to tJie other side; sallow complexion, difficulty of breathing, and 
sense of suffocation after the slightest movement; palpitation of the hearty 
coldness of the hands and feet, often changing to sudden heat: disposition 
to diarrhoea and leacorrhoza, pains in the loins, sensation of weight in the 
abdomen, almost contant chilliness and shivering, spasmsin the stomach, 
with nausea; inclination to vomit, and vomiting; hunger, with repug- 
nance to food ; swelling of the feet and ankles, great fatigue, especially 
in the legs. This medicine is particularly adapted to females of mild 
disposition, disposed to be sad and tearful. 

Dose: Six pills every evening. 

Sepia is a remedy of very great value in this disease when there is a 
good deal of headache, sallow complexion, with dark colored spots ; 
frequent colic and pain, as if arising from bruises in the limbs, with a 
drawing, tearing pain in the thick muscles of the back part of the legs. 
It may follow Pulsatilla, with great advantage, or be given in alternation 
with that remedy. 

Do.se: Six pills or a powder every morning. 

Bryonia. Frequent congestion of the head and chest, bleeding at the 
nose, dry cough, coldness and frequent shivering, sometimes alternating 
with dry and burning heat, constipation or colic, bitter taste in the 
mouth, tongue coated yellow, sense of pressure in the stomach, as if from 
a stone. 

Sulphur is more particularly indicated when there is pressive and 
tensive pain in the back of the head, extending to the nape of the neck; 
humming in the head, pimples on the forehead arid round the mouth ; 
pale and sickly complexion, with red spots on the cheeks; changeable 
appetite, with general emaciation; heaviness in the stomach, under 
the lower ribs and in the abdomen; bowels irregular, great tendency to 



628 DISEASES OF THE FEMALE SEXUAL ORGANS. 

take cold , irritability and inclination to be angry, redness and melancholy, 
with frequent weeping. 

Dose: Six pills every other day. 

Calcaria Curb, is often of the most striking benefit in chlorosis. 
Sometimes a complete cure is effected by it alone, even in the worst cases, 
with (oedema) swelling of the extremities, and extreme dyspnoea. When 
there is complication with tubercular diathesis, accompanied by cough, 
Sulphur and Calcarea Carb., often prove highly beneficial in alternation, 
or if oppressive headache is complained of, Sepia may be given in alterna- 
tion. Sometimes menstruation does not take place for some time after- 
wards, though the general health is very much improved under the em- 
ployment of the remedies prescribed. 

Dose: Six pills every morning. 



SUPPRESSION Oil DELAY OF THE 31ENSES. AMEN- 

ORRHCEA. 

This suppression either takes place during the flow, or in consequence 
of causes acting previous to the actual appearance. In the former case a 
cold may have operated; or cold washing may* be the cause; or the feet 
may have got chilled ; or the patient may not have been sufficiently pro- 
tected by her clothes; mental or moral emotions, vexations, chagrin, anger, 
fright, or dancing, sexual intercourse, dietetic transgressions may have 
led to the suppression. Most of these causes, if operating shortly before 
the time when the menses were to come on, may cause their retention. A 
gradual suppression of the catamenia may take place in consequence of 
deficient nutrition, as well as of the abuse of warm beverages, and the con- 
tinued influence of depressing emotions, We have already shown that a 
change in the mode of living may superinduce a suspension of the menses, 
in the case of young women, without leading to derangements of the gen- 
eral health, 

The more sudden the suppression of the menses, the more violent the 
changes arising from such an occurrence. Some of the most prominent 
symptoms are: Violent headache, great anxiety and oppression of 
breathing, nose-bleed, spitting of blood, congestions of the head, heart, 
and lungs, and the like. In some cases, a suppression of this kind gives 
rise to acute uterine catarrh. If a physician is called in time, he will, of 
course, inquire what gave rise to the trouble, and will seek to remove the 
consequences of fright, mortification, anger, etc., by appropriately specific 
remedies. If the physician is not called until some time after the morbid 
symptoms have existed, the aforesaid remedies will no longer be appli- 
cable, and the constitutional condition generally will have to be acted 
upon by corresponding remedies, and you should follow the same course 
as a physician. 

ALLOPATHIC TREATMENT. Amenorrhcea. If the menstrual flow 
(menses) never has appeared, and the patient is strong and healthy, and 
there is no menstrual molimen (symptoms or sensations of menstruation) 
it is not prudent to resort to any interference. Every means should be 
employed to strengthen and invigorate the system. The body, rather 



SUPPRESSION OF THE MENSES. 629 

than the mental faculties, should be exercised. Life in the open air, and 
tonics containing iron, should be given, if the patient is anaemic (having 
thin blood.) Constipation should be corrected as directed in the 
treatment of that disease. The preparations containing Aloes are espec- 
ially appropriate. 

Scarcely ever is menstruation, (and menstrual sensations,) absent 
after nineteen or twenty years, unless there is a lack of development in 
some of the organs of generation. This is to be inferred, if invigorating 
measures after employment for some time, have proved ineffectual. 
The advice of a skillful physician should be always procured. Develop- 
ment of the womb to a proper size has, in some cases, been induced by 
treatment. 

Retention of the menses is probable when regular symptoms of 
menstruation occur without the flow, and the abdomen of the patient 
gradually enlarges. The cause of retention may be absence of the vagina, 
an imperforate hymen or closure of the mouth of the womb. These may 
be overcome by the skill of the surgeon. 

If the general health is good, and the generative organs, vagina, 
uterus, and ovaries, are well, or reasonably developed, Iron may be effica- 
cious in establishing the menstrual flow. 

Persons who have amenorrhcea (suppression of menstruation,) are 
generally suffering from an indisposition of some kind, with which the 
amenorrhcea is associated, or dependent upon. In some cases, the patient 
has fallen into ill health before the menses have ever appeared, and as a 
consequence, there is no attempt at menstruation. 

It is, therefore, perfect nonsense to attempt to bring on the monthly 
flow, or cure the amenorrhcea, while the general health remains impaired. 
In a patient suffering from consumption, treatment ought not to be 
directed to menstruation at all, until the patient can be brought up to a 
good degree of general health, and then nature will establish the menses, 
if the system is able to sustain the discharge. It is a popular error that 
stoppage of the monthly courses is the cause of the ill-health which 
accompanies it, whereas, exactly the opposite is the truth ; the general 
indisposition has caused the suppression of the menses. In the treat- 
ment of these cases, the return of the monthly sickness is the final result 
to be attained. Improvement in other respects must be first attained, 
and, almost always, the rest will follow as a necessity under nature's 
order alone. 

If the patient is not surrounded by good hygiene, this is the first point 
to attain. She should have pure air, and exercise out of doors should be 
taken. This exercise, if taken for exercise, is apt to be neglected, and 
not be of a character which will make her of cheerful spirits ; recreations, 
such as buggy riding, and walking with cheerful companions, or rambles 
in the fields or woods, will accomplish this, if not carried to a point which 
is fatiguing. 

When the patient becomes exhausted at her exercise, she is going 
a little too far. A sedentary occupation may sometimes need to 
be changed for a more active one. With persons who are unaccus- 
tomed to physical exercise, this habit must be cautiously and gradually 
begun. 



630 DISEASES OF THE FEMALE SEXUAL ORGANS. 

With shop and factory girls, poor hygiene is most likely to be the 
cause of such a poor state of health as will produce amenorrhcea. In these 
cases, while the use of medicines follow the same rules as in other debili- 
tated patients, it is quite secondary to the improvement of their hygenic 
circumstances. 

In schools, too little time is given to unrestrained life (exercise) in 
the open air, and too much time to quiet mental work, and the anxiety 
of parents as to the intellectual development of their children, leading 
them to send them to school at too early an age, and crowding them too 
rapidly, is a prolific source of ill-health, and consequent amenorrhcea. If 
parents would not send their children to school until they were eight 
year sold, and then, if a large portion of the day was appropriated by every 
student, to take such recreations as her inclinations lead her to, the 
breaking down and ill health in schools for girls, Avould be as rare as it is 
now common, provided eight full hours of the twenty-four were regularly 
spent in sleep. 

The importance of exercise is admitted, in theory, in these schools, 
but the amount is not regulated to the wants of each particular case. The 
long walk may be beneficial to the strong and well-nourished, if they are 
accustomed to such exercise. The girls not so strong and well-fed, may, 
in these very walks, lay the foundation for a serious disease. To make 
exercise most useful it must be pleasurable, and for that end restraint 
must be thrown off. Again, exercise ought not to be violent. The 
gymnasium is productive of good if not carried to an extreme. It may do 
much harm. Such exercises as jumping are not to be indulged; occasional 
and moderate horseback riding is good, but carried to an extreme, it may 
do harm. 

Early hours, good nourishing food, of which animal food forms a 
large part, plenty of fresh air, and warm clDthing are necessary to ensure 
good health, both before and after menstruation. 

The constipation and derangement of the digestive organs is generally 
an effect of the state of ill-health, which is to be corrected in the first 
place, before the patient can take such an amount of nourishment as will 
bring her body to a vigorous state, and maintain it there. Two or three 
Compound Rhubarb pills at night, followed by a Seidlitz Powder, or a 
dessertspoonful of Rochelle Salts, in Lemonade, in the morning, may be 
given once or twice a week, for a time; or, after the bowels have moved 
freely, from the use of three or four Compound Cathartic Pills, remedies 
may be used as are directed for constipation. The pills containing Aloes 
and Extract of Nux Vomica, are to be preferred. 

The circulation should be maintained by free, pleasurable exercise in 
the open air, sponging the skin with tepid or cool water, and rubbing 
briskly with a coarse or rough towel, until the skin is aglow, and warm 
clothing. It is very important to keep the feet, legs, and arms so well 
clothed that they will keep warm. 

The two remedies which are especially serviceable in building up the 
health to a point at which menstruation will occur in obedience to nature 
alone, are Iron and Quinine. One of the best forms for its efficacious 
administration is the Citrate of Iron and Quinine in doses of from two to 
five grains three times a day. It may be dissolved in Syrup of Ginger or 



SUPPRESSION OF THE MENSES. 631 

Orange Flower water. Take of Citrate of Iron and Quinine from one and 
a half to three drams, Syrup of Ginger six ounces. Mix. 

Dose: A teaspoonful, or a teaspoonful and a half, three times a day. 

If the bitter taste is seriously objected to, one or two grain pills of the 
Sulphate of Quinine may be given two or three times a day, and the 
same quantity of the Soluble Citrate of Iron may be given in solution 
with Cinnamon or Orange Flower water in the same proportions as 
directed for the Citrate of Iron and Quinine. 

Before buying the sugar or gelatine coated pills of Quinine one of these 
should be cut open with a knife, if they are good they will be soft under 
the coating. 

The Pyrophosphate of Iron answers the purpose very well. It can be 
given as follows: Take of Pyrophosphate of Iron two and a half drams, 
water sufficient to dissolve, Syrup of Orange sufficient to make six ounces. 
Mix. 

Dose: A teaspoonful three times a day. 

The Tincture Muriate of Iron has long deservedly enjoyed a reputa- 
tion in the cure of amenorrhcea, and is one of the most effectual. The dose 
is fifteen or twenty drops three times a day, largely diluted in sweetened 
water. 

After the use of Iron and Quinine for a time, if health is not restored 
it is w r ell to change to the use of Iron with Strychnine. Take of the Ci- 
trate of Iron and Strychnine seven scruples, water sufficient to dissolve, Syrup 
of Ginger or Orange a sufficient quantity to make six ounces. Mix. 

Dose: A teaspoonful three times a day. 

Each teaspoonful contains a fraction less than a thirtieth of a grain of 
Strychnine. 

If the patient does not suffer from impoverishment of the blood, or if 
they have recovered from the anaemia, from three to five drops of Fowler's 
Solution, three times a day, may be given with benefit. Itseems to restore 
the activity of the ovaries. The Chloride of Gold and Soda in pill, one 
twentieth of a grain each, three times a day, is also thought to be benefi- 
cial, in the same way. 

Dj-spepsia must be treated as is directed in that disease. It maysome- 
times be advisable to keep the patient for a time on a milk diet. Only 
such food should be given as is found by experiment to be readily diges- 
ted. Milk, beef tea, eggs beat up with sugar and water or milk, are some 
of the easiest digested and most nutritious articles of food. 

The object in treatment is first, to put the body in good health as the 
amenorrhcea is only a symptom of the state of ill health. 

If menstruation has been suddenly suppressed, it is best to give a hot 
sitz (hip) bath, a copious drink of Ginger tea, place her in bed and give 
her a full dose of Dover's Powder's (ten or fifteen grains,) especially if she 
has had a child. A mustard plaster may be put over the lower part of 
her abdomen, and bottles of hot water about her hips and loins. The use 
of electricity has, in some instances, caused a return of the flow. A hot 
water injection into the rectum may be made. 

When the time for menstruation has passed, we must wait until just 
before the next period, when for three or four days a warm hip bath should 
be given night and morning. If there is no pregnancy some of those 



632 DISEASES OF THE FEMALE SEXUAL ORGANS. 

remedies called emenagogue (calculated to promote the flow of menses,) 
may be given, if the physician desires, but as so much harm may be done 
with these, it is deemed proper not to give directions for their use in a 
popular book. 

When the mental emotions have been the cause of the sudden sup- 
pression, Opium to the extent of producing quiet in doses of half a grain 
to a grain, is the best remedy. Laudanum in doses of ten to twenty drops, 
or Paregoric in doses of two teaspoonfuls may be given. 

Chronic suppression should be treated on the principles before given, 
viz : Correction of the general health, and from month to month encour- 
age the menstrual flow by the gentle measures just enumerated 

HOMOEOPATHIC TREATMENT. Pulsatilla should be employed 
when a suppression takes place from the sudden effects of a chill, when 
the symptoms generally correspond with those described under the head 
of that remedy, in the article on Chlorosis. 

Dose: Six pills in a teaspoonful of water, night and morning, for a 
week (unless a change should sooner occur;) then pause eight days, 
after which the course may, if necessary, be repeated as before, and 
so on. 

Cocculus in cases in which there are habitually attacks of colic-like 
pains in the bowels at the periods at which the menstrual discharge 
should occur if it were regular, more especially if the patient complains 
of great weakness of the lower extremities languor and lassitude, precar- 
ious appetite, and generally also nausea, with much oppression at the chest 
and in the region of the stomach, etc.; especially when this functional 
derangement occurs in full-habited and apparently healthy persons, par- 
ticularly if the suppression be traced to mental emotions. 

Dose : As for Pulsatilla. 

Niwc-nioschata when the suppression is accompanied by spasms 
and other hysteric affections; disposition to sleep and faint away; great 
nervousness ; complete exhaustion after slight exertion ; pains in the loins, 
etc. 

Dose : As directed for Pulsatilla, 

CaulopJiyllani should be given when there are spasmodic, bearing- 
down pains ; and sympathetic, crampy, spasmodic pains in the bladder, 
rectum, or bowels. 

Dose: As directed for Pulsatilla, 

Veratrum should be administered in cases in which the convulsive 
and other symptoms incidental to the suppression, when caused by fright, 
have failed to yield to the last-named medicine ; and when there are pale, 
livid face; frequent nausea and vomiting; cold hands, feet, and nose ; 
great weakness, with fainting turns. 

Dose: As directed for Pulsatilla. 

Lycopodium has proved of service in cases in which the patient 
complains of headache and giddiness; flatulent distention of the bowels 
before each period at which the secretion ought to have returned ; and 
habitual costiveness. 

Dose: As directed for Pulsatilla. 

Belladonna should be employed in cases which are associated with 
fullness of blood, determination of blood to the head, violent throbbing 
of the arteries of the head and neck, and nose-bleed. * 



MENORRHAGIA. 633 

Dose: As directed for Pulsatilla. 

Sulphur is one of the most important remedies for the treatment of 
cases which assume a chronic and obstinate character, more particularly 
if such cases occur in persons of a feeble or exhausted constitution, or 
who bear about tbem, in a marked degree, the traces of a scrofulous habit 
of body, or who are affected with the piles; or, again, when the prevailing 
symptoms are such as have been described in detail under the head of 
this medicine, in the article on "Chlorosis or Green-Sickness." 

Dose: Six pills in a teaspoonful of water, the first thing in the morn- 
ing, for six days, (unless change should sooner occur;) then 
pause ten days, after which the course may, if necessary, be repeated 
as before, and so on. 

Sepia is also of great value, whether at the onset, or after the previous 
administration of Sulphur, for the treatment of chronic and difficult 
cases, and for such as are complicated with scrofulous taint of constitu- 
tion, or which occur in otherwise feeble and exhausted subjects. Sepia is 
more especially appropriate when the prevailing symptoms are such as 
have been described in detail under the head of this medicine, in the 
article on " Green-Sickness." 

Dose : Four pills, in other respects as directed for Sulphur. 



MENOBBHAGIA--FROFUSE MENSTRUATION. 

The quantity of the menstrual discharge varies a great deal in differ- 
ent individuals. The climate, constitution, and manner of living, have 
considerable influence. The duration of the discharge, and the periods of 
return, are also varied. In some women, it continues from four to ten 
days, while in others it lasts only a few hours ; from three to six days is, 
however, the most usual period. The regularity is, in many cases exact, 
to a day, or even an hour; while in others, a variation of several days is a 
usual occurrence, without the slightest disturbance in the usual health 
resulting therefrom. 

An excess of loss of menstrual blood, a true menorrhagia, does not 
occur as often as it may seem to those who complain of it. To constitute 
menorrhagia, several circumstances have to occur that require to be 
carefully discriminated. The average of discharged blood has to exceed 
the ordinary loss quite considerably ; and then, again, we have to inquire 
whether the scantiness of the ordinary menstrual flow is not an abnor- 
mal diminution in the present case. The menstrual flow is likewise 
considered too copious if it continues beyond the ordinary period, 
although this need not necessarily imply that the menses are profuse. It 
is therefore, the morbid character of the menses that is necessary to deter- 
mine the disorder, for a copious flow of the menses cannot be considered 
abnormal as long as the constitutional harmony is in no respect disturbed 
by it. 

The causes of menorrhagia are quite numerous, of which it may be 
best to make mention of a few : Excess is occasioned by onanism, novel- 
reading, a constant dwelling of the fancy upon sexual things, and the 
habitual use of heating beverages. A few other important points have to 
be added: «Under certain circumstances, a profuse flow of the menstrual 



634 DISEASES OF THE FEMALE SEXUAL ORGANS. 

blood becomes a real physiological necessity to the body ; for instance, if 
a larger supply of nourishment than the body requires for its normal 
support, causes a real plethora. This can hardly be regarded as a morbid 
condition. A profuse flow is sometimes occasioned by changes in the 
uterus, such as acute or chronic inflammation of the womb, or some 
foreign growth in the uterine cavity. Nursing exerts a very particular 
influence. As a rule, nursing women do not menstruate; yet it may 
happen, even in the case of quite healthy mothers, that the menses 
reappear again permanently, in which case the flow is often very profuse. 
This is not a normal condition, although it does not inconvenience all 
women. 

Menorrhagias that set in when the process of nursing is continued too 
long, are of an exceedingly threatening character. This accident occurs 
quite often where the women nurse their children for several years for the 
purpose of preventing conception, not thinking that by so doing they 
inflict permanent injury upon their health. "We must not forget to record 
the fact that diseases of other organs, or of the general constitution, exert 
an influence upon the menses. Diseases such as typhus or scurvy, etc., 
the influence of heart disease or consumption, and all such diseases which 
alter the quality of the blood, must be considered. 

It is more especially heart disease that causes menorrhagia, so that 
the heart had better be carefully examined in every case of menorrhagia. 
Finally, the cessation of the menses, at the critical age, is almost always 
ushered in by profuse loss of blood. 

HOMCEOPATHIC TREATMENT. Ipecacuanha is one of the more 
generally useful medicines in severe cases of this derangement, as well 
as in flooding after labor, and may, in most instances, be administered 
first, unless there are strong indications for a preference being given to 
any of the others. 

Dose: Six globules in a teaspoonful of water, repeated at intervals of 
six hours, until amelioration or change. 

Sabina is indicated when the discharge is excessive, of a bright color, 
and occurs in full-habited females who are prone to miscarry; or when 
the subjoined symptoms prevail ; rheumatic pains in the head and limbs, 
great weakness; pains in the loins similar to those of labor. 

Dose: Six globules, as directed for Ipecacuanha. 

China is of considerable utility where there is great debility in con- 
sequence of a more copious menstrual discharge than is natural. 

Dose : Six globules in a tablespoonful of water, repeated at intervals 
of six hours, if necessary. 

Nux-vomica is especially appropriate for the following symptoms: — 
The discharge being of too frequent occurrence, too profuse, and of too 
long duration; and when it commonly stops for a day or so and then 
returns, attended with spasms in the belly; sometimes nausea and faint- 
ing, especially in the morning; pains in the limbs ; restlessness; irascibil- 
ity. Nux-vomica is especially serviceable when the above symptoms occur 
in females who are addicted to the daily or frequent use of coffee, liquors 
and other stimulants, or have been extensively drugged by old-school 
practitioners. 

Dose: Six globules in a teaspoonful of water, repeated at intervals of 
four hours. . 



PROFUSE MENSTRUATION (iS5 

Chamomilla is frequently useful when there is [ a discharge of dark, 
clotted blood, with severe colic, or pains like those of labor; great thirst; 
paleness of the face, and coldness of the limbs. 

Dose: Six globules in a teaspoonful of water, repeated at intervals of 
six hours, until improvement or change. 

Ignatia is of considerable service in cases resembling the above, when 
the derangement happens in hysterical or sensitive females of mild and 
uncomplaining disposition ; or who have had a great deal of trouble. 

Dose: As fox Chamomilla. 

Vevatrum is more particularly required for too early or too copious 
menstrul discharge, always attended with diarrhoea. 

Dose: Three globules, as directed for Chamomilla. 

Gelseminum is indicated in cases in which there is scarcely an inter- 
val between the periods ; which are not, however, attended with much 
suffering ; or, the flow having ceased, is brought on again by fright or 
other mental emotion. 

Dose: Three globules, as for Chamomilla, 

Kreosote will be found useful when the menstrual blood has a deci- 
dedly offensive odor, is too profuse, and lasts too long; the abdomen 
becomes distended before the periods; leucorrhcea, which excoriates the 
parts, between the periods. 

Dose: Three globules, as directed for Chamomilla. 

Diet and Regimen. Patients who are habitually affected with exces- 
sive menstrual discharge should live with great regularity, keeping early 
hours, taking regular, but moderate daily exercise in the open air (during 
the intervals) in favorable weather, and partaking of nothing but the most 
digestible, simple, and unstimulating diet, which, at the same time, should 
be of a nourishing and strengthening description. Emotions of all kinds 
should be avoided as much as possible ; and during the continuance of the 
discharge the semi-recumbent posture should be retained, and the body kept 
cool. Neither food nor drink should be taken hot ; the food should be as 
cool as it can be relished, or chiefly cold, and the beveiage quite cold. In 
addition to these directions, more explicit particulars may be derived 
from the article on "Eradicative Treatment,'' at p. 98. 

ALLOPATHIC TREATMENT. The successful treatment of menorr- 
hagia will depend on the exact recognition of the profuse menstruation, 
and the use of appropriate means for effecting their removal. For this 
reason, if for no other, the skill of a physician is required to secure such a 
knowledge of the causes of the trouble, as will lead to intelligent and 
proper treatment. 

The general condition of the patient is to be looked after. If the 
blood is impoverished, the patient must be invigorated, and the general 
health improved by good hygiene, good food, pure air, and exercise, 
carried to the point of making the patient feel vigorous, never fatigued, 
etc. The directions given for the management of the condition known 
as "anaemia," are appropriate here. If the patient resides in a malarious, 
locality, anti-malarial treatment will be required, as two or three grains 
of Quinine three or four times a day, or a larger dose once or twice a day 
for a few days or a week, followed by such directions as are given in the 
treatment of ague. The use of iron, as directed in the treatment of 
anaemia atid ague, is generally necessary. If the bowels are torpid and 



636 DISEASES OF THE FEMALE SEXUAL ORGANS. 

inactive, they should be moved by a brisk cathartic, and during the day 
of the menstrual flow, a mixture of Epsom Salts and Aromatic Sulphuric 
Acid should be given, as: 

Take of Epsom Salts an ounce, Aromatic Sulphuric Acid half an ounce, 
Syrup three and a half ounces. Mix. 

Dose: A teaspoonful to a dessertspoonful, in water, four times a 
day. 

In cases due chiefly to debility, a half a dram of Sulphate of Iron 
may be added to the above formula. The dose will be the same, given 
three times a day. Two or three times a week a laxative pill may be 
taken, such as are directed for constipation, if the bowels are not suffi- 
ciently active. The chronic congestion of the uterus requires attention 
when this exists, which is always the case in those instances not 
dependant on organic disease. The warm vaginal douche, as directed for 
leucorrhcea, is useful. Tonics are also required which contain Quinine, 
Iron, and Strychnine, as: 

Take of Citrate of Iron and Quinine, and of the Citrate of Iron and 
Strychnine, each a dram and a half; Water of Orange Flowers four ounces. 
Mix. 

Dose: A teaspoonful three times a day. 

This medicine may be sweetened with the addition of sugar or substi- 
tuting Syrup of Orange. 

The coexisting leucorrhcea must be treated as directed for that 
disease. 

Many a case of menorrhagia depends upon a flexion of the womb. It 
is astonishing sometimes, bow quickly the excessive flow will cease when 
this displacement is corrected. 

A chronic inflammation of the womb, resulting from sub-involution 
of the womb, (its failure to regain its natural size after confinement or 
miscarriage,) may cause this trouble. The most suitable constitutional 
treatment appears to be the daily use of the hot douche, and hot hip bath, 
and rest much of the time in the reclining posture. The tonic recom- 
mended for chronic congestion is suitable, with three or four doses a day 
of half a teaspoonful of Fluid Extract of Ergot. If, after this treatment 
has been continued through a whole interval, between times of menstru- 
ation, without benefit, it will be well to try Iodide of Potassium, instead 
of Strychnine, as in this formula: 

Take of Elixir of Cinchona and Pyrophosphate of Iron eight ounces, 
and add Iodide of Potassium five drams. Mix. 

Dose: A teaspoonful to a desertspoonful three times a day. 

During the time of menstruation the use of Ergot as hereafter men- 
tioned, will be very serviceable. 

The daily use of the sponge bath is a most serviceable tonic, and should 
be always resorted to. After the bath, the body should be rubbed with a 
coarse towel until the skin is aglow. 

In the Menorrhagia of the Climacteric Period (change of life) 
in addition to such treatment, sketched above, as the case may require; 
cold hip baths should be resorted to; its good effects are marked. The 
internal remedies may be given the same as for other causes. Applications 
of styptic medicines to the interior of the body of the womb, are called for 
in case of excessive hemorrhage. These will be made by a physician by 



PROFUSE MENSTRUATION. 637 

means of an intra uterine syringe, a probe wrapped with cotton, or other 
instrument for the purpose, after dilating the neck with sponge tents. 
The best applications are the Liquid Sub-Sulphate of Iron, a mixture of 
five drams of Sulphate of Zinc in three drams of Glycerine. 

It is necessary to have the manner of living strictly regulated during 
the time of the menstrual flow. For two or three days before the 
expected period, and during the time, the patient ought to remain quiet in 
the recumbent position. The room should be cool and clothing light. 
The bowels kept open; the diet should be simple and plain, and the appe- 
tite for food or drink only moderately indulged, and the patient must 
refrain from the relations of the bed. These rules closely followed, will 
greatly diminish the flow. 

The internal remedies to be given during the excessive flow, are those 
which produce a contraction of the womb, and so closing the vessels and 
stopping the hemorrhage; and those having the power of arresting 
hemorrhage called styptics. It is unnecessary, in my opinion, to mention 
any other remedy than Ergot for the purpose of controlling an excessive 
menstrual flow; a teaspoonful of the fresh powder in ginger tea, or a tea- 
spoonful of the Fluid Extract in water, may be given four times in the 
twenty-four hours. Of styptics, ten grain doses of Gallic Acid with ten 
drops of Aromatic Sulphuric Acid in a wine glass of water, well sweet- 
ened, is useful, given three or four hours apart. Rue and Savin in doses 
of a grain, are highly recommended. They act, however, in a similar way 
to Ergot. Other styptics as directed for hemorrhage from the lungs or 
kidneys. 

In some cases, the flow may be so severe as to require arresting imme- 
diately, so that while the foregoing treatment is required, it is necessary to 
stop the flow by mechanical means, that is, the vagina must be plugged 
up tightly, so that no more blood can flow. A bivalve speculum is intro- 
duced into the vagina, and a piece of lint slightly moistened with Glycer- 
ine, and then saturated with Liquid Sub-Sulphate of Iron is placed over 
the mouth of the womb, and two or three yards of bandage (previously wet 
with cold water and wrung out) packed into the vagina. It is all then held 
in place by a T bandage. Cloths wet with cold water, are laid over the 
pelvis occasionally. Cold water may be injected into the rectum. 

It is often necessary to support the woman under the exhaustion of 
the loss of blood, by giving stimulants of brandy, and nourishment of 
strong beef tea or milk, quite frequently, but in small quantities. Organic 
diseases causing menorrhagia demand their appropriate treatment, but as 
nothing can be done without the aid of a surgeon the description is not 
given here. 



LEUCORRHCEA— WHITES. CATARRH OF THE SEXUAL 
MUCOUS LINING. 

Simple catarrh is one of the most common derangements of the female 
sex. It originates in a variety of causes. In the first place, we have to 
mention as exciting causes, such as act directly upon the sexual organs — 
excesssive coition, and self-abuse, miscarriage, and to some extent confine- 
ments, which, if occurring in too rapid succession, almost always causes 



C38 DISEASES OF THE FEMALE SEXUAL ORGANS. 

leucorrhoea, especially when after the last named causes, the patients per- 
sist in getting about too soon. 

Sudden and violent attacks of vaginitis and leucorrhoea have been 
observed to arise from causes such as those which follow sudden suppres- 
sions of perspiration; of diarrhoeas, or of sudden suppression of milk, or 
in other instances, suppression of some eruption on the skin. 

The influence of cold, damp weather, or exposure to cold and damp 
from the location of the residence in a marshy district, or perhaps the 
nature of the house itself, (stone, with walls constantly moist on their inner 
surface) and from water standing in the cellar, especially when long con- 
tinued, is a powerful promoter of leucorrhoea. 

An entirely opposite, but not less numerous class of causes of this dis- 
ease, may be found in the high living, stimulating spices, condiments, and 
drinks in which many women indulge. 

Symptoms. At the first appearance of leucorrhoea, there are usually the 
indications of acute inflammation, pain, heat, and redness of the parts 
involved which may subside as the discharge becomes more and more 
fully developed. With this discharge, whether acute or chronic, there will 
usually be more or less pain in the groins and hypogastric m (lower part of 
the abdomen) and in the lower part and small of the back. The urethra 
will often become implicated; causing painful micturation (passing water) 
and sometimes causing almost inability to urinate, in the acute form. 

ALLOPATHIC TREATMENT. The treatment of Lecuhorrhoea or 
Whites must necessarily be directed first to the cause, as failure of the 
general health, as from consumption, or anaemia, (impoverishment of the 
blood.) The treatment will relate primarily to the treatment of 
consumption, for which directions will be given in the article on 
consumption ; or if the patient is anaemic, (pale, weak, and tired, espec- 
ially tired upon rising after full a night's rest,) the treatment will first be 
directed to the removal of the anaemic condition, by the use of tonic 
remedies, especially Iron. When the discharge is very profuse, and 
exhausting, the Phosphate or Hypophosphite of Lime, may be given with 
great advantage. During the general improvement of the body, the 
discharge diminishes. In Parrish's chemical food (Compound Syrup of 
the Phosphates,) we have both the Iron and Lime. The dose is a 
teaspoonful. It may be mixed with an equal part of Syrup of the Lacto- 
Phosphate of Lime, and a dessertspoonful given three times a day. The 
Compound Syrup of the Hypophosphites (Lime, Soda, Potash, and Iron,) 
meets the indications, and is agreeable to take. The dose is from a 
teaspoonful to a dessertspoonful, three times a day. If there is coilcky 
pains, or symptoms of dysentery, the Hypophosphites should be 
combined with Dilute Phosphoric Acid. Take of the Compound Syrup of 
Hypophosphites seven ounces, Dilute Phosphoric Acid one ounce. Mix 

Dose : One or two teaspoonfuls three times a day. 

It is a good rule to add the Dilute Phosphoric Acid to the Hypophos- 
phites whenever they are given. 

In marshy districts, or when ague is prevalent, Quinine should be 
given for a week, alternated with Cinchonidias for a week, in doses of two 
or three grains, three times a day; or such other treatment as is suitable 
for Ague poisoning, given in the treatment of intermittent fever. Some- 



LEUCORRHOEA. 639 

times a change of residence is necessary to retain better hygiene. Exalted 
activity of the sexual organs will demand an omission of the relations of 
the bed. There are few cases of Leucorrhoea in which the uterus is 
sound. The organ is relaxed, and probably enlarged, and the secretion of 
the mucus membrane increased, showing a chronic inflammation, or 
congestion. Flexions (the womb bending on itself,) or other displace- 
ments of the organ, must be corrected by mechanical means. The skill 
of a physician is required, but if unavailable, it may be said here that the 
common ring pessory relieves more cases of displacement than any other 
instrument that can be used by the unskilled hand. The neck of the 
womb should rest within the ring after its introduction. The concave 
pessory ought not to be used as a rule ; it makes a flexion worse, as do the 
stem pessories with a cup. Adjusted by a skilled person, some form of 
Dr. Hodge's bow pessory is suited to most displacements. Correction of 
the malposition of the womb relieves the congestion, and so does much 
towards curing the discharge. This caution must be added: an unsuit- 
able, or illy fitted supporter, is a positive injury. The enlargement and 
chronic inflammation is generally caused by rising too soon from child- 
bed, or after an abortion. A long period of rest in bed is required after 
these events; four weeks will do, but sometimes a longer time is required. 
The binder, wide enough to reach from the ribs to the middle of the 
thighs, should be kept tightly pinned after delivery. After the lochia 
(flow,) ceases, the warm vaginal douche should be commenced. Consti- 
pation must be obviated, as directed for that trouble. The preparations 
containing Aloes are to be preferred. Diet should be nourishing, and the 
exercise at first moderate. Too frequent pregnancies in women, liable to 
abortion, is another cause of chronic enlargement, and of a condition 
causing Whites. The womb must have rest after an abortion, as well as 
after confinement; this is necessary for months, sometimes. Too frequent 
menstruation is another cause to be obviated, if possible. In this chronic 
enlarged condition, a teaspoonful of the Fluid Extract of Ergot, with ten 
or fifteen drops of Tincture of ISTux-vomica may be taken two or three 
times a day. Ten grains of the Iodide of Potassium in sweetened Pepper- 
mint water, three times a day, is a beneficial remedy for this enlargement 
and for the chronic discharge. Iron may be indicated in the form 
mentioned above. Change of climate, and the use of mineral waters may 
sometimes be called for, but generally the indication is met by the 
Hypophosphites recommended above. 

The kind and quantity of food should be regulated to meet the 
wants of the system. Sleep should be long and undisturbed. The skin 
must be kept warm with flannels, bathing, rubbing, and out-door 
exercise. 

The bath should, as a rule, be warm and tepid, taken daily, and 
followed immediately by cool bathing. The combined sitz and sponge 
bath is most generally applicable; after the bath the skin should be 
rubbed until it is aglow. If there is a poor reaction, or no reaction, the 
cool bath should not be used. Some are most benefited by the warm 
baths exclusively. 

While many cases of leucorrhoea can be cured without them, injections 
are very valuable in treating this trouble, and sometimes they are a 
necessity. A long, flexible syringe, having a long vaginal tube, should be 



640 DISEASES OF THE FEMALE SEXUAL ORGANS. 

selected, and used after the form called the "douche.'' Thesyringeshould be 
filled and one end of the tube introduced into the vagina, and the other in 
the bucket containing the fluid, which is raised considerably higher than 
the patient. The tube acts as a siphon. The bight of the bucket and the 
length of this column of fluid governs the force of the current. The flex- 
ible tube should therefore be long. In this way, any quantity of fluid can 
be used at an injection without wearying the patient. She should lie 
upon her back, with her hips raised with a pillow, and a rubber cloth so 
arranged that the fluid may be conducted into a bucket. In the use of 
water injections, I have found warm water (as hot as can be borne) the 
best. The quantity allowed to flow through the vagina should be large; 
one or two gallons frequently repeated. Sometimes the cold douche alter- 
nated with the hot douche, and less often the cold douche alone, gives 
better results. The diseased surface is not generally the vagina, but the 
interior of the womb, which medicated injections do not reach. They are 
often, however, useful. The simple water injection should be used first, 
followed by a quart of the medicated injection. A strong tea, of White 
Oak Bark, with or without the addition of one or two teaspoonfuls of 
Alum in the quart may be used. One or two drams of Tannin and four 
drams of Alum to a quart of water, is often serviceable. One or two even 
teaspoonfuls (drams) of Sulphate of Zinc in a quart of water, may be used. 
It is often better to change the injection from time to time. If the flow is 
offensive, the Permanganate of Potash, two drams to the quart, or one 
dram of Carbolic Acid to the quart of water, may be used for an injection. 
If the discharge is irritating, bathing the external genitals with a solution 
of Soda or Borax will be useful. 

Many times the physician has to resort to topical applications to the neck 
of the womb and its cavity, for which the following preparations of Iodine 
and Tannin are highly useful: Take of Iodinehalf a dram, Iodideof Potas- 
sium and Water, of each a sufficient quantity to dissolve the Iodine, Glycerine 
sufficient to make an ounce, then add two drams of Tannin, or such quantity 
as is desired. The Tincture of Iodine saturated with Tannin, is a very 
efficient application in chronic inflammation of the neck and interior of 
the womb, and in enlargement of the organ, so prolific of leucorrhoeal dis- 
charge. Also an excellent plan of local treatment, which must also be 
made by the physician, is, Idoform one dram, Tannin one ounce. Mix 
well. A sufficient quantity of this powder is to be packed dry around the 
neck. One of the most effectual applications in these same affections with 
ulceration, and consequently, for the leucorrhoea, is the undiluted Car- 
bolic Acid, which may be applied to the neck and cavity of the womb 
with a probe wrapped with cotton, but by a physician only. Before mak- 
ing this internal application, the uterine (womb) cavity should be dilated 
with a sponge tent. 

HOMCEOPATHIC TREATMENT. The radical cure of this disorder 
is attended with much difficulty, and can only be affected by long 
patient, and careful treatment in those cases in which it is incidental to 
serious derangements of the womb, or of its appendages. 

Pulsatilla is indicated when the discharge is thick like cream, or 
milky, and sometimes gives rise to a burning sensation ; when, moreover, 
it is associated with indigestion, and occurs in females of relaxed fibre and 



LEUCORRHCEA. 641 

lymphatic temperament, or in whom the monthly flow is irregular and 
scanty; the discharge is of ten worse when lying down. 

Dose: Six globules in a teaspoonful of water, morning and evening, 
for four days, (unless a decided change should sooner occur ;) then 
pause four days, after wh.ch the course may, if necessary, be repeated 
as before, and so on. 

Sepia should be selected when the affection occurs in delicate and 
exhausted females, the discharge being yellow or green, generally watery, 
and more or less acrid or corrosive; and when it is accompanied by a ten- 
dency to profuse perspiration, particularly on sitting down, after walking. 
Sepia is, also, additionally indicated, if the monthly discharges are irregu- 
lar; and, further, when bearing-down is often experienced. 

Dose : Four globules, in other respects as directed for Calcarea. 

China should be given when the discharge is very profuse, and gives 
rise to great debility; the menses seem to be suspended, or the leucorrhceal 
discharge occurs instead ; painful pressing towards the groins and anus. 

Dose : Four globules, as directed for Pulsatilla. 

JEsculus-Jiip (Buckeye,) is indicated where the whites are accom- 
panied by intense pain and lameness in the back and hips, so that it is 
almost impossible to rise after sitting, or to walk a long distance; consti- 
pation, and piles. 

Dose: Three globules, as directed for Pulsatilla. 

Kreosotum. The discharge precedes and follows the menses, and is 
greatest when standing or walking; it is yellow, offensive, acrid, and cor- 
rosive, causing soreness of the parts, and violent itching. 

Dose : Three globules, as directed for Pulsatilla. 

Podophyllum should be administered in cases in which the 
discharge is thick and transparent, and there is constipation, and a 
feeling of bearing, or pressing downwards on the genitals; falling of the 
womb, and protrusion of the intestine during stool. 

Dose : Three globules, as directed for Pulsatilla. 

Collinsonia is indicated by cases in which the discharge, which 
may be thick or thin, is accompanied by great itching of the parts; 
and there are obstinate constipation, and disordered and painful 
menstruation. 

Dose: Three globules, as directed for Pulsatilla. 

Iodium may be found very useful in cases of long standing ; particu- 
larly in scrofulous subjects ; the whites are most abundant at or near the 
time for the menstrual flow ; and the discharge is so very acrid and corro- 
sive that not only are the adjacent parts made sore, but the underclothing 
is made rotten and destroyed. 

Dose: Six globules, as directed for Calcarea. 

Diet and Regimen. The diet ought to be simple, but generally 
very nutritive. Coffee and tea ought to be avoided, and cocoa or arrow- 
root substituted. Regular exposure to the benign influence of the fresh 
air is commendable, but over-fatigue and prolonged standing should be 
sedulously avoided. 

PROLAPSUS UTEPI— FALLING OF THE WOMB. 

This is one of the most common forms of uterine displacement. It 
occurs in three distinct, different degrees, to each of which some writers 

41 



642 DISEASES OF THE FEMALE SEXUAL ORGANS. 

on the subject have affixed a different name. Thus, relaxation^ simple 
descent of the womb, is understood to indicate the first and least displace- 
ment downward, and to consist only in a simple bearing-down of the 
womb upon the upper portion of the vagina. In prolapsus uteri, the 
organ comes still lower down, and may present at the orifice of the vagina. 
In procerdentia uteri, there is actual protrusion of the organ, even the 
entire body of the womb being, in some cases, extended from the vulva. 
These are but different degrees of descent of the uterus in the line of the 
vagina. Upon examination of the same displaced uterus, at different 
times of the day, it may be found to be more or less prolapsed, according 
to the condition of active exercise, or quiet, in which the parts may have 
been for some hours previous 

Symptoms. The principal and primary symptoms of the descent of the 
womb are: dragging and aching pains in thesmall of the back, pulling and 
bearing-down pains in the lower part of the abdomen, sensation as if some- 
thing would issue from the vagina; sufferings much worse from walking, 
or other exercise; the pains are often noticed to have come immediately 
after some exertion of an unusual kind, and after some more than ordi- 
nary muscular effort; frequent calls to urinate, dysuria (painful urina- 
tion,) or even retention of urine. In the more fully developed forms of 
prolapsus, the history of the case, the attendant circumstances, and the 
external appearance of the mouth of the womb, and even of the entire 
body of the uterus itself, can hardly fail to render the diagnosis at once 
easy and certain. And if the falling of the womb is not so far developed 
as to give any such external signs, the severe aggravation from walking 
and from lifting, together with the relief experienced from lying down, 
render the case sufficiently clear. Should there be any doubt, however, 
the vaginal touch will verify the diagnosis. 

The Causes. Prolapsus of the womb may arise from various causes, 
such as over lifting or some other muscular exertion, or from an improper 
manner of dress, such as tight lacing, or the weight of heavy clothing drag- 
ging on the abdomen. Incase of married women who have borne chil- 
dren, many cases of falling of the womb are caused by mismanagement. 
Perhaps the bandage worn has been too tight, or has slipped up and the 
pressure has forced the bowels to press down upon the womb while in a 
relaxed condition, or perhaps, the patient has gotten up from the bed too 
soon after confinement ; the whole system being weak, it is very easy to do 
a little too much, and bring on injuries which are very often hard to relieve 
one's self of. In cases of displacement of the womb, the recumbent pos- 
ture is a necessary requirement, together with the properly selected remedy; 
a cure can very frequently be obtained. 

HOMOEOPATHIC TREATMENT. There is scarcely any remedy in the 
whole >: Materia Medica that may not be found useful in these displacements 
but for fear of confusing the common reader, will mention only a few of 
the remedies which have proven, during several years of practice, to be the 
most reliable. 

Bell., Chamomilla, Nux-vom., Platina, Puis., Sepia, Cantharis, Con, 
Aeon., China and Arnica. 

Belladonna, Pressure, as though all the contents of the abdomen 
would issue through the genital organs. This is particularly felt early in 



FALLING OF THE WOMB. 643 

the morning; sensation of heat and dryness in the vagina. Pains in the 
pelvic region, which come on suddenly and cease suddenly, or feeling in the 
back as if it would break, hindering motion, suppression of the stool and 
of urine. 

Chamomilla. Frequent pressure toward the uterus, like labor 
pains, with frequent desire to urinate, often passing large quantities of 
colorless urine. Frequent discharge of clotted blood, with tearing pain 
in the veins of the legs, and violent labor-like pains in the uterus. 
Contrary to her condition in health, she is always out of humor, particu- 
larly at her menstrual periods, when she is headstrong, even unto 
quarreling. She can hardly speak a pleasant word, and has to restrain 
herself in order to do so. 

China, In cases where the prolapsus and attendant symptoms 
were superinduced by losses of fluids, particularly of blood. She has 
much ringing in the ears, a sense of distention in the abdomen, which is 
not relieved by eructations. 

Nux Vom. Prolapsus uteri, from straining by lifting. Pressure 
toward the genital organs, early in the morning, in bed, or during a 
walk, with a sensation of drawing in the abdomen. Constipation of large 
hard, difficult stools, or small stools, with frequent urging. Pain in the 
small of the back, preventing her from turning over in bed. Frequent 
urination ; she passes little, and often, with much burning pain. The 
prolapsus of longstanding is often accompanied with dry cough, and a 
sense of constriction around the lower part of the abdomen. 

Pulsatilla. Pressure in the abdomen and small of the back, as from 
a stone, with disposition of the lower limbs to go to sleep, when sitting, 
and attended with ineffectual desire for stool. Menstrual colic, with 
great restlessness, tossing in every possible direction. Mild, tearful, 
yielding, disposition. She cries at everything, is sad and desponding. 
Very bad taste in the mouth in the morning, nothing tastes good. She is 
pale and feeble. 

Cantharis, Burning in the vulva, and violent itching in the 
vagina. Almost constant desire to urinate, with cutting, burning, and 
passing of a few drops of urine, sometimes bloody, sometimes followed by 
a discharge of bloody mucus. 

Contain. Induration and prolapsus at the same time. Much 
nausea and vomiting. Vertigo, particularly when in a recumbent posi- 
tion, and in turning over. Intermittent flow at every emission of urine. 
The breasts become sore, enlarged, and painful at every menstrual period. 
This remedy alone, in many cases where the above symptoms are present, 
is sufficient to produce a cure. 

Aconite. If the prolapsus has occurred suddenly, and there is in con- 
sequence, great inflammation of the parts, witli burning pain as if from 
hot coals; excessive sensibility to the least touch ; bitter, bilious vomiting, 
anguish, and cold perspiration, or hot and dry skin. 

Arnica. When the prolapsus has been caused by a concussion, and a 
bruised, sore feeling remains. She cannot walk erect on account of a 
bruised sore feeling in the uterine region. 

Dose: Each of the foregoing remedies may be given, six or eight pills 
every four hours. 



044 DISEASES OF THE FEMALE SEXUAL ORGANS. 

Platina. Painful sensitiveness and continual pressure and dragging 
sensation in the lower part of the abdomen, and the mons veneris and inter- 
nal organs, with internal chills and coldness. This, as proved by experi- 
ence, is one of the most effectual remedies for prolapsis uteri, and taken 
singly, or in alternation with some other remedy, will give good satisfac- 
tion. 

Dose: A small powder three times each dav. 

Sepia. Painful stiffness, apparently in the uterus. Pressing in the 
uterus, oppressing the breathing; sensation as if everything would come 
out of the vagina and uterus. Sensation of weight in the arms, not 
relieved by an evacuation. Great sense of emptiness at the pit of the 
stomach. The urine deposits a clay-like sediment, which it is hard to 
remove from the chamber. 

Dose: To be administered the same as Platina. 

Platina in alternation with Conium or Belladonna is very beneficial. 

Dose: If given in alternation, every six hours. 



THE CHANGE OF LIFE-MENOPAUSE. 

After a certain number of years, woman lays aside those functions 
with which she has been endowed for the perpetuation of the species, and 
resumes once more, that exclusively individual life which had been 
her's when a child. The evening of her days approaches, and if she has 
observed the precepts of wisdom, she may look forward to a long and 
placid period of rest, blessed with health, honored, yes, loved with a purer 
flame than any which she inspired in the bloom of youth and beauty. 

But ere this haven of rest is reached, there is a crisis to pass, which is 
ever the subject of anxious solicitude. The more common, and less scien- 
tific name for it is the change of life; physicians know it as the menopause 
— the period of the cessation of the monthly flow. It is the epoch when 
the ovaries cease producing any more ova, and the woman, becomes there- 
fore, incapable of bearing any more children. 

The age at which this occurs is variable. In this country, from forty 
to forty-six years is the most common, though instances are not at all 
unusual, where it does not take place until the half century has been 
turned, and we have known instances where women past sixty have con- 
tinued to have their periodical returns. 

Examples of early cessation are more rare. We rarely meet them 
earlier than thirty years, but healthy women have been observed in whom 
the flow had ceased as early as twenty eight. 

The physical change which is most apparent at this time, is the ten- 
dency to grow stout. The fat increases as the power of reproduction 
decreases. And here a curious observation comes in. We have said 
that when a girl changes to a woman a similar deposit of fat takes place, 
(though less in amount) which commences at the loins. This is the first 
sign of puberty. In the change of life, the first sign is visible at the lower 
part of the back of the neck, on a level with the bones known as the cerv- 
ical vertebra. There commences an accumulation of fat, which often 
grows to form two distinct prominences, and is an infallible index of the 
period of a woman's life. 



THE CHANGE OF LIFE. 645 

The breasts do not usually partake of this increase, but become flat 
and hard; the substance of the gland losing its spongy texture. The 
legs and arms loose their roundness of outline, and where they do not 
grow fat, they wither up and resemble those of the other sex. The abdo • 
men enlarges, even to the extent, occasionally, of leading the wife to 
believe that she is to be a mother— a delusion sometimes strengthened by 
the absence of the monthly sickness. Finally, a perceptible tendency to a 
beard often manifests itself, the voice grows harder, and the characteris- 
tics of the female sex become less and less distinct. 

In proportion as women enjoy good health, and especially, in propor- 
tion as the menses are normal in quantity, and regular in their return, 
may we expect to pass through the trying season of the change of life at 
about the usual age, or a little later, and with comparatively little suffer- 
ing; while in proportion as the health has been poor, and especially, at the 
time of puberty, and the menses has been imperfect and irregular, shall we 
have reason to apprehend that the change of life will be, indeed, a 
critical period, and that it will require all the care and skill that can be 
employed to go through it in safety, and with health improved, instead of 
being rendered much worse. For the change of life, once well passed, the 
woman settles down with a new form of life, and it may be with a new 
lease of life, and has a right to look forward to a happy old age. It is 
gratifying to know, that nearly all the threatening affections of the change 
of life can be avoided by such hygienic care, as one can render themselves, 
as they depend upon causes under the control of the individual. 

Symptoms of the Change of Life— vary in different individuals 
according to their respective temperament; for in this, as well as in other 
conditions, women present the plethoric, ( full of blood) the chlorotic, or 
nervous type. Thus, in those of the plethoric type, the symptoms will 
resemble those of congestion ; there may be flushes of heat, rush of blood to 
the face and head, uterine and other hemorrhages, leucorrhoea, and even 
diarrhoea. In those of the chlorotic type, the symptoms, which at or near 
the proper age, would indicate the approach of the change of life, <*re the 
sallow complexion, weak pulse, and various other indications of debility. 
In those of a nervous type is, as the change of life approaches, an evident 
disturbance of the equilibrium, not unlike that which, in similar cases, pre- 
cedes the monthly flow. Hence, the over-anxious look, the brimful eye, 
the terror struck expression, as if apprehensive of seeing some frightful 
objects, the face bedewed with perspiration, and the remarkable tendency 
to hysteria, which are sometimes to be met with. 

In many cases, the change of life comes on so gradually, that the sys- 
tem accommodates itself to the new order of things with no shock to the 
nervous system, and without disturbing the accustomed harmony of the 
general circulation. In such cases, the intervals between the menstrual 
periods become more and more prolonged, and even the menstrual dis- 
charge itself, may gradually diminish in quantity. The most frequent, 
and least dangerous symptom, is an irregular return of the menstrual flow 
every week, or every two or three weeks, or every two, three or four or six 
months, and being more or less irregular as regards quality or quantity of 
menstrual blood. Serious and alarming hemorrhages frequently set in, 
especially among plethoric and nervous women, or such as have indulged 
in sexual excesses. Sometimes these hemorrhages alternate with whitish 



646 DISEASES OF THE FEMALE SEXUA.L ORGANS. 

or yellowish leucorrhoea, which often has a fetid smell, is acrid and 
extremely copious. This leucorrhoea may continue long after the men- 
strual discharge has entirely ceased to appear. At this period, we not 
unf requently meet with colic, uterine cramps, pains in the sides, weight in 
the loins, or distressing itching in the parts. 

The most distressing diseases with which the change of life is 
attended, and often terminate fatally, are ulcers, and polypi of the uterus, 
and cancers of this organ and of the breast, also, pulmonary phthisis, 
(or consumption) likewise, takes a fresh development and frequently 
terminates fatally. 

TREATMENT. In this place, it will be sufficient to refer to the 
different disorders already described, such as hemorrhage, flooding, 
diarrhoea, cancer, etc., and to their corresponding medicines, for the treat- 
ment of the various forms of disease that arise at the change of life. The 
remedies most frequently useful in disorders of the critical age, will be 
found under the head of Menstrual Disorders, and other affections which 
may be the most prominent of those which attend the change of life. 



MASTITIS— IXFLAM3IATIOX OF THE BBEASTS. 

The mammae constituting exclusively a part of the female organism, 
we prefer treating of inflammation of the mammse in this place, instead of 
ranging this disease among the diseases of the thoracic organs. 

Mastitis proper, only occurs duringor immediately after nursing. The 
painful, sometimes rather extensive, hardened swellings of single por- 
tions of the breasts, which sometimes occur among unmarried females or 
married women who are not nursing, especially about the time of the 
menses, are evidently transitory states of congestion which never termin- 
ate in suppuration. The cause of mastitis is always traceable to the 
impeded discharge of milk. By some cause or other, soreness, or a bad 
shape of the nipples, too feeble drawing of the child, one or more milk 
ducts become closed, the milk in the corresponding mammary lobule 
becomes stagnant, and an inflammatory process is the result. Another 
cause of obstruction of the milk-ducts, is the improper manner in which 
some women wear their clothes, owing to which, the breasts either hang 
too loosely, or a direct pressure is exerted upon them. The doctrine that 
mastitis can originate in dietetic transgressions or cold, is a convenient 
supposition rather than a scientific fact. What happens with other 
abscesses, is likewise, true in regard to abscesses of the mammse; in 
some cases they heal rapidly, in other cases they cause vast destructions of 
tissue. Mastitis is most apt to occur soon after confinement, or shortly 
after weaning the child; mastitis occurring at the latter period, is less apt 
to lead to the formation of abscesses. 

Symptoms. The disease never breaks out all at once. Generally, 
women experience, some time previous, a gradually increasing pain both 
spontaneously or while the child is nursing ; and a swelling soon develops 
itself soon after. As a rule, the lower or lateral lobes are inflamed, very 
seldom the upper ones, and still less frequently both breasts. Sooner or 
later, sometimes in a few days, and at other times in some weeks, the 
painful spot becomes red and more sensitive, and the inflammation is 



INFLAMMATION OF THE BREASTS. 647 

intense, the whole organism feels the effect of the inflammatory process, 
and shows its sympathy by febrile phenomena. Soon the infiltrated tissue 
shows the signs of suppuration, the pus being discharged through a small 
opening. As soon as the discharge, which is never complete, commences, 
the pain suddenly ceases and the febrile symptoms abate. 

The course of the inflammation depends upon a variety of circum- 
stances. If the inflammation is confined to one lobe, the abscess most 
commonly discharges close to the nipple, empties itself very rapidly and 
heals. If several lobes are inflamed, or the inflamed lobe is situated near 
the base, the suppuration, swelling, and pain continue for a long time; 
months and even years may elapse before the abscess heals, which 
discharges through several openings near the nipple. This disorder 
never lasts less than two weeks, and, under corresponding circumstances 
may continue for months even, in its acute form. 

The treatment of mastitis includes, above everything else, a prophy- 
lactic treatment which has to be commenced long before confinement, 
especially in the case of primiparae (a woman with her first child.) The 
preservation and proper management of the nipples and of the niammse 
generally, should be a constant subject of our attention. After confine- 
ment, if women do not intend to nurse their children, they will have to 
dispense with liquids as much as possible. Nursing women have to 
keep the following points constantly in view : the breasts must not be 
kept too warm, must not be enclosed in tight clothing, and must, by some 
suitable support, be prevented from dragging down ; every time after the 
baby has nursed, the nipple must be washed, but not be kept moist 
between the acts of nursing; the excessive use of liquids which women 
fancy favor the secretion of milk, must be avoided ; the child should be 
put to the breast as seldom as possible, for the more hungry it rs the more 
vigorously it will draw and the more completely the breast will be 
emptied. At the same time the nipples will not be held so long in the 
child's mouth, and they will not be exposed so much to the risk of being 
made sore by the constant nursing. By following these instructions, and 
more particularly, by putting the child to the breast every two hours in 
the early period after confinement, mastitis will generally be prevented. 
You must do it. 

If the breasts have become hard and painful, the best remedy in the 
case of lying-in-women is Bryonia, less frequently Belladonna, whereas, 
the latter medicine is better adapted to women who are weaning their 
infants. We sometimes succeed in dispersing the stagnation of the milk 
by gently rubbing the indurated portion while the child is nursing. The 
same good effect is sometimes obtained by causing the milk to be drawn 
by an older, more vigorous child. In no event should the infant be all at 
once kept from the breast, even if nursing causes pain. It is only if the 
pain is very acute, and the hardness considerable, that the infant should 
no longer be put to the diseased breast. Belladonna will now have to be 
administered. As soon as redness has set in, the chances of scattering the 
inflammation are very slim; in some exceptional cases we may sometimes 
succeed in effecting this result by a few doses of Mercurius. Warm poul- 
tices should never be omitted; they sometimes favor the dispersion of the 
abscess as much as in other cases, they hasten the process of suppuration. 
Hepar sulphuris will promote the discharge of the pus. A great many 



648 DISEASES OF THE FEMALE SEXUAL ORGANS. 

authorities teach to open the abscess at an early period in order to prevent 
the further spread of the inflammation. We doubt whether such a pro- 
ceeding is justified by corresponding results; after opening the abscess, we 
have often seen the inflammation spread much more rapidly; in the most 
tedious cases of mastitis, the abscess had been opened in accordance with 
this suggestion. In a fortnight at least, the discharge of pus ceases under 
the use of a few doses of Mercurius, aud the sore heals. 

HOMOEOPATHIC TREATMENT. Bryonia is the principal remedy 
in this affection, before the inflammation becomes fully developed, espe- 
cially, when the breasts are hard, red, tense, and tumefied, and feel heavy ; 
and when there is some degree of fever. 

Dose: Of a solution of six globules to four teaspoonfuls of water, give 
a teaspoonf ul every four hours. 

Belladonna is, however, required when the inflammation is more 
intense, and the erysipelatous appearance of the skin is clearly defined, 
usually running in radi; and is, in such instances, usually sufficient to 
subdue all such inflammatory symptoms. 

Dose : As directed for Bryonia. 

Sulphur may be required, more especially for the treatment of scro- 
fulous subjects, and when the previous administration of Belladonna has 
been productive of partial or limited improvement, and evident suscepti- 
bility remaining, even if the active inflammatory symptoms have been 
allayed. It is also useful when, after the bursting of an abscess in the 
breast, the cavity is slow in healing up, and the discharge excessive. 

Dose: As for Bryonia. 

Graphites should be employed, particularly in scrofulous subjects 
where the breasts are in such bad condition from previous inflammations 
and abscesses, that the milk cannot flow, and its retention threatens 
inflammation and abscess. Graphites will, in most cases, ward off this diffi- 
culty. Should Graphites fail, Phytolacca should be tried, no other remedy 
being more prominently indicated. 

Dose: As directed for Sulphur. 

Phytolacca- decandria will be found to be a most valuable remedy 
in many cases ; more particularly where the breasts are hard from the 
commencement of the disorder, sensitive to touch, and more or less pain- 
ful. It will also prove useful for "lumps" in the breasts. 

Dose : As directed for Bryonia, use also, as an external application. 

Mercurius may be required after any of the foregoing medicines, 
when, notwithstanding the previous treatment, and the reduction of the 
inflammatory symptoms, a degree of induration still remains. 

Dose: As directed for Sulphur. 

Phosphorus is indicated when symptoms of threatening formation 
of matter (abscess,) such as increase in pain, with transitory chills, and 
throbbing in the breast ensue. Its immediate employment, under such 
circumstances, will often succeed in speedily relieving pain, and pr3vent- 
ing the ripening and bursting of the abscess. It is also indicated in severe 
cases where there are already fistulous ulcers formed, of blue appearance, 
and having callous edges; and the patient has hectic fever and night 
sweats. 

Dose: Three globules every six hours, until relief is obtained. 



CANCER OF THE UTERUS. 649 

CARCINOMA UTEBI— CANCER OF THE UTERUS. 

In, by far, the majority of cases, this disease occurs beyond the age of 
forty, and is very seldom met with in women of a less advanced age. 
Feeble as well as robust, married as well as unmarried women are attacked 
by this terrible destroyer. Cancer of the uterus is one of the most fre- 
quently occurring forms of carcinoma, and not unfrequently runs its 
course as a solitary cancer. It is only in rare cases, that it breaks out in 
addition to cancerous degenerations of other organs. 

Cancer of the uterus is frequently mistaken, at the commencement, 
for menstrual disorder, leucorrhoea or chronic inflammation of the womb. 
The first symptoms usually menstrual derangements, cessation or a more 
frequent return of the menses, or in place of the menses we have irregu- 
lar hemorrhages and leucorrhcea. The mistake is made the more easily, 
if the patient has not yet reached the critical period, so that these changes 
may be set down as results of a natural cessation of the monthly secretion. 
If the patient has passed through the critical period, a sudde nflow of blood 
takes place, at first resembling the menstrual flow, but soon increasing to a 
true hemorrhage. In the beginning, the patient often complains only of a 
f eelingof weight, drawing in the pelvis, a pressing towards the sexual organs, 
or the pains are excited by bodily motion, a concussion, sexual intercourse, 
touch. An examination shows the vaginal portion harder than in the nor- 
mal condition, of unusual resistance, swollen, misshapen, rugged and 
knotty, sensitive to pressure and readily bleeding. In the course of the 
disease, pains set in, which are, at first, only vague, and occur only now 
and then, but afterwards become more severe, and finally, especially at 
night, exceedingly violent, pressing, stinging, lancinating, burning, not con- 
fined to the region of the uterus, but spreading to the small of the back 
and thighs. Characteristic are the more or less violent, burning, and 
stinging-boring pains over the pubic bones, and in the small of the back, 
along the hips and thighs, interfering with walking, and even sitting; 
very often a burning pain is continually felt deep in the pelvis, accompa- 
nied by fugitive stitches darting through the uterus. The neighboring 
lymphatic glands are generally larger and painful. At the beginning of 
the trouble, a serous, or slimy secretion flows from the vagina, having but 
little smell ; more usually the discharge is copious, of a brownish-red, 
suspicious-looking color, having a horrid smell, and excoriating the skin. 
The bleeding becomes more and more frequent and copious, the blood 
being mixed with detached portions of tissue. These hemorrhages con- 
sume the strength of the patient in a very short time. At this stage of the 
disease, the ichorous dissolution of the cancer progresses very rapidly. 
The disease generally lasts for years, calculating from the first mani- 
festation of distinct symptoms, and without allowing for the influence of 
special circumstances, such as confinement, which is one of the most per- 
nicious occurrences that can happen to a woman afflicted with cancer of 
the womb. It is inconceivable how it is possible for the organism to bear 
up for so long a time under a destructive malady, like cancer, without 
perishing. 

TREATMENT. No more than we reject the possibility of a cure of can- 
cer generally, do we believe that cancer of the uterus is an incurable dis- 
ease, although it is difficult to obtain certainty in this respect. 



650 DISEASES OF THE FEMALE SEXUAL ORGANS. 

Kreosotmn. When the following symptoms are present: Obstinate 
leucorrhcea during frequently recurring losses of blood, with aching or 
pressing pains, and gradually appearing fetid discharge of a serous fluid or 
a bloody ichor. This is attended with burning or lancinating pains in the 
small of the back, and loins. When standing, she experiences a sensation 
as of a weight in the pelvis; coition is painful; all the symptoms are worse 
at the time of the menses. Electrical stitches in the vagina, as if proceed- 
ing from the abdomen, causing the patient to start; voluptuous itching 
in the vagina, with burning and swelling of the external and internal labia; 
ulcerative pain during coition; the menses appear from four to ten days 
too soon, and continue for days, with a discharge of dark, coagulated blood, 
pains in the small of the back, and subsequent discharge of a pungent and 
bloody ichor; gnawing, itching and smarting in the parts; the menses 
stop for hours and days, but afterwards return again in a more fluid form 
and attended with violent, colicky pains. The pressing downwards, and 
the abdominal spasms continue after the menses, more especially in the 
groin and pelvic region; bleeding from the uterus, and a continual cor- 
rosive leucorrhce:i are not wanting. The pains are worse at night. Sen- 
sation of fainting on rising, with a peevish and desponding mood, and livid 
complexion. 

Arsencium-album has been given with excellent success in car- 
cinoma uteri. Arsenic can only be resorted to after the whole organism 
reflects the picture of a cancerous disease. However, it only palliates the 
severe pains and the sleeplessness, and perhaps modifies the profuse 
Menorrhagia, which occurs every now and then in the course of the 
disease. 

Nitri-acidnm is indicated in carcinoma uteri, as it is in many other 
inveterate dyscrasic conditions of the organism. The most important 
symptoms are: Irregular menses, they sometimes remain suspended for 
weeks and then appear again at short intervals; between the menses, 
copious leucorrhcea of a badly-colored, brownish appearance and offensive 
odor. The patient looks worn, feels nervous and is depressed in spirits. 
Obstructions in the portal circulation, such as hemorrhoids, indicate this 
drug. Aciduni nitricum can, however, only be used as an intercurrent 
remedy at the commencement of the disease; if ichorous dissolution has 
commenced, this drug is no longer of any use. 



CARCINOMA MAMMJE— CANCER OF THE BREAST. 

Next to the uterus, (womb) the breasts are the most frequently 
attacked by cancer. The causes of this disease can scarcely ever be deter- 
mined with certainty. The influence of depressing emotions, which are 
so easily and so commonly succeeded by cancerous degenerations, or dis- 
eases, is a much more evident source of the difficulty than the belief of 
some, that it is the result of a bruise, from a blow or contusion. 

Cancer of the breast most commonly occurs between the ages of forty 
and fifty, about the period which is generally designated as a change of 
life. Unmarried women or women who have not had children, seem tc 



CANCER OF THE BREASTS. 



051 



be more liable to it than married women with children. Before and after 
this period, it is proportionally a rare occurrence. 

The commencement of the disease is scarcely ever marked by pecu- 
liar morbid phenomena; the patients generally do not notice anything 
out of the way, until a tolerably large tumor is perceived in the breast. It 
is at lirst round, smooth, movable, grows with more or less rapidity, and 
loses its mobility in proportion as it increases in size, and its surface 
becomes more uneven* At lirst, it is most commonly deep seated, and 
gradually grows towards the surface, is sometimes entirely painless, or 
becomes painful onty at the time of the menses, and when receiving some 
mechanical injury. If the cancer reaches the skin, it coalesces with it, 
after which, the pains are almost constantly felt. At the same time, the 
disorganizing process extends to the deeper tissues, and at an early stage, 
the axillary (arm pit) and other neighboring glands become involved. 
The patients now commence to feel constantly or at intervals, and par- 
ticularly at night, lancinating, boring pains in the affected part, which 
very soon become unbearable. The assimilative functions begin to suffer; 
the patients have a pale yellowish-gray appearance, the spirits are very 
much depressed. A characteristic sign, is the gradual efTacement, and 
finally the complete retraction of the nipple, which discharges either spon- 
taneously or on pressure, a turbid, serous fluid. At the place where the 
cancerous growth first became interwoven with the skin, the latter, by 
slow degrees, loses its healthy color, and finally breaks. An irregular- 
shaped ulcer forms, showing a disposition to penetrate to the subjacent 
tissues; the edges of the ulcer are infiltrated, have a sickly color and an 
uneven base, and secrete at first, a thin, serous, and afterwards an ichorus, 
purulent, bloody, and most commonly very fetid fluid. If the disease runs 
a slow course, the incipient ulcer often heals for a time, but again breaks 
open at a later period ; if the disease runs a rapid course, spongy and 
readily-bleeding excrescences are apt to shoot up from the bottom of the 
sore. If larger vessels become necrosed, hemorrhages take place, which 
are sometimes very profuse, at other times trifling. The further course 
of the disease, which, having arrived at this stage, always terminates 
fatally, depends upon the extension of the cancer, upon the invasion, by 
the carcinomatous process, of internal organs, upon the importance ol 
the hemorrhage, and upon the loss of fluids in consequence of the ichorous 
discharge. 

The duration of the whole disease varies considerably, ranging from 
tw T o to twelve, and even more years. The younger the patient, the sooner 
she will succumb to the disease, and the more sudden the cancerous 
growth, the sooner it will destroy life. The prognosis is very bad, with 
scarcely an exception. 

In many respects, the diagnosis is liable to difficulties, because vari- 
ous kinds of benign tumors may occur in the breast. An incipient can- 
cer cannot always be recognized as such, though it may grow rapidly and 
be painful; these two conditions never occur in the case of benign 
tumors. At a late period, the diagnosis is determined by the retraction 
of the nipple, the fluid which it discharges, the rugged unevenness and 
Immobility of the swelling, the participation of the neighboring glands in 
the disease, the failing of the whole organism without any increase of the 



652 DISEASES OF THE FEMALE SEXUAL ORGANS. 

secretory products. Nevertheless, there occur many cases of cancer, the 
true nature of which remains for a long time undetermined, and is clearly 
revealed only after the disease has run a long course. 

Cancer of the breast is generally considered a surgical disease; it is 
supposed by most authors that internal treatment cannot reach it. The 
disease, at least in its incipiency, is considered purely local, and an opera- 
tion the only cure. For these and other reasons, having given you the 
means of selecting an intelligent and honest p'hysician and surgeon, we 
unhesitatingly commend you to his care and here offer no treatment. 

HOME REMEDIES. Take the juice of Sheep Sorrel, let it evaporate 
on a pewter plate to the consistence of a thick extract ; apply this over 
the cancer. It is very painful but good. 

Another. Take equal parts of Sheep Sorrel, Poke Leaves and Yel- 
low Dock Root, beat them up in a mortar with a little water ; squeeze 
out all the fluid ; place it on a lead or pewter plate, and let it evaporate 
until it forms a thick extract. Apply to the cancer. This is a noted can- 
cer cure. 

Again: Make a ley of the ashes of Red Oak Bark; boil down until 
it is as thick as molasses, and cover the eancer with it, In about an hour 
afterward cover it with a coat of Tar. Remove this in a few days, and if 
any protuberances remain in the womb, apply more of the Oak Bark 
Potash and the Tar plaster, and so on until the cancer is cured. Heal 
the ulcer with some common salve. 



CHAPTERXXXI 



PREGNANCY. 



CONDENSED SIGNS OF PREGNANCY. 

The determination of pregnancy, at the earliest possible period, forms 
a most difficult problem, on account of the same symptoms having been 
known to exist through the influences of other derangements. 

Suspension of the meases is generally the first indication which leads 
the woman, in whom impregnation has been possible, to consider her- 
self enceinte. But the importance of this symptom will very greatly 
depend upon the attendant circumstances : if the woman has been very 
regular, and if the cessation of the menses promptly occur after some par- 
ticular sexual intercourse, the presumption of pregnancy will be very 
strong indeed. But if she has always been very irregular, the mere fact 
of the menses failing to make their appearance at a particular monthly 
period, will carry with it but little weight. Where the entire absence of 
the menses for two or three months occurs, from no other assignable 
cause, and where this suspension is attended with good health and appe- 
tite, and some perceptible increase in the size, or, on the other hand, per- 
ceptible sinking away of the abdomen, the conclusion of pregnancy may 
be considered to be well founded. 



SIGNS OF PREGNANCY. 053 

Changes in the breasts very frequently occur ; they sometimes feel 
heavy, are inclined to itch, and the areola around the nipple becomes dark- 
colored, and sometimes presents an oily appearance. And yet, even 
these circumstances are far from affording unmistakable evidences of 
pregnancy, since they have been known to arise in this combination 
from other causes. 

Another symptom which may, and does often occur in the early 
months of pregnancy, is an itching and irritation of the sexual parts ; 
though in newly-married women, the menses are sometimes suspended 
from irritation of the sexual organs when no conception has taken place, 
and at the same time, there may be an increase in the size of the abdo- 
men, and in the sensibility of the breasts ; so that even this very strong 
combination of symptoms cannot be relied upon. 

Morning sickness forms, in very many women, the next sign of preg- 
nancy. As its name indicates, it is a morbid symptom, but on that 
account none the less valuable as a diagnostic sign. It arises from 
sympathy of the cceliac, or solar plexus, with the organic nervous system 
of the uterus. This morbid irritability may commence immediately 
after conception, but it generally sets in about the fifth or sixth week 
after conception, and ceases soon after the third month. It may become, 
in individuals, a positive indication of their being pregnant, since these 
persons learn by experience that these symptoms occur with certainty 
and regularity at a particular time after conception. Thus, in different 
persons, the presence or absence of morning sickness will have a very 
different diagnostic value. Still, where morning sickness makes its 
appearance persistantly attended with suppression of the menses, and 
in circumstances where there is a liability to impregnation, it can scarcely 
be attributed to any other more probable cause than pregnancy, and this 
indication will be strengthened by the character of the sickness itself. 
The appetite improves and is good through the day, in spite of the nausea, 
vomiting of a peculiar watery fluid, and sinking at the pit of the sto- 
mach, which occur and continue for a short time, only on first rising in 
the morning. The sickness and the fluids vomited up are different from 
those accompanying any other disorder, such as gastric or bilious fevers, 
for example. While morning sickness, from its peculiar character, brief 
daily appearance, usual temporary continuance, and final, sudden and 
perhaps unexpected disappearance, becomes, where it occurs, a valuable 
indication of pregnancy, its absence is hardly to be regarded as an opposite 
sign, as disturbances of the uterus, apart from pregnancy, may occasion 
it, and it sometimes follows suppression of the monthly flow from other 
causes than conception. 

Certain other derangements of the digestive organs, such as eructa- 
tions, heartburn, remarkable longings for some particlar article of food, 
or other substance not used as food ; and, on the other hand, aversion to 
some one or more of the common varieties of food, which may occur 
separately, or in connection with morning sickness, or even subsequently 
to it. 

The same may be said of salivation, which occurs, in some women 
about the fourth or sixth week ; in such cases, the frequent spitting will 
be equally diagnostic, whether the quantity be large or small. Thissali- 



654 PREGNANCY. 

vation, differing from that which is produced by mercury by the absence 
of foul breath, sore gums and great prostration ; it becomes characteristic 
of pregnancy, just as the morning sickness, above described, does by 
reason of its being a sympathetic affection. 

OBSERVATIONS ON PREGNANCY. 

This period may be regarded as one of the most interesting eras of a 
woman's life. She is now no longer acting for herself alone, but becomes 
invested with a new and serious responsibility, and upon some of the most 
apparently trifling of her actions, may depend the future health and 
happiness of a being bound to her by the fondest ties. 

From the mass of evidence collected by careful observers of the oper- 
ations of nature, we are warranted in drawing the conclusion, that th j 
actions of the mother exercise a great influence over not only tl.e 
constitutional and physical, but also, the mental organization of her 
offspring. Keeping this fact in view, we shall endeavor to point out the 
course that mothers, who prefer the welfare of their future offspring to 
their own indulgence, should pursue, and from which they will derive a 
double benefit, an improvement in their own health, with exemption 
from suffering, and the delight of seeing their children pass safely 
through the anxious period of infancy. 

The leading causes of a weak and sickly child, are ill-health, or con- 
stitutional taint of both or either of the parents; very early, or late mar- 
riages; great inequality between the ages of the parents; errors in dress, 
diet, and general habits of life, and lastly, powerful mental emotions. 

Females should seldom, at least in this country, enter into the mar- 
riage bond before their twenty-first or twenty-second year; prior to that 
period their organization is scarcely ever fully developed; those who 
marry at sixteen or eighteen years of age incur the risk of a severe after- 
suffering themselves, and also, of giving birth to weak and delicate 
children. How very often we see the first children of such marriages 
perish in infancy, or after contending through a childhood of continued 
delicacy, sink into a premature grave. Women who marry late in life 
incur considerable personal risk, and severe suffering in giving birth to 
children, and the offspring is seldom healthy. The children of old men, 
although by a young wife, are very often extremely delicate and suscepti- 
ble to illness; they do not unfrequently precede their father to the grave 
or linger but to drag on a miserable and wearisome existence. 

In concluding these observations, we may remark, tha + so far is the 
period of pregnancy from being destined for one of suffering or danger, 
that nature has taken every precaution for the protection of the female 
and her future offspring. While pregnancy runs its equable and uniform 
course, the expectant mother enjoys an almost complete exemption from 
the power of epidemic or infectious diseases, and even chronic complaints 
are frequently suspended ; in fact, with the exception of some slight mor- 
ning sickness, and occasional trifling uneasiness, a well-constituted 
organism should enjoy as good health during pregnancy as at any other 
time; and many women pass through this period and give birth to vigor- 
ous children without even the most trifling inconvenience. 

Though, as we have said, nature seems during this period to adopt 
every possible precaution for health and preservation of the parent and 



HYGIENE OF PREGNANCY. 65o 

her future offspring, yet are her wise arrangements too often rendered 
void by direct violation of her laws. The expectant mother should 
therefore bear in mind, that the duty of leading a regular and systematic 
course, so essential to every individual, devolves upon her with double 
force, since every neglect or breach of these ordinances of nature upon 
her part is frequently visited with fearful energy upon her yet unborn 
infant. 

HYGIENE OF PREGNANCY. 

A few words on this subject, which is quite as important as the med- 
ical treatment of the disorders of pregnancy, inasmuch as it is intended 
to prevent such disorders from occurring. 

In order that this period may be passed with as much comfort and 
its end accomplished as easily and safely as possible, all irregular and, I 
might say, intemperate habits, should be laid aside, and all pernicious 
practice abandoned. The pregnant woman should strive to cultivate for 
herself the utmost cheerfulness and tranquility of mind; she should 
strive to be at peace with all the world, and at peace with herself, for her 
mental and moral state will surely be engrafted upon her offspring, the 
education of the future being commenced while yet in utero. And in 
this effort she should be seconded by her husband, whose responsibility 
is very great at this period — whose conduct toward the wife of his bosom, 
at this period, acting upon her mental organization, will be transmitted 
to their joint offspring for weal or for woe. 

A pregnant woman, during the whole course of her pregnancy, will 
require more sleep than at other periods, and an ample allowance of the 
same should always be indulged in. And yet, at the same time, habits 
of slothfulness should be avoided. "Early to bed, and early to rise," 
applies with additional force at this juncture, and nine, or, at least, ten 
o'clock at night, should find her in bed, and six, or, at the least, seven 
o'clock in the morning, should find her up. Habits of regularity, in all 
things should be cultivated — regularity as to hours for sleeping and wak- 
ing — and regularity as to meals, exercise, stool, etc. 

Air and Exercise. Nothing tends more to the preservation of 
health, than a proper attention to these two important points, and yet, 
unfortunately, there are, perhaps, few more completely lost sight of. 
During this epoch, carriage riding, alone, is not sufficient ; walking 
brings, not only the physical, but the whole of the organic muscles, into 
play, and communicates the increasing vigor of the mother to her off- 
spring ; therefore, walking is indispensable, and every day should find 
the expectant mother taking a walk, leisurely, and with the mind at 
ease; and this rule should be observed, even in cold and unpleasant 
weather, excepting when the walking is rendered dangerous from snow 
and ice. A walk is often an excellent remedy for the feeling of drowsi- 
ness and heaviness, which often creeps over a woman in this condition — 
a much better remedy than taking a nap or a prescription from the 
doctor. 

Some women take a great deal of exercise, yet, without corresponding 
benefit, from their work occupying them wholly indoors, showing the 
inutility of exercise in itself, unless combined with pure air. Others, 
again, injure their health, and frequently induce miscarriage, through 



656 PREGNANCY. 

their excessive levity and thoughtlessness, by unrestrained indulgence in 
active exercise, riding on horseback, dancing, etc. A woman ought to 
recollect, that, if through her own folly, she has brought on miscarriage, 
the greatest possible care should be taken to prevent its recurrence ; that 
a second attack increases her liability in future ; and that she who has 
suffered twice or thrice from this misfortune, even when she escapes it, 
rarely attains her full time. Moreover, continued casualties of this 
nature frequently terminate in premature death. 

Employment of the Mind, etc. Useful employment, reading, or use- 
ful and agreeable conversation, should engage the waking hours, 
not otherwise employed. In fact, I should like to impress upon the 
interested portion of my readers, the importance of cultivating a proper 
condition of mental vitality, as well as physical. How important it is 
that the expecting mother, as a new thread of life is being spun within 
her, should think and do that alone which is good and right, for of a cer- 
tainty, her offspring will have woven into the tissues of its existence the 
resultant of what she is and does during her pregnancy. 

Experience has presented us with many instances in which the pre- 
dominant feeling in the mind of the mother, during pregnancy, has 
influence on the future mental organization of the child. The effect of 
any unpleasant or unsightly object upon the imagination of the mother, 
and the transmission of that effect to the offspring, evidenced in various 
mental or physical peculiarities, after birth, is a theory as old as tradition. 

Clothing During Pregnancy. The dress of the female should, of 
course, be suited to the season, and if she pass from a warm into a cold 
atmosphere, she ought to keep herself well protected to prevent the risk 
of taking cold. But, a point of far greater importance, is the adaptation 
of the clothing to the form, so as to preclude all unnecessary pressure 
upon any part of the body, that might interfere with the functions of 
those important organs which are destined for the birth and nourishment 
of the infant; tight lacing (at all times most objectionable) is particu- 
larly injurious during this period, inasmuch as it interferes with the 
natural action of the body, and bearing directly upon the abdominal 
muscles, the blood-vessels, lymphatic, and the bowels, produces narrbw- 
ness of the chest, disturbes the circulation, and causes derangements of 
the liver, and exercises a most distressing effect upon the breasts and 
uterus. Females, in their efforts to preserve the elegance of their form 
during pregnancy, are little aware that the constricting efforts thus exer- 
cised upon the abdominal muscles, destroy their elasticity, prevents a 
proper retraction after parturition, and thus proves one of the most com- 
mon causes of abdominal deformity. Moreover, to the vanity of their 
mothers in this and other respects, many, it is probable, owe their club- 
feet and other deformities ; and in addition to these evils, this practice 
not unfrequently deranges the position of the foetus— a displacement 
which, together with the consequent want of energy in the muscles, and 
the parts concerned, generally brings on protracted and dangerous labors. 
Besides, this continued pressure on the uterus is liable to bring on prema- 
ture labors. To tight lacing may be attributed the difficulty which so 
many mothers of the present day experience in suckling their infant, by 
the unnatural pressure deranging the process required for the subsequent 



MORNING SICKNESS. 657 

secretion of milk; from this, also, arise sometimes, those dangerous indur- 
ations, cancers and other affections of the breasts and, also, retraction of the 
nipple, from which the act of suckling is rendered difficult, and in some 
instances, impossible. 

Care also should betaken not to wear anything tight about the limbs, 
such as wrist-bands or garters, even elastic garters spanning the leg may 
be injurious, as they impede circulation, and encourage the development 
of various veins, to which the system is already predisposed, and which, 
in many instances, become very painful and troublesome. One fact in 
connection with this question of dress, is here noteworthy, viz: that 
women in the latter months of pregnancy, complain of, and really suffer 
from coldness of the abdomen, the protruding abdomen causing the cloth- 
ing to set off to the extent of almost completely exposing that part of the 
body to direct contact with the air. In view of this, the clothing should 
be so adjusted, or an extra garment worn to obviate the difficulty. Notice 
of these matters are greatly beneficial, and are so apt to be considered of 
minor or insignificant imj3ortance. 

Diet. The diet during pregnancy should be generous in meats, 
vegetables, and fruits, and at the same time plain. Excessive coffee and 
tea drinking should be laid aside. Sugar, salt, and spices should be taken 
in moderation ; stimulants of all kinds, especially such as wines, liquors, 
beer, etc., should be most strictly avoided. If, however, the female has 
been long habituated to wine it may be taken in extreme moderation, 
and diluted with water. 

GASTRIC DERANGEMENTS DURING PREGNANCY. 

Nausea and Vomiting— Morning Sickness. In many women, 
nausea and vomiting set in at an early period of pregnancy, and are 
simply the result of a peculiar reflex irritation of the stomach; in these 
cases this affection usually continues but a short time. Next to the ces- 
sation of the catamenia, and especially in conjunction with it, morning 
sickness becomes one of the earliest, as well as one of the most reliable, 
early signs of pregnancy ; while for all those who have ever before 
experienced it, there is little room for mistake in regard to its nature ; 
for, in each individual in whom it occurs, it has a uniform type and well 
remembered character. 

The nausea may occur at an early period in the morning, with 
unvarying regularity ; or in the evening, or at any period of the day, or 
even of the night. For each individual, it maintains, also, its uniformity 
as to the date of its first appearance ; in some, it appears very soon after 
conception; in others it begins toward the third or fourth month, and, 
in others again, it comes on only toward the close of gestation ; in these 
latter cases, it might have appeared, also, for a short time after concep- 
tion. In the duration there is, also, the same general variety and indi- 
vidual uniformity. Thus, in some women, it lasts but a few weeks— 
from six to eight at most; in others it continues for four or five months; 
while in some few most distressingly severe cases, this difficulty persists 
through the whole period of utero-gestation, unless relieved by art. 

The nausea and vomiting of pregnancy, as already stated, are most 
apt to occur on first rising in the morning; sometimes these symptoms 
disappear in a few minutes, sometimes they last through the greater por- 

42 



&>8 PREGNANCY 

tion of the day. In some, the vomiting is very easy ; in others it is 
attended with very severe retching, and even with other painful symp- 
toms. 

Those who vomit upon waking or rising in the morning, usually 
throw up some viscid, glairy matters, which are generally colored with a 
little bile, especially if the retching has been very severe. Others vomit 
only after eating, occasionally after only one of the daily meals, but some 
times after all of them. Again, in some unfortunate cases, the vomitings 
continue, even in the intervals of the repeats, everything taken into the 
stomach, whether liquid or solid, being immediately rejected. There are 
cases, finally, in which the mere thought of food, or the sight or smell of 
it, is sufficient to induce the vomiting. 

In some cases, nearly all of the food taken seems to have been thrown 
up, even for months in succession, and yet a good delivery succeeds at 
full term ; the repeated and severe vomitings seeming to exert compara- 
tively little influence upon the general health. In like manner, preg- 
nant women may rise from the breakfast table, vomit, and return to their 
food as if nothing had happened. Such characteristics, so different from 
vomiting, arising from any other cause, almost conclusively indicates the 
presence of pregnancy. 

The diet and regimen of the pregnant woman should be carefully 
attended to ; such articles as best agree should be taken in each case, and 
equal care taken to avoid every unwholesome or irritating influence. It 
has sometimes been found that the excessive irritability of the stomach, 
in pregnancy, is due to the presence of fumes from some neighboring 
manufactory, which, although insufficient to induce any unpleasant 
symptoms in the ordinary condition of the woman, very powerfully 
affect her when pregnant. 

TREATMENT. The following remedies will be found to cover the 
principal forms of gastric derangements of pregnancy. For particular 
indications, see "Heartburn." 

Antimonitim crud. Nausea and vomiting, or only nausea with 
white-coated tongue. Watery stools, with occasional hard lumps; fright- 
ful vomiting with convulsions; belching, with taste of what has been 
eaten ; painful sense of fullness of the stomach, which is sore on pres- 
sure. 

Dose: Six pills night and morning. 

Arsenicum. Very great debility and exhaustion ; the least effort 
causes exhaustion. Very pale white look. Bitterness in the mouth, 
particularly after eating or drinking. Cold water seems to lie in the 
stomach until it gets warm, after which she vomits it, therefore she can- 
not drink it although she desires it. Feels cold, and wants to be in a 
warm room, or to be covered up warmly; very uneasy and restless ; 
vomiting of blackish or greenish matter. 

Dose : As for Anti. Crud. 

Hryonia, Nausea on waking in the morning. Nausea is usually 
relieved by keeping quiet; dry, parched lips, dry mouth and tongue; 
head aches as if it wou«ld split; stool of hard, dry feces as if burnt. All 
the symptoms worse from motion, better when still. 

Dose As for Anti. Crud. 



MORNING SICKNESS— HEARTBURN. 659 

Calcarea Carb. She cannot sleep after three in the morning; 
heartburn and food eructations ; soreness of the tongue, either on the tip 
or sides, so that she can scarcely eat or talk. Sensation as if the feet 
were cold or damp. Feels better from warmth, and cannot bear cold air. 
Vomiting of sour matter. 

Dose : As for Anti. Crud. 

Conium, Vertigo, particularly on turning over in bed. Where the 
history of the case of vomiting reveals the fact of swelling and soreness 
of the breasts with each menstrual period, and the patient always feels 
worse after going to bed, so much so, that she is obMged to sit up or walk 
about to get relief. The urine intermits at every flow. 

Dose : Six pills three times a day. 

Ipecac, One continual sense of nausea all the time— not a moment's 
relief. Vomiting of large quantities of mucus. Diarrhoea and colic, dis- 
gust for food ; empty retching; vomiting of food, slime, or blood; sour 
vomiting, cutting pains about the umbilicus (navel). 

Dose : As for Conium. 

Nux vom. Nausea and vomiting every morning with constipation ; 
large difficult feces. Food and drinks have a fetid smell to her. Not 
much appetite, or canine hunger ; aversion to water and bread. Longing 
for brandy, beer, etc. Bitter or sour taste. Vomiting of food, bile, of 
black or sour matter. 

Dose : As for Conium. 

Pulsatilla, Pulsations in the pit of the stomach. Vomiting of 
mucus. Bad tase in the mouth every morning on waking; she has to 
wash it out, soon it is so bad she cannot bear it. Nothing tastes good to 
her. Absence of thirst; she does not relish as much water as usual. 
Nightly diarrhoea; stools very changeable, loss of taste or bitter, fatty, 
saltish, sour, or sweetish taste. 

Dose : As for Conium. 

Sepia. Vomiting of milky water or milky mucus. Sense of empti- 
ness at the pit of the stomach ; the thought of food sickens her ; a sense 
of weight in the anus Eructations tasting like spoiled eggs. Taste as of 
manure. Aversion to meat. In the morning, nausea as if all the viscera 
were turning inside out. Taste bitter or saltish. Disgust for all kinds 
of food. Constipation. 

Dose: Six pills night and morning. 



HEABTB UBX— ACIDITY— WATEBBBASH. 

These distressing forms of gastric disturbance sometimes make their 
appearance soon after conception, while in other cases they may not 
make their appearance until after the fourth month. Some women are 
remarkably subject to these symptoms when pregnant; in others they 
are manifested with less violence; in others not at all. There may be 
merely a burning sensation— heartburn in the throat — which indicates 
sympathetic irritation ; or the severe forms of waterbrash with acidity 
which arise from more fully developed irritation. As in the nausea and 
vomiting of pregnancy, so in waterbrash, acidity, and heartburn, every 
degree of intensity and variety of manifestation and complication may be 



660 PREGNANCY. 

seen in different individual cases. Sometimes these disturbances are 
found accompanied with, and greatly aggravating the nausea and vomit- 
ing, while at other times they seem to appear instead of the vomiting. 

As in the cases of ordinary dyspepsia, these sufferings are worse after 
certain articles of food or drink, such as meats, fat meats or gravies, milk, 
or fruit. In the more severe cases, nearly everything that is eaten 
becomes but an added fuel to the burning fire. Still, a carefu] avoidance of 
all those articles which, whether solid or liquid, are found to disagree most, 
and a careful selection from the remedies given, will, as in cases of nau- 
sea and vomiting, go very far to remove the most distressing symptoms, 
and eventually to secure a great improvement in the general health. 

TREATMENT. Antimoniwm Cruduni. Nausea alone or nausea 
and frightful vomiting with convulsion. Belching, with a taste of what 
has been eaten. Thirst at night. Painful sense of fullness of the sto- 
mach, which is sore on pressure. 

Dose : Eight pills every four hours. 

Arsenicum is very useful when there is very great debility and 
exhaustion. Very pale, white look. Sensation as of a stone in the sto- 
mach. Vomiting of fluids as soon as she takes them. Exhausting diar- 
rhoea. Feels cold and wants to be in a warm room. Very uneasy and 
restless. 

Dose : As for Anti. Crud. 

Bryonia is particularly indicated when there is distressing heart- 
burn, dry, parched, lips, splitting headache. Stool of dry, hard feces, as 
if burnt. All the symptoms aggravated by motion. 

Dose : Six pills every three hours. 

Calcarea Carb, Heartburn and food eructations. Sensation as if 
the feet were damp and cold. 

Dose: As for Anti. Crud. 

Conium. Vertigo on turning in bed. Eructations with heartburn. 
Terrible nausea and vomiting. Where the history of the case reveals the 
fact of swelling and soreness of the breasts with each menstrual period, 
and the patient always feels worse after going to bed, and has to walk 
about to get relief. 

Dose: As for Bryonia. 

Sepia. The thought of food sickens her. Eructations tasting like 
bad eggs. Want of appetite. Taste bitter or saltish. Disgust for all 
kinds of food. Vomiting of food and bile. Constipation, 

Dose: Six pills every night and morning. 



CONSTIPATION OF PREGNANCY. 

Constipation is a very common attendant upon pregnancy, so fre- 
quent that by some it is deemed almost a natural consequence. But it is 
much more apt to occur, and at the same time be more troublesome and 
obstinate, in pregnant women, whose habits of life are confining, and 
those who are naturally of a more costive habit. When it does not arise 
from mechanical pressure exerted by the uterus upon the rectum, by 
which its dimension is lessened, and its action paralyzed, active exercise 
in the open air (avoiding indigestible food, strong coffee, and other stimu- 



TOOTHACHE DURING PREGNANCY. 661 

lating liquids,) is sufficient to remove the complaint, or, at all events, 
render it less troublesome. 

When nature requires further assistance, the following remedies 
have given the best satisfaction in the numerous cases which I have 
treated. 

TREATMENT. Nux v. In women of sedentary habits, accustomed 
to the use of much coffee, wine, and rich and highly-seasoned food, gener- 
ally. Stools large and difficult ; colicky pains, or loud rumbling or rol- 
ling in the bowels. Constipation in persons who have been in the habit of 
using purgatives. Rush of blood to the head during stool. 

Dose: Four pills every evening, dry on the tongue. 

Ignatia can be made use of when the same symptoms as given after 
Nux., with the addition of an empty feeling at the pit of the stomach; 
sighing and full of grief. 

Dose: Four pills every morning, dry on the tongue. 

Bryonia. The stool is mostly dark, dry and hard, as if burnt, and 
is evacuated with much difficulty. The lips are parched and cracked. 
Much thirst. Stinking flatulency. Obstruction of the bowels from hard- 
ened stool. Stool too large to be evacuated without pain. 

Dose: The same as directed for N*tix. 

Sepia. Sensation of weight or heavy lump in the anus ; this is a very 
characteristic indication. The stool is very difficult to pass, even with 
the most terrible and involuntary strainings. Knotty and insufficient 
stool. Sepia has given very marked benefits. 

Dose : A powder each second night. 



TOOTHACHE DURING PREGNANCY. 

Toothache is a common and very distressing accompaniment of preg- 
nancy, being in fact, only a particular form of neuralgia. 

If toothache occurs in sound teeth, as is quite frequent, thev should 
never be extracted, and only the greatest care should be used in extract- 
ing decayed ones, especially, if the patient be of a very nervous tempera- 
ment. The female should, as soon as she is in proper state, put herself 
under proper treatment, for this is a valuable indication of some consti- 
tutional taint lurking in the system, and no remedies can be otherwise 
than palliative, until this tendency is eradicated. 

TREATMENT. Alumina. (Alum) when the pains are excited 
by mastication, (chewing of the food,) and when they are of a tearing 
nature, extending to the cheek bone, temple and forehead. 

Calcarea. When the toothache is excited or aggravated by cold air, 
or anything hot or cold, and attended with painful sensation of the 
gums, and pulsative, gnawing, or throbbing pains which are aggravated 
by noise. 

Sepia. Is particularly indicated when there is pulsative, shooting, 
drawing toothache, with pain extending to the ears, or to the arms and 
fingers, excited by compressing the teeth or by cold air, and attended with 
swelling of the cheek, and enlargement of the glands under the lower 
jaw. 



662 PREGNANCY. 

Magnesia Carbonica. Nocturnal pains in the teeth, insupportable 
when lying down, and compelling the patient to get up and walk ; pains 
generally boring, burning, drawing, tearing, and resembling those of 
ulceration, attended with swelling of the cheek on the affected side. 

Dose: These remedies may be given every three hours, six pills at a 
dose, until relief, and then the time may be lengthened. 

The above are the four leading medicines, for this peculiar condition, 
though there are others which may be called for by particular symptoms, 
of which I will mention a few. 

Arsenicum, Belladonna, Chamomilla, Gelseminum, Hyoscyamus, 
Merc. Sol., Nux-vom., Pulsatilla. 



SWELLING OF THE LOWER LIMBS— VARICOSE VEINS. 

This a very common attendant of pregnancy ; it often occasions no 
little inconvenience, and is usually confined to the seventh, eighth and 
ninth months. It is supposed to arise, in most instances, from mechanical 
pressure alone, and to be free from constitutional disease. This is true in 
those cases where it is not accompanied by dropsical affetions. Standing 
and walking serve to aggravate this; condition ; it becomes worse toward 
evening, gradually increases as pregnancy advances, and is often combined 
with a varicose state of veins. 

Many females suffer much during pregnancy from distention of veins 
in the thigh and other parts, which, becoming violent, eventually cause 
great pain and inconvenience. These varicose veins generally arise from 
obstructed circulation, caused by the pressure of the uterus upon the 
blood-vessels. Considerable alleviation is experienced by constant bathing 
with water or with diluted alcohol or brandy. Also, by bandaging from 
the foot upwards with a gentle and equal pressure, and by preserving a 
recumbent posture, which is required in severe forms of the complaint, 
accompanied with considerable swelling of the feet, ankles, etc. In order 
to afford relief we would recommend the following remedies. 

TREATMENT. Pulsatilla may be given, particularly when there is 
excessive pain and swelling, with a good deal of inflammation, or when 
the veins are of a livid color which is imparted to the whole limb. 

Arnica is of great service when the occupations of the patient render 
it impossible for her to lay herself up, and avoid much standing and mov- 
ing about in discharge of her domestic duties. 

Pulsatilla and Arnica given in alternation, a dose every day, will 
prove very beneficial in such cases. 

Nux-vomica when the affection is attended with constipation and 
piles, and irritability of temper. 

Dose: Six pills every evening. 

Arsenicum when the veins are attended with severe burning pain, 
with a sensation as if scalding water was running over them. 

Dose : Eight pills every second evening. 

Carbo-veg., when Arsenicum is not sufficient to subdue the scalding 
burning sensation. 

Dose: As for Arsenicum. 

Belladonna. Varices with considerable erysipelatous inflammation. 

Dose : Six pills every four hours. 



ITCHING OF THE GENITALS— URINARY DIFFICULTIES. 663 

ITCHING OF THE GENITALS.— (PRURITIS). 

Itching of the genitals, which is a frequent attendant upon pregnancy 

is caused by congestion of blood to the parts, and may often be relieved by 

bathing the parts with water in which borax has been dissolved, or with 

common soda and water. 

o 

URINARY DIFFICULTIES AND DERANGEMENTS DUR- 
ING PREGNANCY. 

As gestation advances, the increasing size of the uterus causes it to 
press more and more against the bladder. Thus the capacity of that organ 
is diminished by the pressure which necessitates a much more frequent 
discharge of urine. The same frequent micturation results, too, from direct 
irritation of the neck of the bladder; causing hourly calls to pass water, 
which are sometimes but partially relieved by the flow of a few drops, 
only, at a time, or the irritation may amount to dysury, (painful urina- 
tion,) or even to a complete retention of urine. 

Where some displacement seems to be the cause, which may some- 
times be known by the suddeness of the onset of the difficulty, especially 
if it follows some accident or over-exertion, the case should receive treat- 
ment for the difficulty, different than which arises from other causes, of 
which I will mention at the end of this article. 

Incontinence of urine sometimes appears, especially in the latter 
stages of pregnancy. When it appears in the early months, it may result 
from the pressure of the womb upon the neck of the bladder before it 
rises out of the pelvic cavity, causing the loss of tone of the part. This 
difficulty will often yield to the proper remedy, but if not, when it comes 
on in the early stage of pregnancy, it may be expected to disappear when 
quickening takes place, and the uterus emerges from the cavity of the 
pelvis. 

For the medical treatment of these difficulties, the following reme- 
dies should be studied. It is to be noted, likewise, that these remedies 
should be consulted and may be required for urinary difficulties occur- 
ring, not only during pregnancy, but before, during, and after parturition 
as well. 

TREATMENT. Aconite. Retention of urine, with stitches in the 
region of the kidneys. Difficult and scanty emission, with pinching 
around the umbilicus (navel). Bright-red, hot urine. Desire to urinate, 
accompanied with great distress, fear and anxiety. Worse from exposure 
to dry, cold air. 

Dose: Six pills every half hour or hour owing to the severity of thecase. 

Arnica. After passing a little urine she wishes to pass more, but is 
unable to do so at that time. Brown urine with brick-red sediment. A 
bruised and sore feeling exists across the lower part of the abdomen. 

Dose: Four or six pills every two or three hours. 

Cantharis. Very frequent urination, even sixty times an hour, with 
violent cutting pain, causing her to scream. The urine is often bloody. 
The urine does not flow in a stream, but dribbles away, or passes drop by 
drop, with cutting and burning pains, and tenesmus of the bladder, which 
is agonizing in severity. 

Dose : Same as for Aconite. 



664 PREGNANCY. 

Causticum. Frequent desire to urinate, a small portion passing 
away involuntarily. Involuntary passing of urine at night. 

Dose : As for Arnica. 

Conium. The urine flows and stops, and flows and stops again, and 
so on. There are cutting pains during the flow, and burning or smarting 
afterward. Vertigo, particularly on lying down. 

Dose : As for Arnica. 

When the cause can be traced to displacement from accident or over- 
exertion, Belladonna and Platina have given me the best results. They 
are to be taken in alternation, every four hours. Complete rest will be 
necessary for a few days, in a case of that kind. 



MISCARRIAGE. 

Women who have suffered once from this affection are exceedingly 
subject* to its recurrence, and this liability is still further increased after a 
second or a third attack. When it occurs before or about the third or 
fourth month it is attended with much less pain or danger, although fre- 
quent miscarriages, owing to the abundant discharge that is generally 
present, break down the constitution, and frequently develop severe chro- 
nic diseases. When a miscarriage takes place at a later period it assumes 
a very serious outlook, and is accompanied with a considerable degree of 
peril to the patient. 

Exciting Causes— Are sudden mental emotions, such as fright, grief 
or excessive joy, mechanical injuries, or excessive physical exertion, such 
as lifting too great a weight, reaching up high, going up or down stairs, 
long walks, riding on horseback or in carriage over rough roads, railway 
traveling at too great a speed, etc. Other causes are, a luxurious mode of 
life, fashionable habits, neglecting to take air and exercise, while an 
unhealthy state of the constitution, giving rise to numerous local and gene- 
ral derangements, is undoubtedly the predisposing cause. 

The Symptoms vary so much in particular cases, that it is almost 
impossible to give any particular train of symptoms— though most cases of 
miscarriage are preceded and attended by the following symptoms: A 
chilly sensation followed by fever with more or less bearing-down, par- 
ticularly when occurring late in pregnancy; also, severe pains in the belly; 
drawing and cutting pains in the groins; or pains frequently bearing 
resemblance to those of labor; discharge of viscid mucus and blood some- 
times bright red frequently mixed with clots; at other times dark and 
clotted followed by the emission of a thin, colorless fluid. The miscarriage 
generally takes place during this discharge, which occasionally continues, 
if not properly checked, to flow for hours, therefore placing the sufferer in 
considerable jeopardy. After the child has been expelled, the flooding and 
pains generally disappear gradually ; but if a portion of the placenta (after- 
birth) be left within the womb, the pains may continue with more or less 
severity and irregularity, the flooding will frequently become excessive 
and alarming, and offensive, putrid discharges will take place from the 
vagina. 

When miscarriage is threatened, the individual must assume the 
recumbent posture, and in some cases, indeed, should be strictly confined 
to the bed, sleeping with few bedclothes ; the apartment should be kept 



MISCARRIAGE. 665 

cool, and every means should be employed to ensure perfect repose to the 
mind. 

In all cases of miscarriage, medical assistance should be summoned as 
promptly as possible; but as life may be lost in urgent cases before a phy- 
sician can be obtained, the following additional particulars should be 
observed:— When the misfortune gives evidence of being unavoidable and 
the hemorrhage is excessive and is not promptly arrested, by properly 
selected medicines, the following directions should be observed: Apply 
cold to the abdomen in the form of cold cloths or sacks of ice or cloths 
wrung out of ice water, etc, which will frequently have the desired effect, 
by causing the womb to contract and discharge its contents. As perma- 
nent cessation of the flow cannot be expected until this is accomplished, 
and as it is frequently slow to dilate sufficiently for that purpose, the pas- 
sage should be plugged to prevent the flow until the womb is sufficiently 
dilated. A piece of sponge of sufficient size, or a plug made of old muslin 
or linen rags with a string attached of sufficient length to disengage it 
when necessary, (called a tampon) may be used for the purpose, and 
should be cautiously inserted. The tampon should be large enough to 
entirely fill the passage, so as to obstruct the flow of blood. At the same 
time the indicated remedy should be given, and frequently upon removing 
the plugs, the womb will be found dilated and will expel its contents. The 
tampon, (plug) however, is only to be used in miscarriages occurring before 
the period of quickening, never afterwards. 

Another, and perhaps the best and safest plan to adopt for dilating the 
mouth of the womb is this: The patient should be placed upon the bed in 
the same position as for labor. The bed should first be protected with oil 
cloths or india rubber cloth so arranged as to guide a stream of water from 
the vulva into a pail or tub placed near the bed. Another pail must be 
provided containing tepid water; with a common syringe, the warm water 
should be thrown directly upon the mouth of the womb. This operation 
irritates and softens the neck of the uterus, so that contractions set in in 
the course of an hour or two, and thus labor is provoked and takes place in 
the most natural manner possible, except when it occurs in nature's own 
way at full term. This operation should be repeated in the course of two 
hours, if the first experiment should not prove sufficient. This will fail 
unless the stream is directed upon the mouth of the womb. The following 
are remedies. 

TO PREVENT AND ERADICATE A TENDENCY TO MISCARRIAGE, 

Sabina is particularly applicable to women who habitually miscarry 
about the third month. Feeling of sinking or faintness in the abdomen. 
Violent forcing or dragging pains extending from the back through to the 
pubis. 

Dose : Six pills in a teaspoonful of water, repeated after the lapse of 
twelve hours, and again after the lapse of twenty-four hours, grad- 
ually lengthening the interval for each successive dose, until the 
period of danger is past,— being careful, however, to watch the effect 
of each administration to discontinue or lengthen the intervals as 
the case may require. 

Secale, Especially after miscarriage has already occurred more than 
once, and is generally more suitable to thin, scrawny, exhausted women; 



666 PREGEANCY. 

passive hemorrhage with little or no pain. Great debiHty, feeble almost 
extinct pulse. 

Dose : Six globules, as directed for Sabina. 

Sepia. Painful sensation of emptiness at the pit of the stomach 
Sense of weight in the anus like a heavy ball. Yellow saddle across the 
nose. Pressing in the womb, with oppressed breathing. Very fetid urine 
depositing a clay-colored sediment which adheres to the vessel with great 
tenacity. 

Dose : As directed for Sabin. 

Viburnum Prun. Spasmodic pains shooting from the abdomen 
into the legs. Frequent and very early miscarriages, thus causing sterility. 
This remedy is almost specific as a preventive for miscarriages. 

Dose : Six drops of the tincture to be taken every evening, in mild 
cases, in urgent ones, every morning, noon and evening. 

THE ACTUAL ATTACK. 

Arnica. When the symptoms have been excited by an accident- 
such as a fall, blow or concussion, and there is a sore, bruised feeling, this 
remedy will prove effectual, if administered as follows; 

Dose: Take six pills every ten, fifteen or twenty minutes, (in very 
urgent cases,) and subsequently every half hour, gradually extend- 
ing the intervals to three hours, and continuing the administration 
until decided improvement or change, 

Rhus. If the symptoms have originated in a strain from lifting, 
pulling, or dragging a heavy weight. Pains worse in the latter part of the 
night. 

Dose : As for Arnica. 

Belladonna. Flushed face, red eyes, throbbing and heat in the head. 
Pain in the back, as if it would break. Severe bearing down, as if every- 
thing would fall out. Profuse discharge of blood, neither very bright nor 
very dark colored. Pains which come on suddenly and ceases just as sud- 
denly. Great intolerence to light and noise. 

Dose: As for Arnica. 

Chamomilla. Periodical pains resembling those of labor with dis- 
charge of dark colored or coagulated blood. Violent pains in the bowels 
extending to the sides, with frequent urination. Becomes almost furious 
about the pains. Hot perspiration about the head. 

Dose; In every respect as for Arnica. 

Nux-vom. Every pain produces a desire to evacuate the bowels, or 
to urinate. Much pain in small of the back, which is made worse by turn- 
ing in bed, writhing pains in the abdomen, accompanied by nausea or 
pains in the back or loins as if dislocated, constipation of large difficult 
stools. Persons of sedentary habits. 

Dose : As for Arnica. 

Pulsatilla. Labor-like pains, attended with hemorrhage ; restless- 
ness. The discharge is arrested for a little while, then returns with 
redoubled violence. Suffocative spells. She craves fresh air, and is worse 
in a warm, close room. Inclination to be chilly, even in a warm room. 
Mild, tearful women, 

Dose : As for Arnica. 

Ipecac. Profuse and continuous discharge of bright red blood, 
accompanied with a pressure downward. Cutting pains around the naval. 



TREATMENT BEFORE CONFINEMENT. 687 

Continual sense of nausea, without a moment's relief, disposition to 
faint. 

Dose : As for Arnica. 

China. In weak and exhausted persons, when there is loss of fluids. 
After miscarriage, when there has been loss of blood unto fainting, gid- 
diness, drowsiness and loss of conciousness. Heaviness of the head, ring- 
ing of the ears, and coldness of the extremities. Twitching and jerking of 
single muscles. 

Dose : As for Arnica. 

HOME REMEDIES. Something simple, and in almost every house, is 
Nutmeg, of which take one and grate into a bowl or cup, and pour boil- 
ing water on. Drink the tea. This often arrests very severe cases of 
hemorhages. 

-~ o 

TREAT3IENT BEFORE CONFINEMENT— PREPARATION 
OF THE BREASTS. 

Young mothers frequently find much difficulty in nursing their infants 
in consquence of some defect or incapacity of the nipple. In many 
instances, the structure of the breasts is disorganized by an ignorant nurse 
having compressed them in childhood, under the idea that such barbarous 
management was necessary to expel some of the contents of the breast ; 
mothers should be particularly watchful against this practice. The use of 
improper stays in after life, by which the skin is rendered so tender as 
to preclude suckling, often occurs. 

The first two cases are beyond the power of art, and if suckling be 
attempted, hardening of the nipple and breast ensues, attended with severe 
suffering. Another difficulty frequently occurring, is a shortness or 
retraction of the nipple, so that it is impossble for the infant to take hold 
of it. I have frequently had charge of young mothers whose nip- 
ples were so small that they were unable to nurse their babe. If this 
should be the case — if the nipple should be sunken instead of protruding — 
it has to be drawn out by means of some suitable instrument in the shape 
of shields, or an exhausting pump; a convenient one, in many instances, 
can be made in this way. Take a bottle with rather a large neck, pour 
hot water into it, then empty and quickly place the neck of the bottle over 
the nipple; the air cooling in the bottle will cause the nipple to draw 
down, and thus lengthen it. 

After the nipples have been drawn out, they have to be gently pressed 
and worked with the fingers in order to harden them, lest the delicate skiu 
should be injured by the sucking of the infant. During the two months 
previous to th e expected confinement, the nipples should be washed every day 
with cold water, borax and water, alum and water, or with rum or brandy. 
The whole breast should be washed quite frequently, more especially 
during pregnancy. It may, also, be here remarked, that when any ten- 
derness exists during the period of nursing, the shield should be resumed 
between the intervals of the infant being applied to the breast, and the 
bathing continued— due care being always taken to lave the nipple care- 
fully with tepid water before it is again offered to the child. 

Sulphur will frequently be found useful if an eruption breaks out on 
the nipples, six pills the first thing in the morning, after which the erup- 
tion generally disappears . 



•668 PREGNANCY. 

PRECURSORY SIGNS OF PARTURITION. 

A few days, or even two weeks, before confinement, the uterus 
begins to descend. Until the thirty-eighth to the thirty-ninth week of preg- 
nancy the uterus keeps rising in the abdominal cavity, and the breathing 
is very much interfered with. As soon as the uterus begins to descend, 
the breathing becomes freer, and the pit of the stomach again becomes vis- 
ible ; but now the uterus presses upon the pelvis like a heavy burden, and the 
female feels as if her hips would come apart. The small oi the back is par- 
ticularly affected by the presence of the child's head against the internal 
surface of the sacrum, which sometimes feels bruised and numb, in con- 
sequence. 

Another sign of impending parturition is the frequent and anxious 
urging to urinate, caused by the increasing pressure upon the bladder by 
the descending uterus. The last and most reliable sign of parturition is 
the appearance of the first labor pains, which may set in a few days pre- 
vious to the act of parturition, but which, generally, are Lot felt until a 
few hours before the event. 

THE BOWELS. 

If the bowels have been constipated, an artificial evacuation previous 
to delivery, may be obtained by a lavement of lukewarm water, repeated 
with a small quantity of linseed or sweet oil when necessary from a fail- 
ure in the first attempt to obtain the desired effect. 

Injection. If of lukewarm water simply, inject about a pint; if the 
addition of oil be necessary, to a pint of water add two tablespoonfuls of 
the oil ; shake them well together in a bottle, or other closed vessel, and 
inject the mixture. 

PREPARATION OP THE BED FOR LABOR. 

If the means allow, the confinement bed had better be arranged a 
few days previous to confinement, since at the last moment something 
might be forgotten, or a needful article might be wanting, because the 
hurry and anxiety of finding things are both unpleasant and injurious to 
the patient. 

The best thing for a patient to lie upon, is a simple matress, which 
should be slightly raised toward the head. The nates (hips) should be 
raised upon a cushion about a hand high, which may be covered with oil 
cloth or rubber cloth, or any common cushion may be used for the purpose, 
the object of which is to raise the body so as to procure the necessary 
space for an examination, and for the reception of the infant. The bed 
should be arranged so that every part of the body, from the nates to the 
head, is supported. 

The body being thus supported, the following rules may be observed 
in regard to the thighs and legs: It is better to have the space between 
the thighs and the foot-board of the bed just long enough so that the feet 
of the patient may press firmly against the foot-board; but if the space 
should prove too much, a foot-bench may be placed between the bed and 
the feet, so that she can press against it without drawing up the knees. 

It is sometimes necessary to have a cord or sheet attached to the foot 
of the bed, which the female may hold in her hands during the pains, for 
the hands are often spasmodically contracted during the pains, and it 



PARTURITION OR LABOR. 669 

affords the patient great relief to hold something firmly in the hands at 
such a time. Holding another person's hands, likewise, affords relief to 
the patient. 

Persons frequently arrange the confinement bed by the side of the 
regular bed, into which they are lifted soon after the act of parturition is 
accomplished. However, those who do not find it convenient to prepare 
a separate couch, must protect the matress by some old cloths, or oil or 
rubber cloths may be placed under them, to prevent the fluids lost by the 
mother and child from soaking the matress. Even after parturition, it 
is best to leave the oil cloth under the patient, for the flow of blood con- 
tinues quite freely for a few hours after labor. After preparing the bed 
for confinement, we will now consider — 

FALSE PAINS. 

False pains sometimes precede labor but a few hours — but in many 
cases come on some days, or even weeks, before delivery, and chiefly differ 
from labor pains in these respects : they usually begin at the upper part 
of the womb, are seldom felt in the back, do not extend so greatly around 
the lower part of the body as the true pains, are either on all the time or 
appear with great regularity, and do not cause the womb to become firm 
and hard, while the true pains do. They are chiefly confined to the belly 
with sensibility to touch and movement, and in fact are very annoying. 
False pains can sometimes be distinguished from true ones by sitting over 
a vessel of warm water after which, if false, they will frequently abate, 
and if labor, they will continue with more regularity or strength. 

TREATMENT. Bryonia is indicated when there are pains in the 
loins resembling a dragging weight, much increased by motion, with pains 
in the abdomen, preceding those in the back. This remedy is more par- 
ticularly indicated when the above symptoms have been excited by a fit 
of passion, or by taking cold. 

Dose: Of a solution of six globules to four teaspoonfuls of water give 
a teaspoonf ul. If soon after the administration of the first dose an 
aggravation of the pain ensues, pause until two or three more parox- 
ysms have occurred ; and if these succeeding pains prove to be of 
diminishing intensity or frequency, do not repeat the dose until re- 
lapse threatens. On the other hand, if no improvement is the result, 
repeat the dose after an interval of three hours, and so on, if the 
proper time for the expected time for labor is not nearly due— dis- 
continuing immediately on relief or change. 
Nux-vomica. When the exciting cause seems to be constipation or 
mental irritation, or too luxurious mode of living, stimulants or spirituous 
liquors, etc. 

Dose: As directed for Bryonia. 

Pulsatilla, Abdominal pains and pains in the loins resembling 
those from continued stooping, or pressure of a tight bandage, attended 
with painful dragging and aching in the thighs, constipation or relaxation, 
mildness of temper or great sensibility; particularly when these pains 
seem to have arisen from indigestion brought on by rich indigestible food. 
Dose : As directed for Bryonia. 



PARTURITION OR LABOR. 

During the first pains of the female, she may remain dressed and 
out of bed, because a certain unrest drives her from place to place, and it 



670 PREGNANCY. 

would not be best to confine her to her bed. But all things should be 
made ready; the attending physician should be sent for; warm water 
should be at hand ; and in some convenient place in the sick room (all in 
one place,) the infant's linen bandages, and little strips of linen, should 
be kept all ready ; also, a pair of scissors and two pieces of string, each 
about one-half a yard long; the strings may either be tape, about a quar- 
ter of an inch wide, or cord of sufficient size and strength suitable for tying 
the cord attached to the infant ; a little fresh lard, or oil, some soap and 
pins, should also be at hand. 

Besides the attending physician and nurse, a friend may, likewise, be 
present in the sick room (if requested by the patient,) in order to comfort 
and quiet the sufferer. But all superfluous, persons, such as callers and 
children, must be kept away. 

If the pains become stronger, the female should lie down. Perhaps 
by this time the water may break, which may take place with a feeble 
report. A young woman who has never borne any children, should be 
warned of this event, so as not to get frightened by the suddenness of the 
occurrence. 

Nothing should be done, by irritating the neck of the womb, dilating 
the mouth of it, or by any other artificial means, to hasten the moment 
of delivery. This is the business of nature, who knows best when the 
right time has come for ushering the child into the world. Every arti- 
ficial interference is contrary to law, and is more hurtful than useful. Of 
course, these remarks apply o ly to natural labor. In preternatural labor, 
or those requiring mechanical means, the conduct of the attending physi- 
cian depends entirely upon his or her own tact and knowledge. 

The parturient female may adopt any position that is most comfortable 
to her — on the side or back, with her limbs stretched out or raised ; but 
she niust not bear down during a pain, until the right time for it has 
come. Premature bearing down may result in distressing weakness of 
the womb ; for not only the child, but the whole organ, is pressed by such 
untimely efforts. No bearing-down should be resorted to until the mouth 
of the womb is dilated so that the infant's head is protruded at least half 
its length. At this period, the patient may assist nature by holding the 
breath and bearing-down during a pain, with her head bent forward, 
(never backward, lest she should give rise to the formation of Goitre). 
During the passage of the head through the soft parts, the perineum 
(bridge oetween the front and back passage) must be properly supported, 
lest rupture might take place; at each pain, the attendant should place 
the palm of the hand against the perineum, without, however, making 
any pressure against it, until the perineum remains hard and globular, 
even between pains. At this season, the patient may contribute a great 
deal to a rapid and successful delivery by a suitable position of the body. 
As soon as the head shows a tendency to pass through the vulva, the 
patient should remain quietly on her back, with her feet firmly pressed 
against the foot-board, an^ legs extended and stretched apart a comfort- 
able distance. At this stage, all bearing-down may cease, lest a too rapid 
delivery of the head should rupture the perineum. 

After the head is born, and the shoulders are still within the vagina, 
a short pause generally takes place, which must not be broken by any 



PARTURITION OR LABOR. 671. 

improper pulling on the head which may give rise to fatal dislocation of 
the vertebrae. Supporting the head with one hand, the abdomen may 
be gently rubbed with the other, in case the pains should not come on 
again with sufficient speed. The patient may now rest assured that, by 
assisting the remaining efforts of nature, delivery will soon take place. 

Occasionally it has happened that parturient females, while com- 
pressing the teeth during a hard pain, have broken off a portion of the 
tooth, or have lost the whole of it ; therefore, it is always best to have a 
handkerchief or napkin placed near her, which she may crowd into her 
mouth as soon as the pain is approaching, or if she should be surprised 
too suddenly, one of her attendants must do this office for her. 

THE PLACE OF THE ACCOUCHEUR (PHYSICIAN) AT THE BEDSIDE. 

As soon as the labor pains assume an expulsive character, the attend- 
ant should place himself or herself by the side of the bed where they can 
use the right hand most convenient, and should not leave the bed-side of 
the patient. ^Ye may assist the female, either sitting or standing, 
according as is most convenient. The patient should not be uncovered, 
as it is entirely unnecessary to expose the patient's person, and is also, 
risking the chance tD take cold, which, at this time, would be very injur- 
ious. As soon as the little one makes its appearance into the world, it 
may be uncovered enough so that it may be wiped off with a soft cloth, 
which may be placed convenient for the purpose, but the mother need 
not be exposed, even at this time. 

THE CARE OF THE CHILD DURING LABOR. 

Immediately after the expulsion of the head, we should feel with one 
finger about the child's neck to see if the cord is around it ; in case it 
should be, a slight traction on the cord may loosen it from the placental 
end, so that it will slip over the child's head, leastwise will keep it from 
choking or strangling it. 

"When the head is born, it should be carefully supported from the 
clots and other discharges from the uterus, patiently waiting for the 
work of nature to complete the delivery. 

After the expulsion of the child, it is better to turn its back to the 
mother, and let her covering fall between the child and herself, thus, at 
the same time bringing the child to our full view and completely protect- 
ing the mother from cold and exposure. A soft cloth should now be used 
to wipe the child's face, eyes, and mouth. It usually cries lustily as soon 
as it is born, but it should be permitted to lie undisturbed for.some four 
or five minutes, or until breathing is established. The cord should then 
be tied about three inches from the child and again about an inch further 
along the cord, and then cut betweeen the two places. The child should 
then be wrapped in a blanket and handed to a nurse to wash. 

After it has been properly washed and thoroughly dried, a piece of 
raw cotton, or cotton batting the size of the palm of the hand, should be 
laid on the abdomen just above the naval, the remnant of the cord laid 
on it with its cut end pointing upward— the cotton being arranged so as 
to embrace the base of the cord — and another piece of cotton of the same 
size placed over the cord, the whole being kept in place by the usual 
belly band. 



672 PREGNANCY 

THE ATTENTIONS TO THE WOMAN AFTER LABOR. 

After the child has been handed to the nurse, the next care of the 
attendant is to look after the delivery of the placenta (after-birth); until 
it is removed, and the uterus is firmly contracted there is more or less 
danger of flooding. In most cases, there is a short suppression of the 
pains immediately after the expulsion of the child, after which the pains 
return in a diminished degree, and the after-birth usually becomes 
detached, and either lies free in the vagina or is expelled without the 
vulva. If it should not be outside the vulva a very slight traction of the 
cord a little upward and outward, taking hold close up to the person, 
will be all that is necessary to disengage it, after which it should be care- 
fully scooped up and placed in a vessel ready for its reception. 

The woman should then be made comfortably dry, and a soft dry 
cloth should be applied to the vulva. She should then be straightened 
out a little in bed, and in all respects made as comfortable as possible, 
both mind and body must be kept in a state of perfect repose ; every- 
thing which may tend to arouse the excitability of the patient, such as 
talking, noise, strong light, and odor must be carefully avoided, and the 
room kept at a moderate temperature. 

GENERAL. MANAGEMENT, DIET, ETC. 

In the first place, we would most severely disapprove of administering 
stimulating, and even spirituous beverages after delivery, which, far from 
possessing a strengthening property, tend only to excite the whole nerv- 
ous system. As a usual thing, for some time after parturition, nature 
calls for but little nourishment; it should be given only, and when the 
woman herself, expressly feels the need of it, and then let her partake of 
such nourishment as she particularly craves, (unless it should consist of 
rich meats, pastries, and vegetables which create gasses in the stomach 
and bowels ;) however, we must allow nature to pursue her own course, 
which, as a general thing, prescribes but little nourishment for the 
first five or six days after delivery, and thereby avoids the necessary call- 
ing of the bowels into action, which state of constipation (if it may be so 
called) is ordained for the wisest purpose, and attended with the most 
beneficial results ; the balance of the system is kept up by the passing ofT 
of effete matter in the shape of increased perspiration, etc. 

Then we cannot sufficiently condemn the use of physics, which only 
tend to promote irritation, and occasionally aid in bringing on puerperal 
fever and other evil consequences. In many cases, this artificial relax- 
ation, also, interferes with the proper secretion of milk. After the fourth 
or sixth day, nature generally acts spontaneously. When it appears neces- 
sary to afford mechanical assistance, we may do so by application of 
warm friction to the abdomen, or the employment of a lavement as 
directed to evacuate the bowels before confinement. When a costive 
state of the bowels continues so long as to cause inconvenience, the 
appropriate medicine may be selected and administered according to the 
directions for constipation of pregnant females. 

AFTER FAINS. 

These pains, which frequently annoy the patient so much, especially 
if she be of highly nervous sensibility, and deprive her of the necessary 



AFTER PAINS— FLOODING— RETENTION OF URINE. 673 

rest, ought, under such circumstances, to be subdued as soon as possible ; 
by means of the following- remedies, good results will certainly follow. 

TREATMENT. Arnica employed internally, and also externally as 
a lotion, when there is a sore feeling all through the patient, as if from a 
bruise. The pains are not very severe, but there is a bruised, sore feeling, 
with pressure on the bladder, and retention of urine. 

Dose: Internal. Six pilte every two hours, commencing immedi- 
ately after the delivery. * Application — externally. To four table- 
spoonfuls of tepid water add fifteen drops of the concentrated Tinc- 
ture of Arnica, and apply to the parts. 

Chamomilla should be administered an hour after the second dose 
of Arnica when the after pains still continue to a severe extent, and the 
patient is highly excitable and sensitive. It is sometimes beneficial to 
alternate the two. 

Dose: Six pills repeated if necessary after the lapse of an hour from 
the first dose, then pause three hours and so on. 

Nux-vomica should be employed when the after pains are very 
severe and there is a continual inclination to relieve the bowels when 
lying down, but passing away when rising, accompanied by inclination to 
cramp in different parts of the body. 

Dose: As directed for Chamomilla. 

Pulsatilla is to be preferred when the pains are protracted and the 
patient is of a mild, tearful disposition, but sensitive and easily alarmed 
about herself; the pains become worse towards evening. 

Dose : Six pills as directed for Chamomilla. 

Secale is indicated in feeble, thin and delicate women when the 
pains are more particularly of a pressing or forcing nature, similar to 
labor pains. 

Dose: As directed for Chamomilla. . 



FLOODING. 



With respect to the treatment of flooding or excessive aischarge of 
blood as incidental to delivery, it will require exactly the same medical and 
general treatment as is given in the article on miscarriage, page 642. It is 
to be remembered, however, that while in flooding after labor at /«# term, 
the application of cold to the abdomen is allowable in severe cases, while 
the tampon or plug is not to be resorted to. It may be mentioned, in addi 
tion, that pressure made upon the womb through the relaxed walls by 
clasping it with one or both hands equally and forcibly, but yet gently 
and without roughness, very frequently arrests the hemorrhage with 
great promptness. Injections of water as hot as can be borne, continued 
for some time, will produce the same good results. 



RETENTION OF URINE— SPASM OF THE BLADDER. 

During the passage of the child's head out of the womb, it is sometimes 
pressed against the bladder with so much force, that it causes an inflam- 
mation and irritation of this organ. The best remedy is Arnica. Next 
to Arnica, Cantharis, or Nux. Vom. 

43 



674 PREGNANCY. 

Dose : Four pills every half hour, especially if the urine passes off 

drop by drop, and the discharge causes pain. 
It may be well to apply warm cloths or other warm applications to 
the parts, for the warmth will have a relaxing tendency. 

INCONTINENCE OF URINE. 

An incapability of retaining the urine is, on the other hand, another 
not unusual sequel of protracted or severe labor. 

TREATMENT. The employment of Arnica, internally and exter- 
nally, as advised under the head of "After Pains" at page 650, is in the 
majority of cases, sufficient to overcome this weakness. When it fails to 
accomplish this object, the following remedies should be had recourse to: 

Pulsatilla is frequently successful in remedying the defect in from 
two to four days. 

Dose: Six globules three times a day, for two days. 

Belladonna may be given, if, in one or two days after the last 
dose of the foregoing medicine has been given, only partial relief has 
ensued. 

Dose : As directed for Pulsatilla. 



DURATION OF CONFINEMENT. 

Strict attention should be paid to cleanliness and ventilation of the 
lying-in chamber. Everything that produces an offensive odor should be 
promptly removed from the room, and a draught of air should be allowed 
to pass through the room (not, however, across the patient's bed). The 
parts should be bathed daily with lukewarm water so long as the dis- 
charge continues: this should be performed under the bed-clothes. 

The patient should make no exertion during the first three or four 
days, or at least until the proper secretion of milk ; after that time, she 
may be carefully moved from the bed to a couch, long enough for the bed 
to be aired a little. After the tenth day she may sit up out of bed, for a 
short time if she is able, which may be lengthened gradually from day 
to day, as she gains strength. Thus, too, she may begin to walk, little by 
little until she gradually grows stronger and more accustomed to exer- 
cise. In summer, she may ride out during the third week; and in win- 
ter, during the fourth week, all things being favorable. 



CHAPTER XXXII. 



DISEASES FOLLOWING CONFINEMENT. 



SECRETION OF MILK. 
This is one of the most interesting and remarkable changes occurring 
during the lying-in period. While the child is still in the uterus, all 
that pertains to the mother unites to effect its nourishment, growth and 
development there. Suddenly all this is interrupted, the child is 
expelled from the little world within, and has to find nourishment else- 



SECRETION OF MILK. 675 

where. Nature intends it to be supplied, as before ,from'the maternal blood, 
though through the medium of mammary glands. The reaction upon the 
organism, from this change from the uterus to the breast, causes what is 
called milk fever, in consequence of which there results a disturbance in 
the system, more or less well marked, according to the obstacles to be 
overcome. 

In some cases appears chills, fevers, headaches, and a great variety of 
pains and suffering; while in others this period is passed without any of 
the above mentioned disturbances. As a general thing, all the disturb- 
ances incident to the coming of the milk, are less when the child is 
applied to the breast as soon after delivery as is practicable. Much advan- 
tage is gained both to the mother and child, by this method, since it 
serves to lessen the suffering of one from hunger, and the danger of the 
other from fever. 

SUPPRESSION OR SCANTY SECRETION OF THE MILK. 

It is of vast importance that the natural operations of the organism 
peculiar to this condition proceed with regularity. Among these, the 
secretion of milk takes a prominent position, and its sudden suppression 
is apt to be followed by internal and local inflammation, flow of blood to 
the head, hot and cold flashes, etc. The use of the following remedies 
should be employed according to their indications. 

TREATMENT. JPulsatill i should be promptly employed in cases of 
sudden suppression of the secretion of milk, whatever cause has occa- 
sioned it ; and this medicine will frequently be found sufficient to restore 
the natural flow of milk. 

Dose : Four pills repeated every four hours (or every eight, in very 
mild cases) until change. 

Bryonia is to be preferred when there is oppression at the chest or 
stitching pains in the chest or side, or more particularly if the suppres- 
sion can be traced to some sudden mental emotion, or to catching cold. 

Dose : As for Pulsatilla, 

Chamomilla should be selected, if the patient be particularly irri- 
table and excitable, and the suppression be followed by intense flushing 
of heat or burning heat of the hands and face, either with crimson flush 
or alternate flushing and paleness, or one cheek red and the other pale. 

Dose : As for Pulsatilla. 

Belladonna should be given in cases in which the suppression is 
characterized by redness of the face, and general symptoms of congestion 
of the head, breasts feel heavy and appear red, and the redness running 
in streaks over them ; sensitiveness to noise, light, or touch. 

Dose : As for Pulsatilla. 

Aconite should be given if active feverish symptoms, such as hot, 
dry skin set in, and, under such circumstances, will remove the whole 
disordered condition with promptitude. 

Dose: Four pills every two hours. 



EXCESSIVE SECRETION OF THE MILK— GALACTOR- 
RHEA. 

Occasionally, on the other hand, it happens that too abundant a secre- 
tion takes place, causing distention of the breasts with spontaneous flow 



676 DISEASES FOLLOWING CONFINEMENT. 

of milk, keeping the breasts constantly wet. Eelief from such an uncom- 
fortable state may be obtained by the appropriate remedy according to 
the indications below. The function of lactation being one purely physi' 
ological, and provided for in the economy of suitable forces. Under the stim* 
ulus of maternal instinct and affection most women enjoy perfect health 
during its continuance. Many, indeed, are never so well as when giving 
suck to their children. Under the influence of this process, there arises a 
greater activity of all the functions at the same time, and, also, a greater 
strength of appetite, and corresponding energy of the digestive powers. 
The process of conversion of food is unusually rapid, the excess going 
to form milk. Where a greater amount is thus formed than is required, 
the system becomes gradually exhausted, even in health. This over-pro- 
duction may be due simply to excess of vitality, while it may result from 
the efforts of nature to supply the required material support, even under 
diffculties. The following remedies will be found beneficial, as the indi- 
cations appear : 

TREATMENT. Aconite may be taken as a precautionary measure 
when there is high febrile action of the whole system, and we are igno- 
rant of the exciting cause. 

Dose: Take four globules repeated at intervals of four hours, until 
the frequency of the pulse is diminished and the skin becomes 
moist. 

Rhus-tox. frequently proves of much service where febrile symp- 
toms arise from distention of the breasts, induced by an excessive secre- 
tion, and indications of what is generally termed milk fever (which, how- 
ever, frequently arises from other causes). 

Dose: Three globules every six hours until amelioration or change. 

Calcarea Carb. should be employed in cases in which excessive 
distention of the breasts, spontaneous emission of milk and loss of flesh 
occur without any marked and active fever symptoms— or after the pre- 
vious employment of Aconite or Rhus, when the fever symptoms have 
been allayed. 

Dose: Six pills as directed for Rhus. 

Phosphorus is of especial value in cases of this kind, when there are 
marked signs of a tendency to consumption, and emaciation takes place 
rapidly. Phosphorus is yet further indicated when there are sensations 
as of a rush of blood, with oppression at the chest, and sometimes even 
short, dry, hacking cough. 

Dose : Three pills as directed for Rhus. 



PERSPIRATION AFTER DELIVERY. 

The increased perspiration which takes place after child-birth, is as 
before mentioned, a substitute for the suspended action of the alimentary 
canal, consequently its sudden suppression is unavoidably followed by 
an injurious result, and not unfrequently followed by fever. 

Exciting Causes. Exposure to cold, or a sudden chill, or applying 
damp linen or clothing not well aired, are the most frequent causes. 

TREATMENT. Dulcamara should be promptly administered when 
the perspiration has been checked by a chill, and in such cases a single 



EXCESSIVE PERSPIRATION— MILK FEVER. 677 

dose will often restore the action of the skin, and prevent further injuri- 
ous consequences. 

Dose: Four pills repeated, if there be a degree of effect after the lapse 
of three hours, but if no evident reaction^should have occurred, pro- 
ceed with the next remedy. 

Bryonia is to be administered when extreme oppression at the chest 
is present, or when there is a feeling of soreness and aching in all the 
limbs aggravated by movement. 

Dose: As directed for Dulcamara, 

Sulphur should be employed after the foregoing medicines, in cases 
in which such treatment is insufficient, and there is more especially 
intense heat of the skin and distress. 

Dose : As directed for Dulcamara. 



EXCESSIVE PEBSPIBATIOX. 

On the other hand, an excessive perspiration is equally as harmful ; 
it is chiefly injurious from the extreme debility and high susceptibility 
of taking cold which it occasions. It is generally brought about by keep- 
ing the room at too high a temperature, the use of too many bed-clothes, 
or by stimulating beverages. 

TREATMENT. Our first care should be the removal of the exciting 
causes, after which, if it still continues excessive, the following remedies 
may be employed. 

China should be employed if the perspiration be of an exhausting 
character and attended with great debility. 

Dose: Six globules every three hours. 

Acidum Sulphuricum is to be preferred when the perspiration is 
excessively profuse when lying still, but is diminished when moving 
about. 

Dose : As directed for China. 



MILK FEVEJR. 



The secretion of milk is considered an operation of nature and not 
one that requires medical aid for its regulation ; but occasionally 
suffer some slight uneasiness for a few days following confinement; and 
when any of the below mentioned group of symptoms present them- 
selves, the affection is known by the name of Milk Fever. 

Symptoms. Shiverings and heat terminating in perspiration; the 
pulse is at first weak, changing to various phases, (sometimes quick and 
frequent,) at others soft and regular ; and in some instances the symp- 
toms are attended with a drawing pain in the back, extending to the 
breast, a disagreeable taste in the mouth, thirst, oppressive breathing, 
anxiety, headache, etc. 

Exciting Causes— are neglecting to put the infant to the breast 
sufficiently early, which allows the absorption of the milk into the cir- 
culation, mental emotions, fright or anger, and excessive talking. 

TREATMENT. Nature herself, if not disturbed by improper treat- 
ment, will, in most cases, suffice to restore the equilibrium of the system ; 



678 DISEASES FOLLOWING CONFINEMENT. 

should the affection become aggravated we may dread the setting in of 
puerperal fever. 

Aconite must be employed in all instances where considerable fever 
is present, and will usually remove all the symptoms. 

Dose : Give four globules repeated after the lapse of three hours if 
necessary. 

Pulsatilla will be found particularly useful in severe cases, espe- 
cially when caused by taking cold, and appearing more like a rheumatic 
affection and have the general symptoms of milk fever. 

Dose: As directed for Aconite. 

Belladonna is very useful in particular cases in which complications 
with very severe disturbance of the brain, or when inflammatory action 
in the breast may supervene. 

Dose: Three globules repeated at intervals of four hours, until a 
degree of improvement sets in, and then at intervals of six hours. 

Rhus, is also of considerable service when extreme fullness, tension 
and painfulness of the breasts, with excessive secretion of milk, attend 
the case. 

Dose: As directed for Belladonna. 



CHILD-BED FETEB—BUEBPEBAL FEVEB. 

This trouble is of so grave a nature that it is with reluctance that we 
approach the subj ect . Where it is at all possible, we would advise a skilled 
physician to be employed. As this work, however, will enter some home 
where no physician can be procured, it has been thought judicious to 
treat the disease at sufficient length to be available in cases of emergency. 

Symptoms. This disease assumes various types and degrees, and has 
received various names. Usually the disease begins on the second, third, 
or fourth day, although in some cases it even appears later, as late even as 
the eighth or ninth. It sometimes begins with a distinct chill, and again, 
there may be only slight chilliness, imperfect and merely noticed. The 
pulse is very rapid, full and soft. In some cases there is neither pain, 
distention nor tenderness of the abdomen ; while in others, the pain is 
very acute, the distention enormous, and the tenderness exquisites 

Profuse sweating is a very common and distressing accompaniment 
of this disorder; the sweating of puerperal fever does not diminish the 
amount of urine, nor abate the quickness of the pulse. An intolerable 
thirst prevails, and the patient drinks immense quantities of whatever 
fluid she may be allowed. Dark spots appear on the wrists or other parts 
of the body. 

At first, the lochia may be unaffected ; they may be even increased 
in quantity, but more commonly they are entirely suppressed. As the 
disease advances, usually about the third day, diarrhoea and vomiting may 
supervene. The patient becomes listless and languid, losing all interest 
in surrounding circumstances, and even in her child, and the expression 
of her face indicates anxiety and great prostration ; or, on the other hand, 
she may be unduly excited, nervous and tremulous. If the disease 
progresses in spite of treatment, delirium commonly supervenes. 
Rattling of the breathing, with enormous distention of the abdomen, are 
usually regarded as fatal symptoms. 



CHILD-BED FEVER. 679 

As the disease advances, the womb, the peritonium and other organs, 
and tissues of the abdomen become involved in the prevailing inflamma- 
tion. The first symptoms of this disease are similar to those of "milk 
fever," but the distinction is to be made by the fact of absence of pain, 
and, more particularly by absence of tenderness in the abdomen. 

Causes. This disease may result in consequence of a chill occasioned 
by a draught of air, or other cause, or from the use of damp or wet linens, 
or it may be occasioned by violence; or again, it may be impossible to 
assign any reason for its occurrence ; in which case we are led to believe 
that it is due to infection, or arises in consequence of some lurking taint 
or predisposition of the system. 

TREATMENT. Aconite should be employed, at first being indicated 
by the feeble condition, and by other circumstances; and will in very 
many instances, when promptly administered, particularly in those cases 
of a more simple form, serve to dissipate the entire disordered condition, 
and restore harmony to the system in an almost magical manner. 

Dose: Give four globules every hour, 01 half hour, according to the 
severity of the symptoms. If, at the end of twelve hours, the symp- 
toms have abated, the intervals may be extended two or three 
hours. 

Belladonna should be administered when the pain is violent and 
cramp-like, coming on suddenly and ceasing as suddenly, with swelling 
of the abdomen ; or the pains are forcing, as if the contents of the abdo- 
men would be forced out ; sensitiveness of the belly to the touch, she cannot 
even bear the jar of the bed ; redness of the face and eyes; headache; dry 
mouth with red tongue; sleeplessness and restiveness ; delirious; suppress- 
sion of the lochia or escape of red and fetid blood ; the breasts are red 
and inflamed, or swollen and empty. 

Dose; As directed for Aconitum. 

Hyoscyamus may be used in some cases of a similar nature to that 
indicative of Belladonna, but where the disease has been developed, by 
mental emotions, and is characterized by spasmodic symptoms, jerks and 
twitches, delirium, throwing off of the bed-clothes, and desire to be uncov- 
ered, etc., it is more particularly indicated. 

Dose : As for Aconite. 

Bryonia will be found useful in cases in which the abdomen is 
swollen equally and is sensitive to the touch; violent splitting headache 
the pains are aggravated by the slightest motion; sitting up, or even rais- 
ing the head, causes nausea and fainting; great thirst with desire for cold 
drinks ; the patient is irritable or restless, and apprehensive as to the 
results of her sickness. 

Dose : As for Aconite. 

Jlhus-tox, is suitable when the fever is of a low typhus grade ; the 
patient is very restless, constantly tossing about. The lochia is again 
tinged with blood, or clots of blood are discharged ; aching soreness and 
stiffness of the limbs ; the tongue is red. 

Dose : As for Aconite. 

Mercurius is indicated by dejected expression of countenance ; great 
thirst; constant flow of saliva; lancinating, boring or pressive pains in the 
belly ; profuse sweat which does no relieve; mucous or bloody diarrhoea or 



680 DISEASES FOLLOWING CONFINEMENT. 

ineffectual desire for stool ; very offensive wind ; the symptoms are usually 
aggravated at night. 

Dose: Give six pills every two hours until improvement or change. 

Nux-vomica is suitable at the commencement, when the lochia has 
been suddenly arrested by some mental emotion, such as vexation; fre- 
quent desire to urinate, with pain, scalding, and burning; heaviness and 
burning in the abdomen ; pain in the small of the back, worse in the morn- 
ing; frequent and effectual in urging to stool ; despondency ; sleeplessness or 
else dreaming frightful dreams ; the symptoms are usually aggravated 
early in the morning. 

Dose : As directed for Mercurius. 

Colocynth will be found valuable when the abdomen is greatly dis- 
tended, and the pains are unbearable, being of a sharp, cutting or lancin- 
ating character, which cause the patient to draw the thighs up as close to 
the belly as possible ; diarrhoea with colicky pains aggravated-or excited by 
eating or drinking. 

Dose : As for Aconite. 

Cham,omilla is useful for cases in which the breasts are flaccid and 
without milk: diarrhoea, pains in the abdomen like pains of labor; general 
heat with redness of the face, or one cheek is red, and the other is not ; 
great agitation, impatience and nervous irritability. 

Dose: As for Mercurius. 

Arsenicum will prove valuable when there are great anguish; sudden 
prostration; sunken countenance, with a sallow complexion; extreme 
restlessness, and anguish with fear of death ; sleeplessness ; dry and par- 
ched lips; great thirst with desire to drink but little at a time; burning 
heat in the abdomen ; feeble and intermittent pulse, with coldness and 
desire to be covered. 

Dose : As for Aconite. 

Secale is good where there is strong tendency to putrify ; the dis- 
charge is pus-like and offensive. 

Dose: As directed for Mercurius. 

Diet and Regimen. The most absolute repose of mind and body 
should be secured; all noise should be shut out, the room darkened and a 
moderate temperature maintained; the room should be well ventilated, so 
as to have the air changed without admitting a cold draught. Purification 
of all aliment must be enforced, and the thirst allayed by small quantities 
of cold water, which should be iced in summer, or when vomiting is pres- 
ent. If the lochia is suppressed, flannels wrung out of warm water may 
be applied to the external genitals, or a tepid injection may be thrown into 
the rectum, if there be great constipation ; but it must be a small quantity, 
that the bowels may not be much disturbed. The infant should be removed 
and fed on cow's milk and water until the patient is out of danger. 



LOCHIAL DISCHARGE AND IRREGULARITIES. 

By the detachment of the placenta from the inner sides of the womb, 
the blood vessels are left open, and for some days after confinement, 
discharge blood; in six to eight days this changes to serum, and finally to 
a white purulent mucus. This is the lochial discharge. In most cases it 
lasts from two to three, while in others, it continues several weeks. In 



LOCHIAL DISCHARGE— DIARRHG3A. 681 

cases where it becomes suppressed suddenly, it needs medical attention, 
also when profuse and long continued. 

Causes. Profuse and protracted lochial discharge may be frequently 
traced to sitting up too soon after confinement, or to keeping the room too 
warm, or to mental emotions. 

TREATMENT. If, after nine days, the discharge continues profuse, 
containing pure blood, whereby an unnatural state is indicated, one or 
more of the following medicines may be required: 

FOR EXCESSIVE DISCHARGE. 

Bryonia is to be preferred when the discharge is of a deep red color, 
and is attended with internal burning pain, in the region of the womb. 

Dose : Six globules, three times a day. 

Nux Vomica is usually required when a chill or the use of stimulants 
has produced the mischief, and the patient is affected with severe pains in 
the back, and a constant and fruitless urging to stool, 

Dose : As for Bryonia, 

Calcarea is most particularly indicated when troublesome itching of 
the parts is experienced ; or when the discharge is protracted, and occurs 
in women of full habit. 

Dose ; As directed for Bryonia. 

Silicea should be employed when pure blood flows with the lochial 
discharge every time the infant is placed at the breast. 

Dose : As directed for Bryonia. 

SUPPRESSED DISCHARGE. 

Pulsatilla. When the lochial discharge is suddenly suppressed— 
which it sometimes is from a variety of causes— and from this cause puer- 
peral fever threatens to ensue, the danger may frequently be warded 
ofFby the administration of this medicine. 

Dose: Four pills every four hours. 

Aconite will generally suffice if promptly administered when the 
sudden suppression is caused by fright, and is attended with febrile symp- 
toms. 

Dose: Four globules every hour until relief. 

Dulcamara will be found beneficial when the suppression is caused 
by exposure to damp or cold. 

Dose: As for Pulsatilla. 

Belladonna. Where sudden suppression is followed by congestion 
of the brain, with flushed face, delirium, etc. 

Dose: As for Aconite. 

OFFENSIVE DISCHARGE. 

Carbo-veg. should be administered, if the discharge becomes thin, 
and offensive. 

Dose: Six pills four times a day. 

Kreosote or Secale should be given twelve hours after the sixth 
dose of Carbo-veg., if the discharge should still continue offensive. 

Dose : As for Carbo-veg. 



DIARRHOEA OF LYING-IN WOMEN. 

Diarrhoea at this time is to be looked upon as a serious occurrence and 
immediate means must be employed for its correction by proper remedies. 



682 DISEASES FOLLOWING CONFINEMENT. 

Dulcamara is generally indicated by the cause of the trouble being 
a check of the naturally increased perspiration from a chill. 

Dose : Four globules administered every three hours. 

Phos. Acid is most effectual for the treatment of painless and almost 
involuntary evacuation. 

Dose : As directed for Dulcamara. 

Antimonium-crud. f is generally sufficient when the evacuations 
are thin, watery and offensive. The tongue is coated white. 

Dose : As for Dulcamara. 

Rheum is to be preferred in cases which, in addition to the indica- 
tions afforded for the last-named remedy. The evacuations and the body 
emit a sour smell. 

Dose: As for Dulcamara. 

Phosphorus should be employed in very obstinate cases, when the 
discharge is watery and almost painless. 

Dose : As for Dulcamara. 

Veratrum should be given if the discharges are very profuse and 
watery, attended with much pain, chilliness, coldness of the surface and 
cold sweat on the face. 

Dose : As for Dulcamara. 

For cases in which neither of the medicines above mentioned have 
the desired effect, consult the article on " Diarrhoea " page 261. 



WEAKNESS AFTER DELIVERY. 

We frequently find our patient very weak after delivery, especially if 
there has been considerable loss of blood, for which the following remedies 
will prove effectual. 

TREATMENT. China ranks first of all and will generally be found 
efficient in restoring the vital energies; especially when there has been 
considerable loss of blood, or very profuse sweating. 

Dose: Give six pills every three hours for the first two days, after 
that give twice daily. 

Aconite should generally be given at first when there is nervous 
weakness, attended with great restlessness and want of sleep. 

Dose : As for China. 

Sepia. This remedy is indicated when there is a painful sensation 
of emptiness at the pit of the stomach. Icy coldness of the feet and hands; 
the urine deposits a very hard crusty sediment; flushes of heat and loss of 
appetite. 

Dose: Six pills once in six hours. 

Sulphur. Weak fainting spells coming frequently during the day; 
feels very faint and weak from eleven to twelve every morning ; flushes 
of heat; cold feet; heat on top of the head. 



ABDOMINAL DEFORMITY. PENDULOUS ABDOMEN. 

Abdominal deformity is more common to those women who have 
borne many children, or to those who present a disposition to corpulency. 
It may be caused by wearing tight stays, which have a tendency to relax 



SORE NIPPLES— INFLAMMATION OF THE BREASTS. 683 

the abdominal muscles, and increase the existing disposition to this affec- 
tion ; or it may take place in consequence of a strain upon the muscles of 
the belly during pregnancy. 

ACCESSORY MEASURES. 

An elastic bandage laced at the back, and exerting an equal pressure 
over the whole of the abdomen may be worn with advantage. In some 
cases where there is a tendency to this affection, particularly in corpulent 
persons, we may, soon after delivery, have recourse to mechanical aid by 
transferring the support of the abdominal muscles to the shoulder, by the 
aid of properly constructed apparatus ; but we must, in the strongest man- 
ner, object to this, or any other pressure being exercised upon the abdom- 
inal region during pregnancy, as such a measure is obviously calculated 
to entail injurious consequences upon the offspring. 

Diet and Regimen. Spare diet and regular exercise must, in all 
cases, be observed. 

SORE NIPPLES. 

In a previous chapter I have shown the necessity of preparing the nip- 
ples for their new function. In spite of all care, however, the nipples 
sometimes become sore three, four or six days after confinement, especially 
if the skin is very fine and delicate. This is a most distressing affection, 
because of the cracks opening whenever the child takes hold to suck. If 
the nipples are too short, the shield before mentioned should be worn 
between the interval of nursing. In case, however, the nipples should be 
insufficient, or their tenderness remain, in spite of treatment, nursing 
may yet be accomplished by using a proper shield, or artificial teat, 
numerous and excellent varieties of which may be procured. It is well 
to bathe the nipples with warm water and milk, or with borax water, 
as soon as the babe is done nursing, being sure to wash the breasts as 
soon as it is ready to nurse again. 

Arnica employed internal and externally. This remedy will very 
often obviate all further inconvenience, if used at the onset. 

Dose. (Internal). Four pills three times daily. Application (exter- 
nal). To a half teacupful of water add fifteen drops of concen- 
trated Tincture of Arnica with which a small strip of linen may be 
wet and applied to the nipple, this may be repeated three times aday. 

Chamomilla. The nipples are much inflamed, and are very tender, 
she can hardly endure the pain of nursing; she feels irritable and cross 
with impatience. 

Dose: Four pills three times daily. 

Sulphur should be given, if after nursing the nipples smart and 
burn badly ; they chap badly about the base and bleed. 

Dose: Six pills night and morning. 



INFLAMMATION OF THE BREASTS. 

One of the greatest obstacles to nursing an infant is inflammation of 
the breasts. The breasts become red and inflamed, occasionally suppur- 
ating in some parts which open, and discharge, while others still remain 
hard, and inflamed, which either end in suppuration, or in the formation 
of hard lumps. 



684 DISEASES FOLLOWING CONFINEMENT. 

Causes which produce this disorder are numerous. Anything which 
may operate as an exciting cause to disturb the local secretion, such as 
fright, passion, cold, etc; though it not unfrequently arises without being 
able to trace it to any particular origin. Inflammation of the breasts fre- 
quently arises from not applying the infant to the breast soon enough 
after its birth; and occasionally from a sudden cessation of suckling, 
caused by the death of the infant, or from disinclination of the child to 
suck, or from other reasons. 

When the milk is copiously secreted, and either from inability on the 
part of the child, or from the obstruction of the milk tubes, or from 
deficiency of the nipple, the milk cannot be freely drawn in the natural 
way, every effort should be made, without loss of time, to secure this end 
by such other means as may be possible. Sometimes the breast may be 
drawn by another child, or by a friend, or by young puppies. The proper 
remedy should be selected, and faithfully administered in order, as rapidly 
as possible, to remove all difficulty. In cold weather the breast should 
be warmly protected. If the inflammation is caused and kept up by a 
tender and ulcerated state of the nipples, let these be particularly atten- 
ded to, in accordance with the directions already given. (For particulars 
see Mastitis, pages 624-626). 

TREATMENT. Aconite. When a chill in dry cold air has been the 
exciting cause, and there is high fever prevailing. There is fear, anxiety, 
and restlessness, thirst for cold water, etc. 

Dose: Six pills every hour until the fever moderates. 

Belladonna. When the breasts feel heavy; there are red streaks 
running like radii from a central point; she is occasionally chilly, a dull 
and stupid feeling prevails. It is well to alternate Aconite with this 
remedy. 

Dose : Four pills every two hours. 

Bryonia. Her breasts have a stony heaviness in them, they are hot, 
hard and painful, but not very red. She feels sick when first sitting up 
in a chair, and still more sick on standing up, rough dry lips, thirst, and 
constipation, stools dry looking as if burnt, she feels worse when moving, 
and wishes to keep still. 

Dose ' As for Belladonna. 

Phosphorus. Inflammation of the breasts, threatening ulceration 
with cutting or stitching pain. Hectic fever and night sweats, deep ulcers 
with blue appearance. 

Dose: Six pills every six hours.. 

Sulphur. The inflammation runs in streaks from the nipple, suppu- 
ration profuse, with chilliness in the fore part of the day, and heat in the 
after part. Sometimes piles in complication. The breasts feel hot. She has 
night sweats, flushes, or heat, weak and faint spells, irresistible hunger at 

11 A. M. 

Dose : Six pills every twelve hours. 

Another treatment of gathered breasts, which has never been known 
to fail, if employed as soon as threatened, is this: take of Chloroform and 
G-lycerine equal parts. As the substances are of unequal weight, the vial 
containing them should be thoroughly shaken, the mixture quickly applied, 
and the part covered with oiled silk, or something equally impermeable, 
to prevent too rapid evaporation. 



PART FOTJR-TEEIVTIl 

TREATMENT CF INFANTS. 

.+. 

CHAPTER XXXIII, 



TREATMENT AFTER BIRTH. 

As soon as the child is born, it should be wrapped in a soft woolen 
cloth, it first being warmed, as care should be taken to gradually inure the 
infant to the temperature of the surrounding atmosphere. The skin should 
then be gently washed with a little warm water; or it may be annointed 
with lard, using a little fine toilet or castile soap in the water with which 
it is washed, but care must be used in the first washing, less it should get 
chilled. It is best only to wash part of the body at a time, keeping the 
other parts protected. After washing, the skin ought to be dried immedi- 
ately to avoid the risk of taking cold. The child should be bathed every- 
day, gradually lowering the temperature of the water after weaning. The 
best time for bathing is in the morning, soon after being taken out of the 
bed. 

I wish I could impress every mother with the importance of dressing 
their infants in a more suitable manner. The practice of bandaging and 
swathing the tender bodies of their infants, and loading them with a 
superfluity of clothing, which, by its weight and length, presses upon the 
lower extremities, and is frequently the cause of deformity and weakness 
in after life, and moreover causes rupture of both navel and groin. 



STILL-BORN CHILDREN— S USPENDED ANIMATION. 

Causes. In many cases this arises from diflicult parturition, pressure of 
the cord around the child's neck, natural debility arising from some scrofu- 
lous or syphilitic taint of either or both of the parents ; or from accumula- 
tion of mucus in the nose and throat; or, if delivered with forceps, it might 
be caused by an injury from them; or again, it is caused by too sudden 
alteration of temperature, the action of the lungs not having commenced. 

TREATMENT. From whatever cause the apparent death or suspen- 
ded animation of the child should result, no time should be lost in making 
proper efforts to establish respiration. 

Mechanical Means to be employed, is to immerse the child sud- 
denly into cold water, or better still, cold or even iced water should be 
poured over it. In some, apparently lifeless children, pouring cold water 
on the head and letting it run down over the body, establishes the circula- 

685 



686 TREATMENT OF INFANTS. 

tion and respiration ; the child should then be wrapped in woolen blankets 
UEttil quite restored. Of course, in all those cases where the breathing is 
prevented by an accumulation of mucus in the throat and nose, such 
measures should be employed as to remove such obstructions. Should 
these methods fail, the one of which a description may be found in the 
article on "Apparent Death from Suffocation," will have to be resorted 
to. Should this method fail, the lungs may be directly rilled and respira- 
tion may be excited by an adult placing his or her mouth directly over the 
mouth of the child, closing the child's nostrils between the thumb and 
forefinger of his hand and blowing air into the child's lungs, and, when 
filled, by gradually and carefully compressing the walls of the chest, 
emptying the lungs again. This should be repeated again not oftener 
than from ten to fifteen times a minute. This artificial respiration, and 
all other methods employed to restore suspended animation, should be 
persevered in for some time, life having returned after the lapse of an 
hour from judicious and careful treatment. 

Medicinal Treatment. If the child should still continue to 
breathe feebly and imperfectly after animation has been restored, the fol- 
lowing remedies may be resorted to. 

Aconite if the child is warm, purple-hued, pulseless, and breathless or 
nearly so. 

Dose : Two pills on the infant's tongue. 

belladonna. The face is very red and the eyeballs are greatly in- 
jected. 

Dose : As for Aconite. 

China if the face is pale, the infant small and of a delicate frame and 
in cases where the mother has had profuse hemorrhage. 

Dose . As for Aconite. 

Opium is good if improvement takes place slowly and the face is livid 
and bluish. 

Dose : As for Aconite. 



SWELLING OE THE HEAD. 

Immediately after birth the head of the infant appears more or less 
swollen ; this in most cases is but a trifling affection, and will disappear of 
itself; medicinal treatment may sometimes be required. 

Arnica or Rhus, will usually be sufficient to hasten the swelling to 
subside; when it is very extensive, it is necessary to resort to external 
application of the same remedies. 

Dose: Two pills repeated again in twelve hours. 

Application, (external) : To four tablespoonf uls of water add six drops 
of the tincture, and apply this lotion to the part, repeating the oper- 
ation after the lapse of twelve hours. 

If there should result an ichorous discharge and caries of the bone 
and prostration. 

Calcarea will in many cases produce a cure. 

Dose : Two pills every second day. 

Silicea is useful, if the trouble yields slowly to Calcarea, to finish the 
cure. 

Dose: Two pills as for Calcarea. 



RUPTURE IN INFANTS— PROPER TIME FOR SUCKLING. 687 

RUPTURE IN INFANTS. NAVAL RUPTURE. 

Hernia or rupture may be developed before birth and a predisposition 
to this affection may be observed in children whose parents are similarly 
affected. The mechanical treatment of naval rupture is as follows: — 
Take a piece of lint or soft cloth just large enough, when folded five or six 
times, to cover the rupture effectually, then press in the protrusion and 
keep it reduced with the hand, until the compress is rightly adjusted 
and secured in its position by means of two strips of adhesive plaster 
placed over the compress in the form of a cross. 

Another compress may be made by taking a button-mould about an 
inch or an inch and a quarter in diameter and cover it with a piece of soft 
linen ; apply and secure it the same as the before mentioned compress, or 
by a bandage made of suitable form to secure it properly. 

This disease being frequently brought on by violent fits of crying, to 
which delicate children are subject, the bandage may be worn for some 
time after the cure, as a precautionary measure against its return. 

It is best to administer a remedy or remedies in order to assist the 
mechanical measure, and in nearly every case whether subsequent treat- 
ment be required or not. 

Nux-vomica may be looked upon as a medicine of primary import- 
ance. 

Dose : Two pills every morning and evening. 

Aconite. This remedy is suitable when the infant feels hot and is 
restless; in that case it is best to give it in alternation with the Nux. 

Dose: Two pills in alternation with the Nux every six hours. 

Chamomilla is sometimes of service; more particularly when the 
infant is very fretful and the motions of the bowels be too relaxed and of 
an unhealthy color, or if there be evidence of griping in the bowels. 

Dose : As for Nux. 

Sulphur is also of great service after any of the previous remedies 
in obstinate cases when there has been partial improvement, but the 
treatment prescribed has been insufficient to complete the cure. It is also 
good for the treatment of soreness of the navel, remaining after the liga- 
ture has fallen off, or even before this takes place. 

Dose : As for Nux. 

Silicea should be given four days after the fourth dose of Sulphur, in 
cases of soreness of the navel in which no decided improvement has been 
effected by the last named.medicine. 

Dose: As for Nux. 

RUPTURE IN THE GROIN. 

All the remedies just enumerated are just as good in those cases of 
rupture in the groin, which are occasionally met with. 



WHEN MAY THE CHILD BE PUT TO THE BREAST. 

Even before delivery the breasts secrete a milky fluid ; the genuine 
milk is only secreted after delivery. In some instances it has been the 
custom to draw off this first milk and feed the child in the meantime on 
catnip tea or chamomile tea, cracker water, or thin soup, etc. Nothing 



688 TREATMENT OF INFANTS. 

can be more irrational or inhuman. Nothing is more calculated to expel 
the meconium (the excrementitious matter discharged from the bowels 
of a new born infant), than the first milk, which has a slightly loosening 
effect upon the child's bowels. It is evident that nature has designed 
it so, else, why should the milk be secreted and the child created with 
a desire to suck as soon as born ? 

After having a few hours rest, the mother may take a little nourish- 
ment, if she should desire it. After this, the child may be put to the 
breast; if the mother should feel rested before, and the child should desire. 
it can nurse before, and at all events do not let more than twelve hours 
elapse before letting the child nurse. If the child was born in the 
evening or night, it need not be put to the breast before morning, espec- 
ially if the mother sleeps ; often both mother and child sleep till morning, 
but if it should wake and become restless, it may be fed on a few tea- 
spoonfuls of water and milk, of equal parts, sweetened. 



OBSERVATIONS ON THE SUCKLING OF THE INFANT. 

Conquist, whose opinion in this respect we perfectly indorse, in his 
"Outlines of Midwifery," remarks: 

"Unless very peculiar urgent reasons prohibit, a mother should sup- 
port her infant upon the milk she herself secretes. It is the dictate of 
reason, of nature, and of common sense. Were it otherwise, it is not 
probable that so abundant a supply of suitable food would be provided to 
meet the wants of an infant when it enters upon a new course of existence. 

It is difficult to estimate the mischief resulting from infants being 
deprived of their natural nourishment; for, however near the resem- 
blance may be between food artificially prepared and breast milk, 
still reason and observation demonstrate the superiority of the latter to 
the former. 

As a further inducement it should be remembered that medical men 
concur in the opinion, that very rarely does a constitution suffer from 
secreting milk; whilst the health of many a woman is most materially 
improved by the performance of the duties of a nurse. 

Presuming that the laudable determination is formed to indulge the 
child with that nutriment which is designed for its support, it becomes 
necessary to state that unless very strong objections should exist, twelve 
hours should never elapse before the infant has been put to the breast. 
Instinct directs it what to do, and the advantages of allowing it to suck 
soon after birth are many and important, both to the mother and the child. 
By this commendable practice, the patient is generally .preserved from 
fever, from inflamed and broken breasts, and from the distressing and 
alarming consequences resulting from those complaints. 

If the breasts should not have secreted milk previous to delivery, the 
act of suckling will encourage and expedite the secretion. Thus the 
mother will be saved from much of the pain connected with distended 
breasts, besides which, if the infant be not put to the nipple until the 
breasts become full and tense, the nipple itself will sometimes almost dis- 
appear on account of its being stretched, and without much and effectual 



THE CHOICE OF A NURSE— DIET DURING NURSING. 689 

labor on the part of the child, it cannot be laid hold of; and. even then the 
pain endured by the mother ; s exquisitely severe, and not unfrequently the 
cause of sore nipples." 



THE CHOICE OF A NURSE. 

For those who cannot give suck to their own children, the selection of 
a nurse is of great importance, and the medical attendant ought generally 
to be consulted, and the following points merit particular attention: 

She should be of sound constitution and of good health, of full and 
moderate plumpness, with a fresh complexion, and clear eyelids, free from 
any appearance of redness, scurfiness or thickening. She should be thor- 
oughly exempt from glandular enlargements, and possess deep red lips 
without cracks, sound white teeth, and well formed, moderately firm 
breasts, with nipples free from excoriation or appearance of eruptions; the 
child of the nurse is one of the bestcriterions to judge by — its being plump 
and healthy is a great point in her favor. We should also endeavor to discover 
if she is free from any hereditary taint; she should, moreover, be of a mild, 
patient and equable temper, not irritable, or disposed to fits of passion, or 
nervous ; of regular and temperate habits, and fond of children. She ought 
also to be about the same age, and to have been delivered about the same 
time, or, at least, within three months of the same period as the mother; 
with respect to age, we must, of course, avoid extremes. A woman, hav- 
ing given birth to a child very late in life, should choose a nurse several 
years her junior, and fully qualified for her duties; the reverse of the rule 
applies to extremely young mothers. 



DIET DURING NURSING. 

As regards the nurse's diet, it should be simple and easily digested, 
and she ought to live upon a proper proportion of animal and vegetable 
food. Nature generally provides for the increased call upon her powers by 
suppression of the menstrual discharge, and a moderate increase of appetite, 
which may be safely indulged ; but all food of a highly concentrated, 
heavy description, is injurious, causing the milk to become unsuited to the 
delicate digestion of the infant; the best guide, in the majority of cases, is 
the regular Homcepathic regimen, which may be consulted with advan- 
tage. Reference must, however, be had to constitution; thus, a strong 
woman of full habit will not require much animal food, and will have, 
generally speaking, a plentiful supply of good milk, if she drink nothing 
but gruel, barley water, toast water, cocoa, tea, etc,; whilst, on the other 
hand, a woman of somewhat delicate constitution and languid circulation, 
will want more nourishing food, milk, etc. 

But we cannot too strongly repudiate that too prevalent but deeply 
erroneous idea that women, during the period of sucking, necessarily 
require stimulants to keep up their strength ; under these impressions, 
both wine and malt liquors— and, among the latter, more particularly porter 
— are frequently resorted to. Porter is not only injurious, from its stimu- 
lating properties, but the deleterious effect which the different ingredients 
composing it produce upon the milk, forms one of the most prolific causes of 

44 



690 TREATMENT OF INFANTS. 

the many evils. that attack infancy. We shall conclude this part of the sub- 
ject with a single quotation from a well-known medical writer: 

" There is an evil too generally prevalent, and most pernicious in its 
consequences on individuals and society, and by no means confined to 
mothers in the lowest classes of the community, which cannot be too 
severely reprobated ; it is the wretched habit of taking wine or spirits to 
remove the languor present during pregnancy and suckling. It is a practice 
fraught with double mischief, being detrimental both to mother and 
child. The relief afforded is temporary, and is invariably followed by a 
degree of languor which demands a powerful stimulus, which at length 
weakens, and eventually destroyes the tone of the stomach, deteriorates 
the milk, and renders it altogether unfit to supply that nutriment which is 
essential to the existence and welfare of the child." 



SUPPLEMENTARY DIET OF INFANTS. 

Unfortunately, some mothers do not possess sufficient milk for the 
proper nourishment of their offspring ; if this arises merely from a defi- 
ciency in the secretion, and the woman is in other respects healthy,we must 
have recourse to supplementary diet to make up for the diminished quan- 
tity of the natural nutriment. Goat's, ass's, and cow's milk are excellent 
substitutes, especially the latter, diluted with one-third of water; goat's 
milk being apparently objectionable from its peculiar aroma. The milk, 
therefore, of the cow ought, when possible, to be obtained, and, if given 
undiluted, to be boiled,— cow's milk being generally considered too heavy, 
which boiling in a great measure obviates; it ought also to be slightly 
sweetened, so as to resemble as closely as possible that of the nurse, and 
should, moreover, be about the same temperature, say from ninety-six to 
ninety-eight degrees,— a point less regarded than it should be, and easily 
determinable by the thermometer. If any constitutional taint exists in 
the mother, the sooner the child is transferred to another breast, the bet- 
ter for both parties ; and if a nurse be not procurable, the above will gen- 
erally prove sufficient nourishment until the front teeth appear, which is a 
clear indication that the digestive organs are prepared for more solid food ; 
if, however, the milk diet appears to disagree with the infant, wemay give 
thin water gruel, or mix a little thin arrow-root, rusk, or well tosted bread 
in water, to which the milk may be afterwards added ; such alterations in 
diet are, however, but rarely required. 

We may here observe, that no portion of the milk ought to be retained 
for a subsequent meal, from the quickness with which it becomes sour; 
the same remark applies to any of the above preparations, in which milk 
forms the principal ingredient. 

In the cow's milk, at first diluted as above described, we may, after two 
or three weeks, gradually diminish the quantity of the water, as the 
digestive organs become stronger; but we cannot too stringently press 
the point, that, where it is at all practicable, the child ought to derive as 
great a portion of its nutriment as possible from the breast, no food 
being able efficiently to supply the place of that which nature intended 
for it at its birth. 

When it is necessary to give supplementary nourishment, a sucking- 
bottle ought to be used, as the best imitation of nature, in giving the 



DURATION OF SUCKLING— WEANING. C91 

food slowly ; particular care being taken to observe the utmost cleanli- 
ness. The child ought, in feeding, to be kept in a reclining, not supine 
position, as the latter frequently causes it to incur the risk of suffocation ; 
and when it evinces disinclination to its food, no more should be offered. 

The child should be accustomed to take its nourishment from each 
breast alternately ; as, if this precaution be not adopted, inflammation is 
likely to arise in the breast not used, and the child is apt to become 
crooked from being always retained in the same position. 

The physician is frequently asked how often the child ought to be 
applied to the breast; the best rule on this point, is, to give the breast 
when the infant desires it, and to withdraw it when the child appears 
satisfied. As the infant increases in strength, it may be easily accustomed 
to regular hours. It should not be permitted to " lie at the breasts " dur- 
ing the night ; which is a most pernicious practice for both mother and 
child. 



DURATION OF SUCKLING— WEANING. 

The period of suckling ought seldom to last longer than forty weeks ; 
but in this we must be guided, in a great measure, by the constitution of 
the infant; weak, ill-conditioned children, in whom teeth are long in 
making their appearance, it has been recommended to continue at the 
breasts for eighteen months or even a longer period. Weaning ought, in 
fact, to be regulated by the constitution both of mother and child. 
The full development of the front teeth, wmick in healthy children is 
from nine to ten months, but in delicate and scrofulous constitutions, is 
delayed for several months later, has been considered the best indi 
cation of weaning; but this is by no means an unexceptionable rule 
If the strength of the mother appears unequal to the task, and the supply 
of milk begins to fall off, the child may be gradually weaned, even before 
the teeth appear; still, even when the supply is ample, and the mother 
and child are apparently strong, a continuance of suckling beyond the 
tentli month is generally injurious alike to parent and child. 

Weaning should not take place suddenly, but the infant should be 
gradually accustomed to other food, and a less frequent administration of 
the breast, until entirely weaned; the time to commence this grad- 
ual course, is upon the first appearance of the front teeth, so that the 
weaning may terminate with their full development; thereby the 
secretion lessens by degrees, preventing all evil consequences of swollen 
or inflamed breasts, and the child, also becomes quietly reconciled to the 
deprivation. 

Weaning ought not, however, to take place, if the child suffers con- 
siderably from the irritation of teething, or any acute infantile disease. 

When, however, it is found absolutely necessary to wean, the above 
precautionary measures should be observed, both with respect to the 
mother and child. 

FOOD OF THE INFANT. 

After the child has been weaned, its nourishment should generally 
consist of the same simple food as before mentioned. The transition to a 
more substantial diet ought to be extremely gradual and guarded, and no 
material alteration made until after the appearance of the eye-teeth. 



692 TREATMENT OF INFANTS. 

SLEEP— SLEEPLESSNESS. 

From the inability of the infant itself to maintain a proper degree of 
warmth, it should sleep by its mother's or nurse's side, for at least the 
first six weeks, particularly during winter or early spring. Care must be 
taken not to overburden it with bedclothes, and to place it in such a posi- 
tion as to prevent it slipping under them, and thereby becoming exposed 
to the risk of breathing a vitiated atmosphere, or even of suffocation ,- 
after six or eight weeks, when the organism becomes stronger, and able 
to preserve a proper degree of natural warmth, a separate bed or cradle 
will be more conducive to the health of the infant; this change of 
arrangement will be found beneficial to both parties— to the child, from 
its breathing a purer air; and the mother, being freed from the necessary 
watchfulness and restlessness consequent upon the child sleeping with 
her, will enjoy better health, and be more likely to secrete good and 
nutritious milk. Moreover, sleeping in the same bed with an adult, and 
particularly with an old person, is somewhat detrimental to the health, 
not only of infants, but even of children. 

As to the length of sleep allowed to the infants, the chief business of the 
first months of its existance being sleep and nourishment, we may safely 
leave the point to nature, and not attempt to coerce the inclinations of 
the child; if the infant is lively on waking, we may conclude it has not 
slept too much ; and as it increases in vigor, and is able to endure longer 
intervals of wakefullness, we may proceed (recollecting that night is the 
proper period for sleep,) so to regulate its habits of taking its food and 
rest, as to accustom it to an uniform system, and particular hours. Chil- 
dren, up to two years of age, require rest during the day, and the nurse 
ought to endeavor to get them into the habit of taking it in the forenoon ; 
for, if it be taken in the afternoon, it generally interferes with the night's 
sleep. Whether by night or day, we must carefully exclude both light 
and noise from the nursery; for although they may be insufficient to 
arouse the infant, still they cause its sleep to be disturbed and unrefresh- 
ing, and, by acting upon the nervous sensibility, predispose the child to 
convulsions or spasmodic attacks from slight accidental causes. 

It is true that, during the first month, the infant sleeps immediately 
on leaving the breast, and no evil consequences ensue; but it must be 
borne in mind, that it takes but a little at a time, and milk is at that time 
wisely adapted to its delicate digestion ; but as the secretion becomes 
richer, and suited to the increasing power of those organs, it is injurious 
to put the child asleep immediately after a full meal, for its rest is then 
unquiet and disturbed, from the process of digestion being interfered with, 
more particularly when the nurse foolishly endeavors to force nature, by 
resorting to the baneful practice of rocking. 

Nothing causes greater annoyance and even anxiety to the mother, 
than a disposition to wakefulness on the part of her infant. A healthy 
child should always be prepared for its rest at the usual hours; if, instead 
of going to sleep, it appears restless, fretful, and disinclined for its accus^ 
tomed rest, it is an evident indication of some derangement of the child'* 
general health; frequently, through ignorance, nurses, instead of attend' 
ing to this warning voice of nature, which, by the sleeplessness of the 
infant demands appropriate relief, endeavor to stifle it, and sometimes, t<i 



EXERCISE. (>93 

free themselves from a little temporary annoyance, administer opiates, 
often in the form of "carminatives,'' " soothing syrups," which induce 
an unrefreshing slumber, and not imfrequently a deep stupor, mistaken 
for sleep, while the original evil still continues to make head against the 
vital power. This baneful practice has not only been the ruin of many 
constitutions in after life, but to it, conjoined with improper diet, stimu- 
lating or unwholesome drinks, quack medicines, together with the highly 
erroneous practice of a frequent administration of laxatives, in infant 
maladies, a considerable number of diseases and even deaths are annually 
attributable. Every mother should' not only caution her nurse against 
the use of opiates, but use her utmost vigilance to detect any breach of 
her injunctions, which should be visited with the immediate discharge of 
the person so offending; for she must be truly unfitted for such an impor- 
tant trust, who, after being warned of its injurious tendency, will perse- 
vere in a practice placing in jeopardy the life of her infant charge. 

TREATMENT. Amongst the homoeopathic remedies which have 
been found the more generally useful in removing restlessness and sleep- 
lessness in children, the subjoined deserve especial notice. 

Coffea is very efficacious when the child seems unusually lively, 
restless and wakeful; but will commonly fail to answer its purpose when 
the nurse is in the daily habit of taking coffee as a beverage. 

Boss: Two globules, dry, at night and morning. 

Opium may be substituted for Coffea when the nurse is in the daily 
habit of taking coffee, and is especially indicated if the face of the child 
looks red. 

Dose : As for Coffea. 

Chamomilla will do good when the child is tormented with flatu- 
lence, and distention of the bowels, and appears to suffer from colic, indi- 
cated by drawing up the legs, screaming, etc. 

Dose : As for Coffea. 

Aconitum is preferable to any of the preceding, when there is gene- 
ral febrile heat and great restlessness. 

Dose: Two globules, dry, on the tongue, three times each day. 

ADDITIONAL PARTICULARS. 

The reader should further consult, if necessary, the general article on 
44 Sleeplessness," and that on " Crying, Wakefulness, and Colic of Infants," 
in the subsequent pages. 



EXERCISE. 

For the first six or seven months the great business of natureseems to 
be the proper development of the infant frame, and particularly of the 
respiratory and digestive organs. During this period, also, the cartilage 
is gradually forming into bone, and the infant's delicate muscles are 
acquiring power and strength. We find, however, that consciousness is 
yet indistinct, and the infant evinces no anxiety to indulge in voluntary 
motion, the muscles of the neck and back not possessing sufficient power 
to support the head, or to keep the body in an erect position ; for this 
reason, children during this period, should, when carried in the arms, be 
kept in a reclining position, so as to avoid an undue pressure upon the 



694 TREATMENT OF INFANTS. 

spinal column ; a neglect of this precaution, and a premature carrying of 
the infant in an upright position, is a too frequent cause of deformities of 
the spine, and derangement of the functions in after life. 

As its powers gradually develop, the infant seems inclined to exercise 
them, and evinces a desire to sit upright, which we may safely indulge, 
taking care not to overtask its strength by keeping it sitting up during 
the greater part of the time it is awake. A careful attention to nature in 
this, as in all other cases is the best guide. 

The practice of dandling the child in an upright position, seems rather 
to proceed from the pleasure of indulging the feeling of parental affection, 
than from any benefit the child can, by any possibility, be expected to 
derive from it; in fact, it is highly injurious, even at a rather more 
advanced period, as exciting a premature involuntary exercise of the mus- 
cles, and consequent deformity. The act of respiration bringing into play 
a great variety of muscles, occasional crying seems sufficiently active exer- 
cise during this period. 

In mild spring and summer weather, the child may, under favoring 
circumstances, after the first fortnight has elapsed, be carried out into 
the air for a quarter of an hour at a time, and the period of exercise grad- 
ually increased ; in fact, if the weather be fine, it can scarcely be too much 
in the open air. Should its birth occur in winter, advantage may be 
taken of a fine day, after itisamonth or five weeksold,asthe frame is grad- 
ually acquiring the power of generating heat; but, at the same time, great 
care must be taken to prevent its catching cold; and should the child 
exhibit the slightest sign of being affected by the atmosphere, the practice 
of carrying it out of doors should be immediately discontinued, and it 
should be carried up and down in a well ventilated room, the nurse mov- 
ing it quietly in her arms from side to side. Many children are lost through 
a foolish idea of making them hardy, by acustoming them to endure cold ; 
this can occur only through ignorance; for nature, in very early infancy, 
does not possess sufficient energy of reaction to overcome the power of a 
sudden or long-continued chill. We may recommend an occasional gen- 
tle friction of the hand over the body and limbs, which materially assists 
in the promotion of the circulation of the blood, and will, in unfavorable 
weather, serve, in some measure, as a substitute for exercising the infant 
out of doors. 

The practice of assisting children to walk, or of exciting them to a 
premature exercise of their powers, is highly reprehensible, causing, in 
many cases, curvature of the limbs, the bones not yet being sufficiently 
formed to bear the burden imposed upon them. By allowing nature to 
act, the infant's power will become more gradually, but at the same time 
more fully developed; its carriage will be more firm and erect, and its 
limbs straight and well formed; moreover, it will walk with greater con- 
fidence and independence, by the expiration of the first year, than those 
who have been taught to walk by the assistance of the nurse, leading 
strings, or mechanical inventions. 



RETARDED STRENGTH OF THE LIMBS. 
TREATMENT. Calcarea carb. is, in the majority of cases, the 
appropriate medicine when the child continues to be feeble, and any 



INFLAMMATION OF THE EYES. 695 

attempt to walk, or the capability of sustaining an erect position, is 
unduly procrastinated. 

Dose: Two globules every morning, the first thing, for four days 
(unless some condition requiring other treatment should sooner 
arise); then pause eight days, after which repeat the course as before; 
then pause again for three weeks, and repeat the course once more. 
But if within three weeks after completion of the third course, no 
very apparent change should have taken place, consider the following 
medicines. 
Silicea or Sulphur may be required after the previous employment 
of Calcarea, when the last named medicine has been productive of no very 
apparent improvement, more particularly if the child manifests a gener- 
ally feeble or scrofulous habit, and is affected with enlargement of joints 
or tendency to curvature of the bones, or rickety affections. 

Dose: Of the remedy selected, give two globules, as directed for Cal- 
carea, 



CHAPTER XXXIV. 



DISEASES OF INFANCY. 



INFLAMMATION OF THE EYES— OPHTHALMIA. 



Newborn infants and older children are subject to purulent ophthal- 
mia, or inflammation of the eyes. This disorder is always more or les3 
serious, for, unless speedily cured, the inflammation may result in ulcera- 
tion, and the contents of the eye-balls be discharged, causing permanent 
deformity as well as hopeless blindness. 

The first indication of the disease is, generally, the eyelids becoming 
glued together during sleep, with redness and swelling externally. 

The Causes are sudden exposure to the light of day, to cold, or the glare 
of a lamp or fires. Many cases of inflammation of the eyes occur in babes 
whose mothers are affected with leucorrhoea, therefore we must conclude a 
discharge from the genitals of the mother is a very frequent cause of 
opthalmia in newborn infants; or it is sometimes epidemic; and no doubt 
many children who are what is commonly called " born blind," owe their 
misfortune to the neglect of proper precaution, in many cases the exter- 
nal indications of this affection being so slight as to escape observation. 
For additional particulars see page 16S. 

TREATMENT. Aconite should be administered as soon as we become 
aware of the existence of this evil; a few doses will generally be found 
sufficient to subdue this affection in all mild cases. 

Dose: Two pills every four hours. 

Belladonna. The eyes look very red ; cannot bear the light; open- 
ing the eyes only when in a dark place. This remedy is good to alternate 
with Aconite. 

Dose: As for Aconite. 



696 DISEASES OF INFANCY. 

Sulphur, There are pimples, more or less over the body; the eyes 
seem to itch very much. This remedy should be selected when we have 
reason to suppose the constitution of one or both of the parents is affected. 
A little breast milk applied to the affected eyes of an infant often affords 
speedy relief. 

Dose: Two pills repeated every twelve hours. 



HICCUF. 

This affection, though in itself of slight importance, frequently causes 
a considerable degree of uneasiness to the young mother. It generally 
arises from exposure of the body, even in a warm room, to the atmo- 
spheric air, even during the operation of dressing and undressing the new- 
born child. 

Wrapping the infant warm in bed, or better still, applying it to the 
breast will generally lead to a cessation of the affection ; should it, how- 
ever, continue, the administration of a small quantity of white sugar, as 
much as will cover the end of a teaspoon, dissolved in a teaspoon ful of 
water will frequently effectually remove the evil. 

Nux-vomica. Two pills placed in the mouth of the infant will 
arrest the trouble, if the other advice should fail. 

ALLOPATHIC TREATMENT. Hiccup is generally relieved by a 
sudden arrest of the attention, as by a reproof or a sudden expression of 
great surprise. Hot cloths wrung out of warm or hot water may be con- 
tinually applied, or a mustard and flaxseed poultice laid over the region 
of the diaphragm. The common internal remedies are cold water, snow, 
pounded ice, or ice cream. Anodyne and antispasmodic drugs are useful 
in this, as in other coughs. A combination of Chloral, Bromide of Potas- 
sium with or without an opiate, is generally effectual. Take of Hydrate 
of Chloral and Bromide of Potassium and Bicarbonate of Potash one scruple. 
Paregoric two drams. Peppermint Water sufficient to make two ounces. 
Mix. 

Dose: A teaspoon half full, to a dessertspoonful every two or three 
hours. Obstinate cases will require professional advice. 



SNUFFLES, OR COLD IN THE HEAD-COBYZA, 

Snuffles, or cold in the head is one of the earliest and most common 
affections of the young infant. It consists of an inflammation of the 
mucous lining of the nose. The first that is known of it is, that the 
infant's nose is stopped up so as to hinder its breathing, hindering it in 
the action of sucking, by not allowing the breath to pass through the nos- 
trils, obliging the infant to release the nipple in order to breathe, causing 
it to become fretful and irritable 

While this state continues, it has its influence against the infant's 
thriving, both by hindering it from taking a sufficient amount of nour- 
ishment, and by annoying the breathing of the child so as to disturb its 
sleep. When the nose is dry while administering a remedy, to remove 
the evil, relief may be obtained by oiling the nose on the outside and by 



COLIC OF INFANTS. C97 

using a feather or camel's hair pencil on the inside. Fresh lard, goose 
grease, cream, or a little'breast milk will often afford grateful relief. 

TREATMENT. Aconite. This remedy, if administered at first wheir 
there are febrile indications, will often cut short an attack of coryza. 

Dose: Two globules every two hours. 

Nux. The trouble is worse at night, particularly toward morning o/ 
in the morning. Through the night the nose is very dry. 

Dose: As for Aconite. 

Euphrasia. Profuse, fluent discharge and acrid discharge from thf 
eyes ; the eyes are much involved. 

Dose : As for Aconite. 

Chamomilla. Where there is watery or mucus discharge; the 
child is quieted by carrying it up and down the room. One cheek red 
the other pale. 

Dose : As for Aconite. 

Pulsatilla is indicated by thick, green or yellow bloody matter, like 
discharge from the nose attended with frequent sneezing. Worse towards 
evening. 

Dose: As for Aconite. 

ALLOPATHIC TREATMENT. Cold in the head generally require? 
but little more than maintaining an equal temperature for a few days, 
when it naturally subsides. It is necessary to keep the nostrils open 
that the child may nurse. 

For this purpose, the nostrils may be moistened with Glycerine applied 
with a camel's hair pencil. Nurses are in the habit of provoking sneez' 
ing by dropping milk into the nostril, so clearing it out. and smearing 
the nose with Olive or Almond Oil. A very useful application when the 
discharge tends to continue, is Tannin fifteen grains, Fluid Extract of 
Belladonna twenty drops, Glycerine two drams. Mix, and apply with a 
camel's hair pencil two to four times a day after first cleansing the nos- 
tril with a camel's hair brush and warm water. If the discharge is offen- 
sive, a solution of one or two grains of Permanganate of Potash to th8 
ounce should be used to cleanse the nostril. In chronic cases, the above 
mixture of Tannin may be used alternately with the dry powder or a 
solution of Alum, five grains to the ounce, may be employed. 

If the disease depends on scrofula, the following mixture may be 
given : Take of Iodide of Potassium sixteen grains, Pyrophosphate of 
Iron ten grains, water sufficient to make a solution, Syrup of Peppermint 
suffi/:ient to make two ounces . Mix. 

Dose: A teaspoon half full, to a teaspoon ful, three times a day. Or 
three to five drops of the syrup of the Iodide of Iron may be given. 



CRYING AND WAKEFULNESS OF NEW BORN INFANTS- 

COLIC. 

Occasional crying of new born children is a wise provision to bring 
the respiratory organs into play, and to expand the chest. When, how- 
ever, the crying becomes excessive and threatens to prove injurious, we 
must, in the first place, endeavor to discover its origin, which will fre- 
quently be found in some derangement in the infant's dress, a wet diaper 



698 DISEASES OF INFANCY. 

or tight bandage, or perhaps it may feel thirsty and would like to be 
refreshed by a little cold water. Care and love will easily detect the 
cause of the child's cries, and a good, true mother will scarce ever lose her 
patience at such times. Sleeplessness is often caused by similar circum- 
stances; the children sometimes lie with their heads too high, or they 
are too warm, or they are sometimes affected by nursing their mother 
when she is in a nervous and excited condition ; all these things must 
be considered. 

TREATMENT. Belladonna will frequently be found sufficient to 
remove the evil, when no exciting cause or guiding symptoms of disease 
present themselves, and the infant is peevish and irritable, affected with 
incessant whimpering and wakefulness, or prolonged fits of crying. The 
infant's face looks somewhat flushed. 

Dose: Two pills every three hours until relief or change. 

Chamomilla is of very great service, when the child appears to have 
griping pain (colic,) indicated by drawing up the limbs, contortions of the 
body and face; or when there is a yellowish, greenish watery discharge 
from the bowels, the child wants to be carried all the time. 

Dose : As for Belladonna. 

Coffei cruda will generally prove beneficial, when the child is 
exceedingly wakeful and bright, may be somewhat fretful or not. 

Dose : As for Belladonna . 

Aconite should be employed when there is, in addition to the above 
mentioned symptoms, considerable dry heat of the skin, with extreme 
restlessness. 

Dose : As for Belladonna. 

Nux-vomica will usually succeed in restoring ease, when flatulent 
colic, accompanied with violent fits of crying, drawing up of the legs 
and a costive state of the bowels, appears to be the cause of the disturb- 
ance. 

Dose : As directed for Belladonna. 

Pulsatilla is very suitable when the derangement arises from over- 
loading the stomach, or improper food, and the crying, or wakefulness, 
is accompanied with colic, wind and diarrhoea of stools, with no two that 
look alike. 

Dose : As for Belladonna. 

ALLOPATHIC TREATMENT. Crying, when not dependant on hun- 
ger, fright, willfulness, or peevishness, is generally dependent on dyspeptic 
colic. These are loud and may be long. 

Whimpering, moaning, painful cries, depend on inflammatory or 
exhausting diseases. The smothered cry depends on true or false croup. 
The treatment, therefore, will have reference to the causitive conditions. 
The use of soothing syrups is not free from danger, as they contain a 
secret amount of Morphine, which is an unsafe drug to give to children, 
Simple restlessness may be relieved by two to five-grain doses of Bromide 
of Potassium dissolved in syrup. 

When necessary to give an anodyne, it is best to give Paregoric ; the 
doses of which is on the printed label, suited to the age. It can be given 
with the Bromide of Potassium, or an equal amount of Tincture of Hyos- 



VOMITING OF MILK. 699 

cyamus. But rather than by any drugs, should relief be obtained by 
correcting whatever derangement causes the crying. 

Colic may be temporarily relieved by a dose of Paregoric suited to the 
age, given at suitable intervals of from half an hour to longer intervals, 
until the pain is relieved. Warm cloths or poultices, over the abdomen 
are useful. The principal treatment consists in correcting the derange- 
ment of the stomach and bowels. Irritation from unsuitable milk is a 
frequent cause, as is noticed at the period of menstruation during lacta- 
tion ; the occurrence of another pregnancy, violent mental emotions, hard 
exhausting labor, errors of diet, or some other causes which render the 
breast milk unsuitable. These causes suggest their own change. If the 
amount or quality of the breast milk is insufficient, the trouble will be 
relieved by proper artificial feeding. An excess of acidity in the stomach, 
as shown by sour eructations (belchings) sour and greenish stools, scat- 
tered, sometimes, with lumps of undigested material, call for alkalies 
sufficient to correct these symptoms. The best is Bicarbonate of Soda 
in doses of one or two grains, or teaspoonful doses of Lime Water, given 
often enough to correct the sourness (acidity). Two to five grain doses 
of Pepsin, with an equal quantity of Bismuth may be given three or four 
times a day. 

The regulation of the diet to the exact wants of the system is the most 
important part of the treatment. This will have to be accomplished 
somewhat by experiment. The milk for artificial, as tested by litmus 
paper, should be alkaline, and not used until sufficient Lime Water or 
Soda is added to make it so. It should be perfectly fresh, and kept on ice 
to prevent any decomposition (souring.) or if this is impossible, and it can- 
not be freshly milked each time it is used, scalding will help to keep it, 
and is in this case, permissible. 

The juice of lean meat may frequently be given, instead of milk, with 
advantage, or raw lean beef, chopped fine and ground in a mortar, and 
strained through a sieve, may be salted or sweetened and fed a teaspoon ful 
at a meal. It will frequently be digested when milk will not. 

In older children, the treatment will be the same for the relief of 
pain. If the irritating matter is not removed by a free, loose stool, a tea- 
spoonful or a dessertspoonful of Castor Oil (mixed with an equal quantity 
of inodorous Glycerine, and flavored with a couple of drops of Oil of Win- 
tergreen or Cinnamon, to make it palatable,) should be given. 



VOMITING OF MILK— SOUR STOMACH— FLATULENCE. 

The infant, the same as the adult, is subject to attacks of indigestion, 
and the disorder in the one case bears a certain similarity to that in the 
other. Though vomiting in every case is by no means the result of indi- 
gestion, for when the stomach is simply overloaded or rather overfilled, 
it relieves Itself of the excess by vomiting, and this act takes place with 
little effort and no suffering, the process of digestion still going on undis- 
turbed. 

When indigestion, colic, constipation or diarrhoea arises from impro- 
per food, in babies raised by hand— that is, from food which evidently 



700 DISEASES OF INFANCY. 

does not agree with the child's stomach— or even from unwholesome ma- 
ternal milk, we will frequently have to encounter many difficulties before 
we can select a suitable article of food that will agree with the delicate 
digestive apparatus of the babe. We should endeavor to make a good 
choice of food ; and if, having done so, we find that the choice has been a 
mistake, we should try again, not desparingly, but remembering always 
that what is one baby's food is another baby's poison. 

TREATMENT. Ipecac, There is much sickness of the stomach ; the 
more constant the nausea, the more certain will Ipecac relieve; the stools 
look fermented. 

Dose: Two pills, repeated after a lapse of four hours. 

Chamomilla, The child is very irritable and fretful, must be carried 
all the time; distress after nursing ; sleepless starting and jerking while 
asleep; stools smell like rotten eggs and are green, chopped, or -consist of 
white and yellow mucus. 

Dose : As for Ipecac. 

Arsenicum. The food is thrown up as soon as taken into the sto- 
mach, and passes off through the bowels undigested; the stools are offen- 
sive; much crying during and after nursing, or as soon as the child begins 
otake food. Emaciation and restlessness. 

Dose : As for Ipecac. 

Nuoc wim, is indicated when vomiting of milk is attended with flatu- 
lence, constipation, uneasiness or irritability of temper. 

Do ( e: As for Ipecac. 

Bryonia. Should be given the second dose of Nux after the lapse of 
four hours, if the symptoms mentioned in the last remedy have notentirely 
yielded to its action. 

Dose: As ion Ipecac. 

ALLOPATHIC TREATMENT. Flatus will be relieved by alkalies, 
given as above, and care regarding food. 

Vomiting, except as a symptom of serious disease, and not simply a 

regurgitation from over-distention, of the stomach, will be relieved by the 

ame means occurring from over-distention; the infant should be given a 

little less of that article of food at a time. With infants at the breast, it 

is generally of no consequence. 



FLATULENT DISTENTION OF THE STOMACH AND 

BOWELS. 

Gentle friction with the palm of the hand, which has been previously 
warmed, will often give grateful relief. It is best to begin at the lower 
right side of the bowels, passing the hand gently up the right side as high 
as the stomach, then across and down the left side and so on. At the same 
time the following remedies should be employed. 

Nux voni. should be employed at the onset for children of a spare, 
meagre habit, or who are more subject to a costive condition. 

Dose: One pill every two hours. 

Pulsatilla is to be preferred, if the children are of a relaxed habit or 
who are subject to discharge from the eyes and eyelids ; or particularly 
when diarrhoea is present. 



MILK CRUST.— MILK SCAB. 701 

Do.se : As directed for Nux. 

Chamomilla should be administered four hours after the third dose 
of Nux or Pulsatilla, if no permanent relief should have resulted; and 
more especially if convulsions or diarrhoea be developed as attendant 
symptoms. 

Do.se : As directed for Nux. 

Diet. The diet must, at the same, time be attended to and altered if 
of an indigestible nature and the suspected cause of the mischief. 



MILK CRUST.— CRUSTA LACTEA.—MILK SCAB. 

Description and Symptoms. This eruption occurs in children while 
nursing, and more commonly while teething, and appears to be very 
closely connected with that process. It commonly commences on the 
cheeks, and forehead, by the breaking out of a number of small yellowish 
pustules, (pimples) crowded together on a red surface. These pustules 
excite great itching, and are quickly broken, discharging a viscid fluid that 
dries, forming greenish-yellow scabs; the scabs are frequently rubbed off 
but form again; fresh crops of pustules appear around the scabs which 
quickly extend to the scalp, and even the^face. The eruption appears 
behind the ears, and patches will sometimes appear also, upon the neck and 
breast. The discharge from the pustules is caught by the hair upon the 
head, and forms into small irregular friable masses, which may resemble 
the bruised yolk of a hard boiled egg. The pustules or achores, as the small 
superficial ulcers which they form upon the skin are sometimes called, 
have an irregular form, contain a straw-colored fluid, rest upon an inflamed 
base, and are succeeded by a thin brown or yellowish scab. There is much 
irritation, heat and itching; the discharge is very profuse, and with so 
much itching that it is easily rubbed off, leaving the surface raw and 
excoriated. Whenever this discharge is brought in contact with the skin 
—in the face, where it trickles down on the breast, where it falls, and upon 
the backs of the hands, violently used by the child to rub with — it proves 
so acrid as to produce there a fresh eruption. The same is true even of the 
arms of the nurse upon which the child rests its head at night. The itch- 
ing and burning acridity of the eruption, and discharge are much worse at 
night. All external application should be avoided, with the exception of a 
little sweet cream or olive oil, which has sometimes proved very grateful. 
Everything should be carefully avoided which would have a tendency to 
drive this eruption in, since it might result in some more serious trouble. 

TREATMENT. Aconite should always commence our treatment, 
when we And excessive restlessness and excitability produced by this affec- 
tion, and when the skin around the parts is red, inflamed and itching. 

Dose: Two pills repeated every two hours. 

Viola Tricolor. As soon as the benficial effect has resulted from 
the administration of Aconite; and six hours after the last dose of that 
medicine, it will be well to proceed with the remedy under consideration, 
which, in the simple and uncomplicated form of the disease, is often suf- 
ficient to effect a cure. 

Dose: Two globules every night and morning. 

Calcarea. Eruptions, with thick scabs, and yellow pus-underneath. 



702 DISEASES OF INFANCY. 

Stools having a chalky appearance. Sometimes the eruption appears in 
the form of a ring-worm . 

Dose: Two globules every morning. 

Graphites should be given when a transparent, glutinous fluid 
exudes, which causes the crusts to fall off; the eruption appears more 
particularly on the chin and behind the ears ; emits a fetid odor, and 
itches intolerably. 

Dose: As directed for Viola Tricolor. 

Arsenicum is indicated when the eruption is very dry and scaly 
and causes destruction of the hair. 

Dose: As directed for Viola Tricolor. 

Hhus Tox. when the scalp is considerably affected ; thick scales ; a 
bright edge of inflammation surrounds every portion of the eruption, and 
there is much itching, particularly at night. 

Dose : As for Viola Tricolor. 

Sulphur when the eruption extends more or less over the whole 
body, with much itching ; although the main affection appears on the 
head. 

Dose : As directed for Calcarea. 

Sepia. Eruption very moist; almost constantly discharging pus- 
like matter. The child ofterfjerks its head to and fro, seemingly from 
the itching. 

Dose: Two pills every evening. 



APHTHM—THB, USH. 

The thrush often attacks the infant in the second week, and is char- 
acterized by the mouth and tongue being covered with minute whitish 
blisters, which are rubbed offby the action of sucking. A succession of 
these vesicles is constantly taking place as long as the disease lasts, and if 
not checked, becomes confluent and sometimes present an ulcerated 
appearance, or form a thin, white crust, which generally lines the whole 
cavity of the mouth, and in severe cases, extends to the throat, and even 
throughout the stomach and bowels. 

The affection, although of itself neither malignant nor dangerous 
frequently causes, not only considerable suffering to the child by prevent- 
ing it from suckling, but great pain and inconvenience to the mother by 
being communicated to the nipples and causing excoriations, etc. 

TREATMENT. Chamomilla. When the child exhibits much 
uneasiness, and must be carried all the time, this remedy will prove more 
beneficial. 

Dose : Two pills every three hours. 

Mercurius is to be recommended when there is more than usual 
moisture in the mouth. There is inflammation in the whole cavity of the 
mouth; the gums have ulcers on them. 

Dose: Two pills to be taken every four hours. 

Carbo veg. The mouth is very hot, the tongue almost immovable, 
and a sort of bloody saliva escapes occasionally. 

Dose : The same as for Mercurius. 

Sulphur. The child does not take its usually long sleep; it awakens 



CONSTIPATION. 70 5 

often and the same symptoms prevail, even after taking the other reme- 
dies. 

Dose : As for Mercurius. 

Bryonia. The mouth seems unusually dry with thirst; dry lips, 
rough and cracked; the child does not like to take hold of the breast, but 
when once in its mouth and moistened, and it is fairly at work, it nurses 
well. 

Dose: The same as for Cliamomilla. 

External. Application.— The mouth should be carefully washed 
after nursing, with a soft old linen rag dipped in tepid water, or in water 
containing a small quantity of Borax and Honey in solution. Pure molas- 
ses, applied by means of a piece of old linen or muslin, or by the finger, 
constitutes one of the best healing washes, where one seems to be needed. 

ALLOPATHIC TREATMENT. Thrush: A good digestion and regu- 
larity of the bowels, should be secured. The nourishment of the child is 
generally insufficient, so that in cases of weakly infants, additional feeding 
is necessary. A little new creamy milk, the juice of lean meat, or freely 
ground lean beef may be given. For local use, a wash of Lime Water, a 
solution of Chlorate of Potash or Borax is appropriate. 

If ulceration, occurs, the popular Golden Thread tea and Borax may be 
used. Sulphurous Acid two drams in an ounce of water, may be applied 
with a linen mop. Other remedies are given on page 201, in the 6 treatment 
Stomatitis. 



CONSTIPATION. 

Even very young infants are sometimes affected with constipation ; in 
fact, during the first two months of infantile life, constipation is frequent, 
while diarrhoea is comparatively rare. This may be occasioned by some 
hereditary predisposition, and be maintained by the constantly imparted 
influence of a costive habit on the part of t>he nursing mother. 

In the medical treatment of the constipation of infants, recourse must 
always be had to the cause. If this be found in the nursing mother, the 
proper remedies should first be administered to her. Should there be any- 
thing in her diet which may be capable of rendering either her or her 
child constipated, this should also be attended to. With scarcely a single 
exception, cases of costiveness in nursing infants will be found dependent 
upon the influence of diet, hereditary and constitutional weakness and 
inaction of the bowels or actual derangement of the liver. 

MECHANICAL MEASURES. 

Before proceeding to enumerate the remedies, we may observe that an 
injection (lavement) of tepid water, or of some milk and water, may occa- 
sionally .be used, if necessary, to remove the obstruction of feces; or, a 
suppository consisting of a small strip of paper or linen, spirally twisted 
and lubricated with oil, may be introduced by a gentle rotary movement. 
If these means should fail at first, they should be repeated after the lapse 
of a few hours. Rubbing the stomach and bowels frequently in the course 
of the day with a warm hand sometimes assists the means employed. In 
order to overcome the constitutional tendency, it will be well to use the 
appropriate remedies. 



704 DISEASES OF INFANCY. 

MEDICINAL MEANS. 

Nux vom., when the stools are large and difficult, or small, frequent 
and painful, with disturbed or restless sleep, frequent efforts to evacuate 
the stool without effect. 

Dose: In ordinary cases give two pills morning and evening for two 
days, then pause two days. 

Bryonia is suitable, if the stools are very dry, as if burnt, and of a 
dark color; dry lips and mouth, and there is alternation of constipation 
and diarrhoea. This is a good remedy to alternate with Nux vom. 

Dose: As for Nux vom., or when alternate with Nux vom , give Bryo- 
nia in the morning and Nux vom., in the evening. 

Calcarea carb., is to be preferred when the stools are of a whitish 
or a clay color. 

Dose : As for Nux vom. 

ALLOPATHIC TREATMENT. Constipation is best relieved by injec- 
tions of soap and water or cold water. I have known teaspoonful doses of 
Olive Oil to relieve constipation in infants without being followed again 
by constipation. Syrup of Rhubarb in doses of half a teaspoonful to a 
teaspoonful and a half may be used. Fluid Extract of Senna in doses of 
ten to thirty drops in syrup is generally an effectual remedy in constipa- 
tion. Change in the diet which will overcome costiveness is called for. 
To this end fruit is indicated. It may be raw or cooked. 

If hard feces have lodged in the rectum (lower bowel) which the injec. 
tions do notremove, they should be broken down by the finger or removed 
with the handle of a spoon. 

In older children free exercise should be taken ; in cities the systema- 
tic use of gymnastics may be useful. Cold wet packing of the abdomen 
often succeeds. Exercise and bathing and a diet with plenty of fruit will 
probably relieve. The Fluid Extract of Senna may be given, and for 
continued use Tincture of Nux Vomica and Belladonna will establish the 
habit of a regular stool. Take of Tincture of Nux Vomica and Tincture of 
Belladonna each two drams, Syrup of Orange Peel four drams. Mix. 

Dose: One to twenty drops once a day according to the age of the 

. child. 



DIAHHH(JEA OF INFANTS. 

Infantile diarrhoea constitutes one of the most frequent and serious of 
all diseases that occur in infancy and childhood. Of itself alone diarrhoea 
does not often prove directly fatal, but its long continuance seriously 
weakens the patient, and endangers the health, and it constitutes more- 
over a very grave complication of other forms of disease. 

Causes of diarrhoea are various ; the introduction into the stomach of in- 
appropriate indigestible food; the deranged condition of the mother's milk 
induced by mental emotions, improper diet, or other causes on the part of the 
mother ; fright and exposure of the infant to cold ; and the improper use 
of laxatives, etc., may be enumerated as being the most frequent exciting 
causes of this disorder. 

It is well to notice closely as to the symptoms. A healthy infant at 
the breast, passes on an average from three to six motions in twenty-four 
hours ; but in some instances the evacuations are more frequent, yet with- 
out in any degree affecting the health of the child ; in such cases then. 



DIARRHCEA OF INFANTS. 705 

there ought to be little or no interference, so long as the stools remain free 
from fetor, possessing merely the slightly acid smell, peculiar to unnatural 
indication. When, however, the stools become green, and watery, or 
yellow and watery, brown and frothy, as if fermented, mixed with phlegm 
or mucus, or consisting entirely of mucus, emit an offensive odor, and are 
generally preceded or accompanied by signs of suffering, it becomes neces- 
sary to have recourse to remedial aid. 

TREATMENT. Aconite should be employed when the skin is hot 
and dry ; and the child is restless ; stools watery and often of a dark color; 
after the fever has subsided the diarrhoea will usually disappear also. 

Dose: Give two pills every hour, until the fever abates, then gradu- 
ally lengthen the time. 

Antimonium crud. When the tongue is coated white, and there is 
some nausea and watery discharges ; sometimes there are hard lumps of 
feces with the water. 

Dose: Four pills every four hours. 

Chamomilla is almost indispensable in bowel complaints, when the 
following symptoms are present; redness of the face or of one cheek, 
hardness and fulness of the belly, attended by severe colic : constant cry- 
ing and drawing up of its legs, wants to be carried. Its discharges smell 
like rotten eggs. 

Dose : Two pills every two hours. 

Arsenicum is suitable when there is much exhaustion and rapid 
emaciation ; stools undigested, offensive, and painful immediately after 
taking nourishment; stools and vomiting at the same time. 

Dose : The same as for Chamomilla. 

Bryonia. Diarrhoea from hot weather, or is aggravated by the return 
of every hot spell of weather. 

Dose : The same as for Chamomilla. 

Calcarea Carb., is particularly suitable for children who have large 
heads and open fontanelles; the head perspires so much as to wet the pil- 
low far around. Muscles soft and flabby. 

Dose : As for Antimonium Crud. 

Carbo-veg. should be administered when Bryonia fails. 

Dose : As for Bryonia. 

Pulsatilla is suitable for diarrhoea arising from indigestion, or from 
a chill. The stools are very changeable, no two alike, and are usually 
worse at night. 

Dose : As for Chamomilla. 

Ipecac is particularly good when there is much nausea and vomiting, 
or almost constant nausea ; the stools are frequent. This remedy is par- 
ticularly indicated at the time of weaning, or when food disagrees. 

Dose: As for Chamomilla. 

Jlercurius is characterized by the following symptoms; much pain 
before the stool, great relief afterwards ; stools frothy, slimy, bloody or 
dark green, with much straining. The child's legs, and thighs are cold 
and clammy, particularly at night. 

Dose: As for Anti. Crud. 

Belladonna, When the child is very dxowsy, half asleep and half 
awake, much moaning. 

Dose: As for Anti. Crud. 

45 



706 DISEASES OF INFANCY. 

Podophyllum should be employed when the diarrhoea is worse i a 
the morning, stools green or watery, or which may be quite natural, only 
too frequent. This is particularly good when there is falling of the 
bowel. 

Dose : As for Anti. Crud. 

Sulphur is particularly good for children who have delicate parents. 
Much redness around the anus, eruption of pimples upon the skin ; or, if 
the child, after getting better, under other remedies, always gets worse. 

Dose : As for Anti. Crud. 

Veratrum alb. Much exhaustion after every passage, with cold 
sweats upon the forehead, or upon the skin in general. 

Dose : As for Chamomilla. 

ALLOPATHIC TREATMENT. For treatment of the diarrhoeas of chil- 
dren, see Chapter XIII., p. 262. 



CHOLERA IKFANTUM-SVMMEB COMPLAINT. 

This is a special form of bowel complaint, which requires special 
notice. This disease very often proves fatal, even under the best of treat- 
ment, since it appears usually in the latter part of the summer, when the 
young infant's system is already somewhat exhausted by the previous 
heat ; when the air is impure and the weather sultry, or warm and damp, 
and seems to spring up as an epidemic from some atmospheric miasm 
which is little less than malignant. In this, the worst form of infantile 
diarrhoea, all the symptoms seem equal in intensity and the disease runs 
a very rapid course. Children under two years are most liable to attack. 

Vomiting and diarrhoea form the most noticeable symptoms. The 
stomach is so irritable that it rejects immediately and sometimes with 
great violence, everything that it receives. At first, the matter vomited 
consists of the ordinary contents of the stomach, but this does not con- 
tinue long ; as the malady advances the matter vomited is tinged with 
bile and presents a greenish hue. 

The discharge from the bowels usually consists of a colorless or some- 
times greenish, inodorous and watery fluid ; occasionally with shreds of 
mucus mixed with it. The stools are usually discharged without effort — 
sometimes unconsciously — or are squirted out as though thrown from a 
syringe. Frequently there is considerable pain with straining, the infant 
manifesting its sufferings by a whining, plaintive cry, by restlessness and 
by drawing up and extending its limbs. As the disease advances vomit- 
ing becomes spontaneous and the matter ejected resembles that passing 
from the bowels, while the number of stools increase. Sometimes there 
is a sudden lull in the whole force of the disease, or the diarrhoea may 
abate and the vomiting continue, or the opposite. There is extreme Ian. 
guor and prostration and generally very rapid emaciation ; which condi- 
tions, together with the vomiting and the diarrhoea as above described 
clearly and unmistakably point to cholera infantum. 

As the disease progresses, the discharges from the bowels become still 
more frequent, are passed involuntarily, and are usually more profuse, 
resembling dark -colored dirty water, or " washings of meat/' and are 
very offensive ; emaciation becomes extreme ; the eyes are languid and 



CHOLERA INFANTUM. 707 

dull, or hollow and glassy, and the child takes no notice of surrounding 
objects or persons; the lips are dry and shrivelled. In many cases, the 
child lies in an imperfect doze, with half-closed eyes, and entirely insen- 
sible to external impressions. The abdomen frequently becomes disten- 
ded and hard, or is sunken or flaccid. 

Frequently, in fatal cases, the child falls into a complete state of stu- 
por, and convulsions ensue. It not un frequently happens, particularly 
in children predisposed to affection of the brain, that in aw early stage of 
the disease, the brain becomes involved, and the child dies with all the 
symptoms of inflammation of the brain. 

Favorable Symptoms are: An abatement of the fever, and the 
gradual restoration of an even temperature, with decreased frequency of 
the pulse; cessation of vomiting, and decrease in the number of evacua- 
tions, with a gradual return of the stool to a more natural condition and 
appearance; natural and peaceful sleep; desire for food; and a general im- 
provement in the appearance of the child, together with a return of 
playfulness. 

TREATMENT. Much of what has been said under the head of Treat- 
ment, in the preceding article on " Diarrhoea of Infants " (page 682,) may 
be made available in selecting the remedy suited to a case of cholera 
infantum, and that article should therefore be carefully consulted. The 
subjoined medicines, however, are those most frequently called for in the 
treatment of the disease under consideration, and are approved as of the 
utmost efficacy when carefully selected for the individual case. 

Aconitum is very frequently indicated, and should be given, in cases 
in which there is febrile excitation, manifested by acceleration of the 
pulse, heat and dryness of the skin, and thirst. Under such circumstances 
it often happens that Aconitum, when promptly administered, not only 
removes the febrile indication, but, as well, cuts short the entire disease, 
and very promptly aids in restoring the babe to health. 

Dose : Two globules dry, on the tongue, every one or two hours, accor- 
ding to the severity of the symptoms, until manifest improvement 
or change. If a favorable change should result, however slight, at 
once lengthen the intervals between the doses to two, three, or four 
hours, as the case may be according to the existing condition, and 
finally cease giving medicine upon the exhibition "of marked and 
decided amelioration and improvement. iShould, however, no 
evidence of improvement be manifested after the sixth dose, or 
should symptoms indicative of some other remedy sooner occur, 
proceed at once to the administration of another and better indicated 
remedy. 

Arsenicum is suited particularly to cases in which there is great 
weakness from the first, so that the child does not care to hold its head 
up; there is much thirst, while drinking induces vomiting and stool ; 
vomiting and purging occur at the same time, and greatly exhaust the 
child; the child has a pinched and distressed look, and is very restless, 
which restlessness, together with the other symptoms, grow worse after 
midnight ; coldness of the hands, feet, etc. 

Dose: In every particular as directed for Aconitum. 

Ipecacuanha should be given when the stools, which are very fre- 
quent, have a fermented appearance, or resemble greenish water; and 



^08 DISEASES OF INFANCY. 

when, more particularly, nausea and vomiting predominate, the child 
seeming to be sick at its stomach, almost constantly. 

Dose : In every particular as directed for Aconitum. 

Chamomilla will frequently prove useful in the early stages of some 
cases, particularly if the child be suffering from the irritation incident to 
dentition; it is more particularly indicated by the presence of griping, 
colicky pains, with greenish stools; fretfulness and crossness, with desire 
to be carried. 

Dose. Two globules dry, on the tongue, every three hours, until 
manifest improvement or change. 

Veratrum is required in cases in which the purging and vomiting 
are almost constant and simultaneous, and are excited by even the small- 
est quantity of nourishment or drink ; motion even excites nausea; there 
is very great prostration, with coldness of the face and extremities, and 
cold sweat forming on the forehead, and an almost imperceptible pulse. 

Dose: As directed for Aconitum. 

Secale is indicated by a chain of symptoms very similar to those 
pointing to Veratrum, but is more particularly indicated by paleness 
of the face, with sunken eyes, dry heat of the body, restlessness, and 
sleeplessness. 

Dose : As directed for Aconitum. 

Podophyllum, should be given in cases in which the dejections have 
an exceedingly offensive odor, and are passed most frequently in the 
morning; the child moans during sleep, lying with half-closed eyes, and 
rolls its head from side to side. 

Dose : In all respects as directed for Aconitum. 

Mercurius should be given, particularly at the commencement, if 
there be much colicky pains, which are relieved by the purging, the stools 
being slimy or bloody; or, when there is a great deal of perspiration, par- 
ticularly on the thighs. 

Dose: As directed for Aconitum. 

Croton tig, should be administered in cases in which the stool is 
forcibly expelled, as though forced from a syringe, one gush and it ceases. 

Dose : As for Aconitum. 

belladonna is required in some cases, particularly if there be great 
heat of surface, with flushed face, and evidences of a tendency to conges- 
tion of blood to the head ; the child is very thirsty, drinks hurriedly, and 
thrusts its hands constantly into its mouth. 

Dose : As for Aconitum. 

Calcarea Carb. will prove valuable in cases in which the stools are 
whitish and watery ; and have a sour smell, as does the matter vomited ; 
there is great emaciation, while the abdomen is bloated ; the face has an 
old, wrinkled look ; the extremities are cold. It is especially adapted to 
scrofulous children, with retarded dentition, or where the case has become 
chronic. 

Dose . Two globules, dry on the tongue, repeated every four hours, 
until manifest improvement or change. 

Sulphur may be called for, in cases similar to those indicative of Cal- 
carea, It should be given, likewise, in cases where the patient, having 
got better, relapses, and this process is again repeated, so that the case 
seems to linger, and has a tendency to become chronic. 



CHOLERA INFANTUM. 709 

Pose: As directed for Calcarca. 

Bryonia, Nux vomica may be called for in the treatment of this 
malady, in its earlier and later stages. For discriminative indications for 
their use, consult, under the heading of each medicine, respectively, the 
article on " Diarrhoea of Infants. n 

Diet and Regimen. Very little nourishment will be taken by an infant 
suffering from cholera infantum. Breast-milk should constitute its chief 
source of food and drink, in cases in which the child suckles ; but in other 
cases, however, great care must be taken to avoid giving anything that can 
add to the irritation already existing in the stomach and bowels. Pure 
dilute milk, boiled and sweetened, or thin, well boiled oat-meal gruel, will 
afford sufficient food and drink. Water may be given in small quantities, 
if it does not excite vomiting ; in which latter case, the infant may be per- 
mitted to suck small pieces of ice from time to time, if its lips be parched 
and dry, or a small piece of ice may be enclosed in a linen rag, and the 
child allowed to suck at it. Every effort should be made to sustain the nat- 
ural warmth of the body, particularly of the abdomen and lower extremi- 
ties, by the application of warmed woolen cloths ; but the resort to the 
application of cloths wrung out of hot spirits, or claret wine, or other poul- 
tices, is highly objectionable, and should not be resorted to. 

ALLOPATHIC TREATMENT. In the cholera of infants, if vomiting 
and purging have not emptied the stomach and bowels of their irritating 
contents, as shown by undigested substances in the stools or vomited mat- 
ter, an emetic of three or five grains of Ipecac should be given in water, or 
a purge of three grains of Calomel should be given. The latter should be 
assisted in its operation by an injection of warm water. If no indigestible 
matter is noticed, neither a purge nor an emetic should be given, but no 
time should be lost in stopping the discharges. This is best and soonest 
done with Opium. One drop of Laudanum may be given with a teaspoon- 
ful of Chalk Mixture, or three grains of Sub-Carbonate (or Nitrate) of 
Bismuth in a teaspoonf ul of Lime Water. This may be given every hour 
to a child a year old. To those younger Paregoric should be given instead 
of Laudanum. If neither Bismuth and Lime Water nor Chalk Mixture 
are at hand, the Opiate should be given with a grain or two of Bicarbonate 
(baking) Soda. 

The object is to diminish the discharges from the stomach and bowels 
and improve their character. When the discharges are checked or the child 
begins to be stupid, the opiate should be discontinued or given less fre- 
quently. When the vomiting has ceased, if the bowels continue moving, 
if the child is not inclined to be stupid an injection of two to five drops of 
Laudanum may be given, with half a teaspoonful of milk in a small hard 
rubber syringe. 

If the child is nursing it should be confined wholly to the breast, and 
then only allowed to draw small quantities at a time. If the breast milk 
is rejected, it can be allowed lean meat finely minced, pounded in a mortar 
and strained, which may be seasoned with salt. The white of eggs mixed 
with water, and rendered alkaline with Bicarbonate of (baking) Soda, five 
to ten grains, is frequently well digested. The raw meat juice and white 
of e^ are of great use when there is great prostration or emaciation. 

If the pulse weakens or collapse threatens, stimulants should be freely 



710 DISEASES OF INFANCY. 

given. Brandy or Bourbon Whisky is best suited. The dose is fifteen or 
twenty drops to a teaspoonf ul given with the milk, meat, or egg, and can 
be repeated at intervals varying from one to four hours. Stimulants are 
generally indicated early. 

Rice or barley water can be drunk ; small lumps of ice may be allowed. 

A warm poultice over the stomach will be beneficial. Great heat of the 
skin will require cool sponging. If the skin is cool, or cold, a warm bath 
of one hundred to one hundred and four degrees, will be beneficial. 

Sometimes cholera infantum is caused from ill nourishment. In these 
cases the acute symptoms are relieved by Opium as above directed, and 
better nourishment completes the cure. When the disease occurs from the 
effects of heat, Bromide of Potassium is highly serviceable, and is thought 
by some to be generally applicable. Take of Bromide of Potash two scru- 
ples, Mucilage of Gum Arabic two ounces. Mix. 
Dose : From fifteen drops to a teaspoonf ul. 

Five grain doses of Cerium, an eighth of a drop of Creosote, or Carbolic 
Acid in water, are useful in relieving the vomiting. Continued diarrhoea 
will call for astringents as directed for that disease. Anaemia (thin blood,) 
will require tonics, such as : Take of Citrate of Iron and Quinine ten to 
fifteen grains^ Orange Water anl Peppermint Water each an ounce. Mix. 

Dose : Give a teaspoon half full three or four times a day. 

If the cause of the dise;:ss is malarial, one or two grains of Quinine 
ought to be given at the first intermission. 



CHAFING-EXCORIATIONS. 

Excoriations, soreness, or chafing, frequently occurs in those parts of 
the skin of infants which are either rubbed together in the natural move- 
ment of the limbs, or liable to be fretted by friction of the diaper or other 
article of clothing. Thus the groins, the surface between the genitals and 
the thighs, behind the ears, under the arms, and even the folds in the neck 
of fleshy children, may become the seat of these excoriations. 

Such tenderness of the skin is due, in the first place, iu a great part, at 
least, to taint in the constitution; and for its complete removal will re- 
quire, therefore, a suitable remedy. Against this affection, cleanliness is 
the best preventive, 

TREATMENT. Chamomilla will be found speedily effective if the 
child cries much, and requires to be carried continually up and down the 
room. 

Dose : Four globules night and morning. 

Mercurius. The excoriation is much worseat night ; it is very raw 
and bloody; the child does not sleep much. 

Dose : As for Chamomilla. 

Calcarea carb, will be suitable for very fat and flabby children. 

Dose: Two pills in the evening. 

Grraphites will be found useful when the affected parts discharge a 
quantity of transparent glutinous fluid, especially behind the ears and 
between the thighs. 

Doss : As for Calcarea carb. 



ASTHMA MILLARIS. 711 

Sepia. The skin is very delicate; the least injury tends to ulcera- 
tion. 

Dose : As for Calcarea carb. 

Sulphur. There is liiuch itching of the skin in generaland of the 
parts affected. 

Done: As for Calcarea carb. 

A most valuable application to the excoriated parts of infants is to 
take green tea and pulverize it to a fine powder and apply the same as any 
powder. 

ALLOPATHIC TREATMENT. Protecting the chafed or excoriated skin 
from irritation, will provide for its cur©. If the trouble is caused by the 
discharges from the bowels or bladder, the napkin should be immediately 
removed and the child cleaned. These discharges must be rendered un- 
irritating by giving Bicarbonate of Soda, in doses of one or two grains, 
sufficiently often to accomplish the result. 

The raw surface on the skin may be dusted by starch, flour, Oxide of 
Zinc or Calomel, or the Benzoated Oxide of Zinc Ointment may be ap- 
plied. 



ASTHMA OF INFANTS— ASTHMA MILLARIS. 

Attacks children between two and eight (seldom infants at the breast 
or full grown persons,) is very similar to croup. The attack almost al- 
ways sets in in winter, in consequence of a cold; first at night, suddenly 
without any distinct premonitory symptoms, and sets in at once with 
the most violent symptoms of suffocation without any rattling or wheez- 
ing. 

The pulse is hurried and small. If cough sets in it is short, rough, 
without gagging or expectoration ; the voice is hoarse, deglutition diffi- 
cult. However, the child does not complain of a local obstacle in swal- 
lowing or breathing or of pain in the larynx or trachea, but of a dull pain 
or spasmodic drawing throughout the chest, as if caused by suffocating 
vapors. Slight spasms and change of color are noticed. A general ere- 
thism of the circulation and nervous system, scanty and pale urine hav- 
ing a sweetish odor. The patient is suddenly roused with a fearful look 
and an expression of anxiety in the altered features. The voice is deep, 
barking, hollow sounding, husky, very seldom wheezing or crowing. 
During the convulsive movements of the chest the labored inspirations of 
the chest are suddenly followed by a noisy expulsion of the air. The face 
becomes dark-colored, the eye becomes staring and protruded, the veins 
of the neck and temples swell. If the attack does not destroy life it ends 
in a few hours with sneezing, eructations and vomiting. The breathing 
becomes easier, the peculiar sound disappears and, amid a general subsi- 
dence of the symptoms, the child falls into a quiet slumber from which it 
awakes exhausted and desponding. Generally a second attack sets in the 
following night, more violent than the former with increasing fever. 
The danger of suffocation is greater, the face and lips become mottled blue, 
the shoulders are raised, and all the muscles of the thorax are violently 
worked. The face becomes more and more distorted, the nostrils dilate, 
the pulse becomes very rapid and intermits; the patient tosses about, is 



712 DISEASES OF INFANCY. 

covered with cold or lukewarm perspiration, feces and urine are passed 
involuntarily, but the consciousness is undisturbed; finally, the patient 
dies of suffocation amid convulsions. Only a few children survive more 
than one attack, and death almost always sets in during the third or 
fourth attack. 

The attacks never terminate with expectoration. 

Asthma Millaris cannot well be confounded with croup, if we remem- 
ber that in croup the larynx is always tender to pressure, and that the 
patients bore their heads into the pillow, whereas in this disease the child 
sits erect and does not complain of pain in the larynx, but of spasmodic 
constriction of the chest. In croup the breathing is fine and crowing ; in 
asthma millaris it is deep and hollow. 

If the disease is speedily recognized subsequent attacks may be aver- 
ted and the present attack modified and alleviated by one of the following 
remedies. 

TREATMENT. Ipecacuanha. Sudden paroxysms of suffocation at 
night with a sensation of violent constriction in the chest, short and anx- 
ious inspirations and sudden and jerking expirations, pale, bloated face 
with blue margins around the eyes; peevish mood. 

Sanbucus nigra. Sudden starting up from sleep with a shriek, 
anxiety and trembling, sudden, wheezing inspirations which sometimes 
intermit, deep, hollow rough voice, bluish pumnessof the face and hands, 
protruded eyeballs with the mouth half open. Anxious tossing about; 
heat without thirst, hurried and tremulous pulse, torpor and copious, 
mostly cold sweat. 

On comparing these indications with the symptoms of the disease, it 
is readily seen that Ipecac is only given to advantage in the beginning of 
the attack, and if the attack attains to its full development Sambucus has 
to be given. If the attack should set in again during the night following 
nothing can be expected of this agent, and it will be advisable to give 
Arsenicum. All these remedies have to be given in the form of a watery 
solution — a dose every five or ten minutes. 

Other varieties of asthma can be most frequently controlled by Arsen- 
icum. 

For asthma, caused by the inhalation of sulphur, we give Pulsatilla. 

Asthma, caused by a fit of anger, or a cold, can be best relieved by 
Chamomilla or Nux-vom., the latter being more particularly indicated by a 
vehement disposition. 

For asthma, caused by the inhalation of stone dust, in the case of stone 
cutters, sculptors, etc., we give Calc. Carb., Silic. or Sulphur. 

Calcarea Carb. is a main remedy for chronic asthmatic complaints, 
with disposition to draw a long breath, and sensation as if the breath were 
arrested between the shoulder blades. The distress is relieved by raising 
the shoulders. Mere stooping causes the breath to give out frequent par- 
oxysms of dry cough, at night especially. 



SWELLING OF THE BREASTS. 

These organs in infants— more especially female infants— sometimes 
become swollen and hard, which is often the result of the absurd and 
wicked practice on the part of nurses, of squeezing them, under the erro- 



ATROPHY— EMACIATION— MARASMUS. 713 

neons opinion that if the milk is not squeezed out of them, they will not 
perform their proper functions in after life. This practice is a cruel one, 
and very often brings about the state of affairs it is intended to prevent, 
for by squeezing the gland, inflammation, swelling, and perhaps suppuration 
and destruction follow, and the breast is rendered useless, and the source 
of a great deal of trouble and suffering in after life. 

TREATMENT. Aconite should be given ; if there be much fever at, 
the onset this remedy may dispel the whole difficulty. 

Dose : Two pills every six hours. 

Arnica. The breasts are merely hard, with no apparent inflammation 
or if the redness has not appeared. 

Dose : The same as Aconite. 

Belladonna. If the breasts are very red and run in streaks to the 
adjoining parts. 

Dose : As for Aconite. 

Bryonia when the breasts are quite hard and of a pale red color. 

Dose : As for Aconite. 

Chamomilla. The child is very fretful ; the breasts are very tender 
to the touch. 

Dose : As for Aconite. 
Hepar Sul. will be useful if the matter or pus has already formed. 

Dose : As for Aconite. 

«$> ~-^-^. 

ATROFHY— EMACIATION— MARASMUS. 

General Causes. Emaciation of infants and children usually arises 
from a predisposing constitutional cause, which frequently becomes de- 
veloped during the irritation of teething, or is called into activity by inap- 
propriate or unhealthy nourishment, either from the breast, or in the form 
of supplementary diet, at an earlier period ; or again, and, unfortunately, 
not unusually, it is engendered or developed, and rendered more compli- 
cated, and almost incurable, at a somewhat more advanced age, by the per- 
nicious habit of a free and reiterated use of mercurial preparations, in the 
vain hope of bringing about a healthy state of the primary organs of diges- 
tion, when these have become deranged by repeated infractions of appro- 
priate rules, as to diet and general habits. The manifestation of worms, 
and the usual attendant symptoms of invermination, and the enlargement 
and induration of the mesenteric glands, are frequent, antecedent, occa- 
sional causes of the disease. 

TREATMENT. Sulphur is appropriate in almost all cases at the 
commencement of the treatment, when the disease has become fairly 
developed, or occurs in scrofulous children, but is more especially indica- 
ted by the following symptoms : Craving appetite for food and drink, 
watches eagerly for the cup or spoon, and clutches at them, thrusting 
everything into its mouth ; enlargement of the glands in the groin or arm- 
pits; slimy, excoriating diarrhoea, or obstinate constipation; pale com- 
plexion, sunken eyes ; jumping, starting, and screaming; restless sleep. 

Do.se: Three globules every morning, the first thing, for ten days, 
unless decided change or new symptoms should sooner occur; then 
pause five days, after which the course may, if still indicated, be 
repeated as before, and so on, until decided amelioration or change. 

Calcarea should either be employed at the onset, or after the pre- 



714 DISEASES OF INFANCY. 

vious administration of Sulphur (as just directed), if the following symp- 
toms be more especially predominant, or should supervene ; or if, again, 
Sulphur should not have been productive of apparent improvement within 
eight days after the completion of the second course. The indicative 
symptoms are : great emaciation, with craving appetite ; enlargement and 
induration of the mesenteric glands and of the belly ; great weakness, 
clayey evacuatious, a dry and flabby skin ; too great a susceptibility of the 
nervous system ; large, open f ontanelles ; profuse sweat about the head ; 
cough with rattling of mucus. 

Dose: Three globules, as directed for Sulphur. 

C/iamomilla is chiefly required when the following symptoms occur: 
Frequent screaming, with drawing of the legs towards the stomach ; hard- 
ness and fullness of the belly ; great restlessness andfeverishness ; acidity ; 
flatulence, frequent purging, the stools being of a deep grass-green, or very 
yellow color, or whitish, yellow and frothy, sometimes resembling beaten 
eggs, and of an offensive odor, often like that of rotten eggs ; occasional 
sickness, the matter vomited being more or less of a bilious description ; 
thirst ; want of appetite ; frequent change of complexion. 

Dose : Three globules thrice a day. 

Pulsatilla is indicated when less restlessness and peevishness pre- 
vail than under Chamomilla, and little or no thirst, with complete loss of 
appetite; or, on the contrary, voracious and inappeasable hunger, with 
acid or other disagreeable risings; or disposition to vomiting the contents 
of the stomach ; frequent papescent stools of a greenish, bilious description ; 
or watery, slimy evacuations, at times of a light or whitish color; the 
child is always better in the open air. 

Dose: As directed for Chamomilla. 

Antimoniinn, c. may be had recourse to, twelve hours after the last 
dose of the preceding remedy, if no improvement has resulted ; or this 
remedy may be preferred, from the commencement, if the child cannot 
bear to be looked at, or touched by any one ; or if its tongue be covered 
with a thick white coating. 

Dose: As directed for Chamomilla. 

Ipecacuanha is usually a most useful medicine, when nausea or 
copious and frequent vomiting form more prominent features in the case 
than purging; or, when there is both vomiting and purging; the substance 
ejected from the bowels being chiefly of a greenish-yellow color, and often 
bearing resemblance to matter in a state of fermentation. 

Dose: As directed for Chamomilla. 

Mercurius is required when the evacuations from the bowels are 
very frequent, but generally scanty and slimy, and usually attended with 
distressing straining; or greenish, sour-smelling, or fetid; also when 
small white ulcers make their appearance on the inner surface of the lips 
and cheeks, or on the tongue, etc.; when, with less flatulency, most of the 
symptoms mentioned under the head of Chamomilla are present; or, and 
more particularly, when the patient is affected with enlarged joints and 
glands, and distorted limbs— provided always these latter symptoms have 
not been induced, or at least materially aggravated by the abuse of Calo- 
mel, or other mercurial preparations, under allopathic treatment— this 
medicine is also of much efficacy. 

Dose : As directed for Sulphur. 



ATROPHY— EMACIATION— MARASMUS. 715 

Nux-vomica. The interposition of constipation, or alternate states 
of costiveness and relaxation, with fickle, variable, or entire loss of appe- 
tite; regurgitations or vomiting, flatulency, acidity, excessive irritability 
of temper, great feebleness, soreness of the mouth, or formation of small 
white, ulcerative specks or spots, are all indicative symptoms for the em- 
ployment of this remedy. 

Dose: As directed for Chamomilla. 

Bryonia. Vomiting occurs almost immediately after eating ; consti- 
pation ; the child always feels cold ; the lips are dry and parched, and the 
mouth is dry. 

Dose: As directed for Chamomilla. 

Arsenicum is one of the most important remedies; it is indicated by 
dryness of skin, which resembles parchment ; hollow eyes ; desire to drink 
often, but little at a time; excessive agitation and tossing, especially at 
night; short sleep, interrupted by jerks ; colic, with relaxed stools of 
greenish, brownish, or blackish color, or evacuations containing undiges- 
ted food ; night sweats ; extreme prostration ; pale, waxy appearance. 

Dose : As directed for Sulphur. 

Baryta carb. is indicated by enlargement of the glands; of the nape 
of the neck; tenderness of the belly, with tumefaction and induration of 
the abdominal glands ; continual desire to sleep ; great indolence, and 
aversion to exertion and amusement ; dysenteric or loose stools, sometimes 
containing thread worms. 

Dose: As directed for Sulphur. 

Aciduni nitriciun is chiefly required in cases which have been devel- 
oped or exacerbated by the abuse of mercurial preparations ; the bones 
and joints being swollen and tender, the mouth and gums more or less 
inflamed and sore, the mesenteric and other glands much enlarged ; the 
bowels confined or much relaxed, and attended with straining. 

Dose : As directed for Sulphur. 

Phosphorus is more or less useful, in cases with protracted and debil- 
itating watery diarrhoea, and when the mesenteric glands are diseased. 

Dose : As directed for Sulphur. 

Belladonna is to be preferred when the prevailing symptoms and 
conditions are as follows: capriciousness and obstinacy ; nocturnal cough 
with rattling of phlegm ; enlargement of the glands of the neck ; unquiet 
sleep ; precocity of intellect; (blue eyes and fair hair). 

Dose: As directed for Chamomilla. 

China is required for excessive emaciation ; voracity ; diarrhoea at 
night, or frequent, white, papescent motions, or evacuations of undigested 
matter; frequent perspirations, especially at night; great debility and 
languor; unrefreshing sleep. 

Do.se: As directed for Chamomilla. 

Cina is more particularly required when the patient suffers from 
worms ; or for wetting of the bed, insatiable appetite, etc. 

Dose: As directed for Chamomilla. 

Rhus should be selected, when there is slimy or sanguinous diarrhoea; 
debility, and excessive languor, with constant desire for the recumbent 
posture; great restlessness; the symptoms are all aggravated after mid- 
night. 

Dose: As directed for Chamomilla. 



716 DISEASES OF INFANCY. 

Diet and Regimen When the disease is manifested in infants at 
the breast, recovery will, in many cases take place on the substitution of 
a good nurse of sound constitution, or of appropriate artificial feeding — 
such as goat's milk, or, sometimes, weak broths — for the faulty nutriment 
which has originated the disease. But when the child is of scrofulous 
constitution, and glandular enlargements, etc., have become developed, 
the addition of regular and appropriate medicinal treatment is required. 
Again, when the affection has been engendered by improper food, in 
children who are being reared by the hand, or who are past the age of 
infancy, if the progress of decay is not too far advanced, and no organic 
disease be developed, a cure may, as in the former case, be accomplished 
by the correction of the main source of all the mischief. The improper 
food ought, therefore, to be at once withdrawn, or the quantity reduced, 
if that has been too great. Goat's milk or cow's milk, wLich has previ- 
ously been boiled and diluted (one part of water to about three of good 
milk,) and, occasionally, chicken broth, or, to children of more advanced 
age, farinaceous food, generous beef tea, or mutton broth, free of fat, may 
be substituted for food of a more solid or indigestible nature, with which 
the child has been dieted. Pure air and regulated exercise, are also of 
great importance. 

ALLOPATHIC TREATMENT. Atrophy. A full discussion of the 
treatment of infantile atrophy (wasting away) would require considerable 
space. It may briefly be said to be caused by lack of proper nourishment. 
If the child is at the breast, the amount of breast milk is insufficient or its 
quality poor, or, from accidental causes, it is absolutely harmful. In the 
latter case, the child should be raised by a wet nurse, which is preferable, 
or weaned ; in the two former cases, it ought to be raised by a wet nurse, 
or artificially fed, in addition to the food it gets from the breast. 

For artificial feeding, milk is most suitable. The milk should be daily 
tested with litmus paper, and if it is alkaline, i. e. turns red litmus paper 
slightly blue, it may be sweetened a little, and diluted as further directed 
and given to the baby, without further preparation. If it is not alkaline, 
sufficient Lime Water or Bicarbonate of Soda should be added to render 
it so. 

Previous to a month old, one-half water should be added to the milk ; 
at a month old, only a quarter part water should be added. A little cream 
should be, also, added to make up for the water. After four months, 
milk may be given plain, except that it should be rendered alkaline, if not 
naturally so, with Lime Water or Soda. Milk is the food for children. 
A child a month old should take a quart of milk a day prepared as above; 
but not over a quarter of a pint at a time. Cow's or goat's milk should be 
treated as above. If possible, the animal should be fed on grass and should 
have only pure water to drink and subject to no confinement. 

If the child should continue to waste after being suitably fed as above 
directed, other foods may be given as directed in the dyspepsia of infants 
treated with colic. 

Cod Liver Oil may also be given in doses of ten drops in the first 
place, gradually increased to a teaspoonful. 

The tonic effect of Iron and Quinine is of service. Take of Citrate of 
Iron and Quinine fifteen grains, Syrup of Orange Peel and Peppermint Wa- 
ter each an ounce. Mix. 



DENTITION. 717 

Dose: From fifteen to thirty drops three times a day. 

Pepsin or Lactated Pepsin in doses of two to five grains, after feeding 
or nursing, may be advantageous, or Liquid Pepsin (Sheffer's formula) 
may be tried as an aid to digestion. 



DENTITION. 



The development of teeth in their regular order, although a perfectly 
natural process, is often attended with much suffering. AVhen dentition is 
slow, retarded and difficult, it not only becomes of itself a serious disorder, 
but it involves also a Ions: train of morbid symptoms and actual diseases 
which may exhaust the patient's strength, and finally destroy its life. The 
primary difficulty in such cases is in the nutrition, and as w T e often see in 
older children a remarkable backwardness in the development of the osse- 
ous (bone) system in general, so we often find in earlier periods of infantile 
life a corresponding slowness in the development of the teeth. And both 
these forms of imperfect development occurring, as they often do, succes- 
sively in the same children, are to be attributed to some profound consti- 
tutional taint which affects the nutrition. 

In order that our reader may judge of the deviation from the normal 
standard of dentition in any given instance, we propose to state here the 
mode and order of the appearance of the teeth in health. It should first 
be observed, how T ever, that there are anomalous cases of dentition in which 
the non-appearance of the teeth should not be regarded as requiring active 
interference, unless other morbid symptoms are present. The non-appear- 
ance of theteeth at the usual time, unless accompanied by symptoms indi- 
cative of constitutional disturbance, really furnishes less occasion for 
apprehension than their premature appearance would. Even in the con- 
dition of apparently perfect health, some infants begin to cut their teeth 
very early, even by the third month, while in others this process com- 
mences at a very much later period. 

In the early months the infant's mouth is naturally dry ; this dryness 
is relieved by frequent nursing. But usually about the fourth or fifth 
month a very considerable change takes place in this respect; the mouth 
is now found constantly full of saliva, and the child is constantly drivel- 
ing — or drooling, as it is sometimes called — but no other indication appears 
of the approach of the teeth to the surface, except that the edge of the gums 
becomes broader than it w r as before. No further change may take place 
for many weeks, and it is generally near the end of the seventh month, 
oftener later than earlier, before the first teeth make their appearance. 
The middle incisors of the lower jaw are generally the first to pierce the 
gum; next in order appear the middle incisors of the upper jaw ; then the 
lateral incisors of the low r er. The first molars next succeed, and often 
without any very definite order as to whether those of the upper or of the 
lower jaw are first visible, though in the majority of cases the lower 
molars are first to appear. The four canine (stomach and eye teeth com- 
monly called) teeth succeed, and lastly the four posterior molars, making 
in all the number of twenty deciduous teeth. There are, however, inter- 
vals of rest between the successive irruptions of teeth ; thus a period of 
six or eight weeks generally intervenes between the lower and the upper 



718 DISEASES OF INFANCY. 

middle incisors ; the lower lateral incisors come very soon after. But a 
pause of three or four months may occur before the first molar teeth make 
their appearance; another of equal length may occur previous to the 
appearance of the canine teeth ; and still another before the first dentition 
is completed by the irruption of the last molars. 

In some few cases the teeth come through so readily as to scarcely 
disturb the infant; but more frequently indeed the mouth becomes hot 
and the gums look tumid, tense and shining, while the exact position of 
the tooth is marked sometimes before its appearance, by the prominence 
of the gum ; or the irruption of the teeth is preceded or accompanied by a 
somewhat different condition of the mouth, in which there is much heat 
and intense redness of the mucous membrane, an extremely copious flow 
of saliva, and a disposition to the formation of small aphthous ulcers on 
the tongue and on the inside of the lips, though the gums themselves may 
not be particularly swollen and painful. Either of these states is usually 
attended with some degree of febrile disturbance, and apparently with 
considerable suffering to the infant, who is constantly fretful and peevish, 
or cries out occasionally as if in pain. A third morbid condition of the 
mouth is sometimes seen, which is usually ushered in or attended by very 
considerable fever. The gums then become extremely hot and swollen, 
and unusually tender, especially over some tooth or other in particular ; 
and in that situation we find the gum swollen up into a kind of little 
tumor. Small unhealthy ulcerations with a sloughy appearance often 
form upon the summit of the gum, and especially around any tooth which 
has partially pierced through it. To this affection, which is often very 
painful and difficult of cure, the name of odontitis infantum has been 
applied. 

A single word with reference to lancing the gums. This operation is 
in almost all cases unnecessarily performed, and in many cases it proves 
positively injurious. And yet it sometimes affords the most important 
and immediate relief. Where the gums are red and inflamed, in our 
opinion they never need to be lanced, but only when in their very slow 
growth they have changed to a dense, firm and unyielding, cartilaginous 
formation, thick and of a whitish color, through which the teeth vainly 
attempt to make their way, and the irritation of the child's system 
threatens to destroy its life by sheer exhaustion, or by inducing fatal con- 
vulsions. 

Before proceeding to indicate the remedies to be employed in disor- 
ders of dentition, we remark that the tooth does not mechanically cut its 
way out of the gum, but its growth causes slight pressure by the crown of 
the tooth, a pressure which excites the absorbents to remove the impedi- 
ment. In this manner the absorbents do absolutely, when the infant is 
in a perfectly healthy condition, open up the way for the tooth to escape 
without pain or suffering. Now the duty of the physician, or the one act- 
ing as such, is so to direct the course of events, that the evolution of the 
teeth shall become as painless as any other process of development. All 
the laws of health should be rigidly enforced, and every prescription care- 
fully made and finally, when the period of dentition fairly commences, if 
suffering is experienced, or difficulty arises, the following remedies should 
be carefully and particularly studied and administered. 



DENTITION. 719 

Aconite, Constant restlessness as from distress, which no change of 
posture or circumstance seems to relieve. The child gnaws at its fingers 
or something else, cries, whines or frets much of the time. Its sleep is 
very much broken, and there are usually much heat about the head, and 
a dry skin, sometimes with cold hands and feet. Soon after or whilst 
waking from sleep its cries of discomfort recommence. Accompanying 
this state of things sometimes there is constipation, when the stools are 
watery and dark colored, or bloody and slimy. The child is usually very 
thirsty and seems to be relieved very much by holding on to the cup con- 
taining cold water with its mouth, apparently for the purpose of cooling 
its gums. 

Dose : Two pills every three hours. 

Antimonium crud. "When the stomach so sympathizes as to pre- 
sent prominent symptoms. Tongue white ; much vomiting ; no thirst; 
stools composed of hard lumps and watery secretions passing together. 

Dose: Give two pills three times daily 

Arsenicum alb. The child has undigested, foetid stools, and is 
emaciated ; dry and shriveled skin ; particularly restless after twelve at 
night. It has paroxysms of anguish day and night, during which it often 
strikes its face or head with its little hand, as though that afforded relief. 
It often vomits all fluids soon after swallowing them, particularly water. 
It will only take a sip or two at a time, but very often. The child often 
has a pale, waxy look. 

Dose : Two pills every four hours. 

Belladonna. The child moans a great deal; violent starting or 
jumping of parts, or of the whole of the body whilst sleeping or 
waking ; convulsions, followed by very profound sleep ; agravation every 
afternoon ; very hot fever at night, often lasting all night, with delirium ; 
face and eyes red, and often with heat of the head. 

Dose: Two pills, to be repeated every two hours. 

Bryonia alb. Dry, parched lips ; dry mouth and constipation, thu? 
stools being dark and dry, as if burnt. The child wishes to be kept very 
quiet ; seems to dread to be moved. If it be raised to the perpendicular 
it often vomits ; seems faint, and wishes to lie back again ; vomits 
its nourishment soon after taking it ; the gums look swollen, are hot and 
dry, though pale or light red. 

Dose: Two pills every four hours. 

Calcarea Carb. The child has large open fontanelles. The head 
perspires during sleep so as to wet the pillow far around. Stools large, 
hard, and of a chalky appearance, or thin and whitish. The child's feet 
are often cold and damp ; the abdomen is in some cases large, and little 
lumps are sometimes found about the neck ■ sometimes a loose rattling 
cough is present ; soft and flabby muscles. 

Dose: Two pills morning and evening. 

Cina. The child rubs its nose much, and is unusually hungry ; 
very restless in its sleep; must be kept in motion nearly all the time by 
walking, or otherwise ; diarrhoea ; stools occurring immediately or very 
soon after drinking; child very peevish, does not like ^o be looked at, 
spoken to, or even touched ; its urine, when it can be preserved in a ves- 
sel, or when seen in a puddle on thf* floor, soon turns white like milk ; 



720 DISEASES OF INFANCY. 

restless at night ; frequent crying out, as from colicky pains, and calling 
for water. i 

Dose : As for Aconite. 

Chamomilla. The child starts and jumps during sleep ; when awake 
it must be carried all the time, in order to soothe its sufferings ; some- 
times it will only sleep whilst being carried in the arms ; one red cheek, 
the other pale ; diarrhoea watery and slimy, or like chopped eggs and 
spinach, having the odor of rotten eggs ; very thirsty ; likes to hold its 
mouth in cold water a long time when drinking ; the appetite is not as 
good as usual, and there is frequent vomiting of thin, sour milk. 

Dose : As for Aconite. 

Hyoscyamus. Pressing of the gums together, with putting the 
hands to the jaws, putting the fingers to the mouth, and other indications 
of pain in the jaws ; difficulty in swallowing ; convulsions, beginning with 
twitching of the muscles of the face, especially about the eyes ; dilation of 
the pupils ; deep sleep after the spasm goes off. 

Dose : Two pills to be given every two hours. 

Ipecac. Continual nausea, with occasional vomiting; diarrhoea; 
stools fermented and of many colors, as green as grass ; face pale, with 
blueness about the eyes. 

Dose : As for Hyoscyamus. 

Were. Sol. Copious flow of saliva, and sometimes little blisters are 
seen on. the tongue, gums and cheeks ; quite large ulcers are seen on the 
protruding gum. With the above conditions the nights are very trouble- 
some; stools usually slimy, bloody, green, and accompanied with strain- 
ing. A single dose of Merc, is often sufficient. 

Nux vom. For teething children, being raised by artificial food, or 
whose mothers indulge in highly seasoned food, wines, etc.; worse about 
four in the morning; constipation, with large difficult stools or they 
become small, frequent, lumpy or fluid ; bloody saliva often stains the pil- 
low when sleeping. 

Dose : Two pills four times each day. 

Podophyllum.. Grinding of such teeth as are already cut, with wor- 
rying and crying, of ten with painful diarrhoea; rolling of the head from 
side to side, with green stools, or frothy, undigested stools ; falling of the 
bowel with every stool ; voracious appetite ; food soon sours after eating ; 
much gagging as if it would vomit ; dicharge of carrion-like smelling 
stools. 

Dose: Give two pills every four hours. 

Stramonium. When the child's brain seems so affected as to cause 
it to cease making its wants known except by motions ; it seems to shrink 
from the sight of objects when first presented, as if afraid; convulsions 
with cries as if from being frightened by the sight of some hideous ob- 
ject. 

Dose: Give two pills every two hours. 

Sulphur. W'hite sour diarrhoea with redness about the anus; papu- 
lous eruptions on the skin, with much itching ; the child takes no more 
long naps, as is its custom ; jumps in its sleep. 

Dose: Two pills each night and morning. 



SPASMS— CONVULSIONS. 721 

SPASMS- CONVULSIONS. 

Even in very young infants, spasms, or general convulsions, are of 
frequent occurrence. They are present at the commencement of many 
diseases of children, and they attend the fatal termination of nearly all. 
Convulsions may be occasioned by morbid conditions of the nervous sys- 
tem— idiopathic convulsions— or they may be merely sympathetic, symp- 
tomatic of disorders in other organs, especially in those of the alimen- 
tary canal (the whole canal through which the food passes). Among those 
of the nervous system, may be enumerated those which arise from pri- 
mary disease of the brain or other large nervous centers, and those which 
result from general exhaustion of the vital force, as in cases of difficult 
dentition and in the advanced stages of Whooping Cough ; among the lat- 
ter class of sympathetic convulsions may be enumerated those cases which 
arise from the irritation of intestinal worms, from the presence of un- 
wholesome food, such as curdled milk, and from the influences which are 
about to develop eruptive disorders or typhoid fevers. 

Convulsions which appear immediately after nursing, and especially 
if there is vomiting of curdled milk, it is then evident that the character 
of the milk is unsuitable. Such cases occur in the children, even of 
mothers perfectly healthy, if they give suck while in a state of high phy- 
sical excitement or mental distress. In cases which come on suddenly 
and without apparent cause, especially if the convulsions are associated 
with fever, stupefaction, and vomiting, there may be reason to apprehend 
the beginning of some eruptive disorder, such as scarlatina, measles, 
chickenpox, etc., and this opinion will be strengthened by the prevalence 
of one or the other of these epidemics at the time. Many cases of the brain 
disorders commence with vomiting and convulsions. In such instances, 
upon minute inquiry, it will always be found that some indications of 
cerebral disorder have been present for several days, and there is usually 
severe pain in the head immediately before the attack. 

In most cases, it will not be difficult to find out the exciting cause of 
the spasms, which may be suppression of some cutaneous eruption, or its 
too tardy appearance, direct injury of the head or some portion of the 
nervous substance, fright of the child, or even of the nurse, a feverish con- 
dition of the mother's milk, the influence of some epidemic miasm, the 
beginning of some brain difficulty, etc., etc. 

TREATMENT. Remove as far as possible the exciting cause, whether 
it exists in the nurse or the child itself, avoid every excitement and keep 
the child perfectly quiet and free from every disturbing influence, of noise 
light, etc., and very carefully administer the remedy which appears to be 
indicated by the nature of the case, and by the attendant conditions. 

Aconite. High fever with dry, hot skin, anxiety and restlessness 
during dentition, grinding of the teeth, and convulsive hiccough. 

Dose: Four pills every half hour until the fever subsides, then every 
two, three, or four hours. 

Arnica. Where the spasms arise from some mechanical blow or in- 
jury; from concussion of the brain, a blow or fall. 

Dose: Four pills every hour or two. 

Arsenicum. Spasms preceded by great restlessness and burning heat 
over the whole body. Extreme thirst, drinking little and often. Patient 

46 



722 DISEASES OF INFANCY. 

lies motionless as if dead ; finally, the mouth is drawn first to one side and 
then to the other ; a violent jerk appears to pass through the whole body 
and consciousness gradually returns. 

Dose : The same as for Arnica. 

Belladonna. Heat of the head with flushed face, red eyes and 
dilated pupils. Starting and jumping during sleep. Drowsiness with 
inability to sleep; convulsive motion of the mouth, facial muscles and 
eyes ; foam at the mouth and grating of the teeth ; drowsiness after the 
spasm. 

Dose: As for Aconite. 

Chamomilla. Stretching of the limbs with convulsions of the ex^ 
tremities, eyes, eyelids, and tongue. Jerking and twitching during sleep. 
Redness of the face or one cheek red and the other pale. The child is very 
cross and fretful, must be carried all the time to be quieted. Hot sweat 
on the forehead and hairy scalp. Constant moaning and craving for 
drink. 

Dose: Four pills every one, two, or three hours. 

Cina. Spasms of the chest followed by rigidity of the limbs or the 
whole body. Especially suited to children troubled with worms. Con- 
stantly picking and boring at the nose. Frequent swallowing, as if some- 
thing were in the throat. Dry hacking cough. Urine turns milky after 
standing. 

Dose: Four pills every three hours. 

Cuprum. Shrill cries during the attack. Drowsy and stupid during 
the intervals with nausea and vomiting of phlegm. After the convulsion 
the child screams, turns and twists in all directions. If caused from sup- 
pression of scarlatina, measles, or like eruptions 

Dose: Four pills or a small powder every two or three hours. 

Gelseminum. Spasms during dentition with sudden loud outcries. 
Nervous excitable persons who are very sensitive. 

Dose: The same as for Cuprum. 

Hyoscyamus. Convulsions with twitching and jerking of all the 
muscles, especially those about the face and eyes. Convulsive trembling 
and foam at the mouth. After sudden fright. Cough worse when lying 
down, relieved by sitting up. 

Dose : As for Cuprum. 

Ignatia. Sudden starting from a light sleep with loud screaming 
and trembling all over. Single parts seem to be convulsed, or single 
muscles here and there. The spasms return every day or every other day 
about the same hour. 

Dose: Four pills every two hours. 

Ipecac. Much nausea and vomiting accompanies the spasms. Espe- 
cially if caused by eating indigestible food, or when, during an eruptive 
fever, the eruption strikes in. Green, diarrhceic stools. 

Dose : Four pills every hour or two. 

Opium. Trembling over the whole body and tDssing about of the 
limbs. Loud screaming before or during the spasm. The child lies 
unconscious as if stunned, with heavy difficult breathing. Convulsions 
caused by fright. 

Dose : As for Ipecac. 



SPASMS— CONVULSIONS. 723 

Secale. Twitching of single muscles. Twisting of the head to and 
fro. Contortions of the hands and feet. Labored and anxious breathing. 
Thin scrawny children with shriveled skin. 

Dose : As for Ipecac. 

Stramonium. Convulsions from fright with tossing of the limbs 
and involuntary passages from the bowels and bladder. Awakens with a 
shrinking look as if afraid of the first object seen. Spasms caused by some 
suppressed eruption, or if the eruption does not come out freely. 

Dose : As for Ipecac. 



VACCINATION. 

The customary place for vaccination to be performed, is on the outer 
side of the upper part of the left arm. Three to six points should be in- 
serted. In two or three days the swelling is noticed, and the fifth or sixth 
day the vesicles are formed, which reach their greatest size from the 
seventh to the ninth day. This is the time to vaccinate from arm to arm, 
The crusts mature and are ready to drop off on about the twentieth day. 

The itching, burning, and pain occasioned by the vesicles, may be 
greatly relieved by brushing over them a mixture of one dram of Fluid 
Extract of Belladonna, with four drams of Olive Oil, or, if the inflammation 
is very intense, a cloth wet continually with a solution of fifteen grains ot 
Sugar of Lead, and five to ten grains of the Acetate of Morphine in a pint 
of rain water, can be constantly applied if the patient remains in bed. The 
feverishness and discomfort does not require any treatment. 

A child should be healthy when vaccinated. 

The vile disease, Syphilis, is the only constitutional affection which can 
be transmitted by vaccination, so that if it cannot be practiced from the 
arm of a healthy infant, having healthy parents, the lymph, or crust, from 
the heifer, (cow-pox), should be used. A vaccination which is perfectly 
pure may arouse up a constitutional vice existing in the patient, and give 
rise to eruptions or troublesome sores. 

Vaccination should be performed in infancy. 

Revaccinations should be made when the child is from five to eight 
years old, and again before reaching adult life, and also through life when 
especial danger from small pox exists. 



F-A-IfcT FIFTEENTH, 

SURGERY. 

CHAPTER XXXV. 



ACCIDENTS OF VARIOUS KINDS. 



AFFABENT DEATH. 

Asphyxia. In every instance where an individual has, to all appear- 
ance, suddenly expired from external causes, animation may only be sus- 
pended. There are many cases, of course, where sudden death is no mere 
suspension of animation ; but there are others where apparent death is 
far from uncommon ; in all cases, therefore, where there is the least 
uncertainty, care should be taken to do nothing that may cause death, 
and interment should be avoided until certain signs of putrefaction set 
in. 

Apparent Death from Hunger. Give small injections of warm 
milk, repeatedly; great care should be taken to give the food when the 
patient begins to rally, in the smallest possible quantity at a time. Milk 
may be given, drop by drop, and gradually be increased to a teaspoonful, 
and after some interval, a small quantity of beef tea, and a few drops of 
wine. After a sound sleep has succeeded, but not till then, a small meal 
may be given ; but it is best that the patient should eat little at a time, 
but often. It must be borne in mind that for all persons suffering from 
starvation, eating too much and too hurriedly, is in the highest degree 
dangerous. 

Apparent Death from a Fall. Place the patient cautiously on a 
bed, with his head high, in a place where he can remain quiet. Put a 
little Arnica on his tongue, and wait till a medical man visits him to see 
if there is any fracture, or whether there are still signs of life; bleeding 
may be here sometimes of benefit, but it requires great caution. Arnica 
may be repeated, and also administered in injections. If the patient has 
been bled, give China or Quinine; but it is obvious that if much blood has 
been lost by the fall or wound, venesection would be injurious. 

Apparent Death from Suffocation, (hanging, pressure, choking). 
Remove all tight clothing. Put the patient in a proper position, the head 
and neck rather high, the neck quite easy, not bent forward. Begin by 
rubbing gently, but constantly, with cloths ; give an injection of a dozen 
or two globules, or a few drops of Opium, dissolved in a half pint of water 

724 



APPARENT DEATH. 726 

and injected slowly. This may be repeated every quarter of an hour t 
whilst the ribs are being rubbed gently. Hold, from time to time, a 
mirror before the mouth, to see if the breath dims it; open the eyelids and 
see if the eyes contract; put warm cloths on; hot stones, wrapped in 
blankets, to the feet, between the thighs, to the sides, neck, and shoulders. 
If, in an hour, no change is produced, take a bitter almond, pound it fine, 
mix it in a pint of water, put a few spoonfuls into the mouth, or into the 
nose, and give the rest in injections. 

Apparent Death from Lightning. The body should be immedi- 
ately removed into a current of fresh air; and cold water dashed frequent- 
ly on the neck, face and breast/ If the body be cold, warmth, by friction, 
must be employed in the same manner as recommended for the drowned, 
in the next article; as well as the means therein prescribed for inflating 
the lungs. A few globules of Nux Vomica may be put upon the tongue, 
and repeated in half an hour, when, if no effect is produced, a little Nux 
Vomica in water, rubbed on the neck, and some injected, may be of ser- 
vice. Or, better still, place the patient in a half-sitting, half-recumbent 
posture, in a cavity freshly dug in the earth, cover him over with newly 
excavated earth (leaving the face alone exposed, which should be turned 
towards the sun, until the first signs of returning animation become appa- 
rent,) after which Nux-v. is to be had recourse to, as above directed. There 
is no doubt but that in many cases of apparent death from lightning, both 
in the case of man and animals, careful and persistent use of this simplest 
of nature's means will restore the apparently departed life. The 
writer hereof has succeeded in the case of a person who«had been supposed 
to be dead for three hours. If the fresh earth is not moist it should be 
slightly moistened. 

Apparent Death from Drowning. Dr. Marshall Hall's so-called 
"ready method " of recovering persons from apparent death by drowning, 
has proved so successful in some cases, when zealously and indefatigably 
employed, even after a submersion of half an hour's duration, that it ought 
always to be tried in the first instance. The following is a summary of 
his directions: 

RULES. 

1. Treat the patient instantly, on the spot, in the open air, freely expos- 
ing the face, neck, and chest to the breeze, except in severe weather. 

2. Send with all speed for medical aid, and for articles of clothing, 
blankets, etc. 

I. TO CLEAR THE THROAT. 

3. Place the patient gently on the face, with one wrist under the 
forehead. 

(All fluids and the tongue itself then fall forwards, and leave the 
entrance into the windpipe free.) 

II. TO EXCITE RESPIRATION. 

4. Turn the patient slightly on his side and apply snuff, o*- other 
irritant, to the nostrils; and dash cold water on the face, previously 
rubbed briskly until it is warm. 

If there be no success, lose no time; but 

III. TO IMITATE RESPIRATION. 

5. Replace the patient on the face. 

6. Turn the body gently, but completely, on the vide and a little be- 



726 ACCIDENTS OF VARIOUS KINDS. 

yond, and then on the face alternately; repeating these measures deliber- 
ately, efficiently, and perseveringly fifteen times in the minute only. 

(When the patient reposes on the chest, this cavity is compressed by 
the weight of the body, and expiration takes place ; when it is turned on 
the side, this pressure is removed and inspiration occurs). 

7. When the prone position is resumed, make equable but efficient 
'pressure along the spine; removing it immediately before rotation on the 
Bide. 

(The first measure augments the expiration, and the second com- 
mences inspiration). 

IV. TO INDUCE CIRCULATION AND WARMTH, CONTINUE THESE MEASURES. 

8. Rub the limbs upwards, with firm pressure and energy, using 
handkerchiefs, etc. 

9. Replace the patient's wet clothing by such other covering as can 
be instantly procured, each bystander supplying a coat or a waistcoat. 

Meantime, and from time to time, 

Y. AGAIN TO EXCITE INSPIRATION. 

10. Let the surface of the body be slapped briskly with the hand, or 

11. Let cold water be dashed briskly on the surface, previously 
rubbed dry and warm. 

The measures formerly recommended, and now rejected by Dr. Hall, 
are "Removal of the patient, as involving dangerous loss of time ; the 
bellows or any forcing instruments, and the warm bath, as positively 
injurious; and galvanism and the inhalation of oxygen as useless. The 
inhalation of diluted pure ammonia has in it more of promise." 

Avoid all rough usage. Never hold up the body by the feet Do not 
roll the body on casks . Do not rub the body with salts or spirits. Do 
not inject smoke or infusion of tobacco, though injections of spirits and 
water may be used 

Another Method (Sylvester's) is : 

Lay the patient on his back, and, having pulled the tongue forward, 
draw the arms up slowly over the head, by which means the ribs are 
elevated by the large fleshy muscles of the chest, which are attached to 
the arms, and Aspiration is produced; the arms are then to be brought 
down to the side of the chest, which they are to compress in aslight degree 
thereby inducing expiration. These movements are to be repeated as 
slowly as in the Marshall Hall method, and it is said that they give a 
more complete change of air to the lungs. 

The means employed should be persisted in for several hours, till 
there are signs of death. 

When symptoms of recovery begin to show themselves, stimulating 
injections of wine or brandy may be useful; but be careful not to admin- 
ister any liquids by the mouth until animation is fully restored, lest they 
pass into the lungs, and so suffocate the patient. At this period the 
patient should never be left alone, as some have been lost from want of 
care, who otherwise might have been saved. 

Apparent Death from Being Frozen.— When a patient is found in 
a state of frost-bitten asphyxea, arising from exposure to intense cold, he 
should be moved with great gentleness and caution, to guard against any 



VERIFICATION OF DEATH. 727 

injury, as fracture, etc., to a place of shelter, such as a barn, or unheated 
apartment, since only a moderate degree of heat might annihilate all hope 
of restoring animation ; at the same time, the patient ought to be protected 
from the slightest draught. 

He should then, especially if the limbs have become stiffened by the 
frost, be covered over with snow to the hight of several inches— the mouth 
and nostrils, alone, being left free. 

The patient ought to be put into such a position that the melted snow 
may run off readily, and its place be supplied by fresh. When there is no 
snow, a cold bath, the temperature of which has been reduced by ice (or 
a bath of cold sea or salted water,) may be substituted, and the body im- 
mersed therein for a few minutes. 

The process of thawing is, by these means, to be affected, and when 
every part has lost its rigidity, the patient should be undressed by degrees, 
or the clothes cut from the body, if requisite. As the muscular, or soft 
parts become pliable, they may be rubbed with snow until they become 
red ; or the body should be wiped perfectly dry; if snow is not to be had 
placed in flannel, in a moderately warm room, and rubbed with warm 
hands of several parties, simultaneously. 

In the event of no signs of returning animation declaring themselves 
soon after the forgoing treatment, small injections containing Camphor 
may be administered every quarter of an hour. As soon as any symptoms 
of approaching restoration become perceptible, small injections of luke- 
warm black coffee (coffee without milk) may be thrown up the bowels, 
and as soon as the patient is able to swallow, a little coffee may be given 
in the quantity of a teaspoonful at a time. 

The measures above detailed ought to be persevered in for several 
hours, against the excessive pain which is generally experienced when life 
is restored, Carboveg. should be prescribed in repeated doses, and if it 
fails to relieve the suffering, Arsenicum maybe given. The party rescue I 
must avoid subjecting himself to the heat of fire or stove for a consider- 
able length of time after his recovery, as serious consecutive ailment, and 
particularly disease of the bones, is likely to follow. 

Apparent Death fromNoxious Vapors. — The treatment consists in 
removing the body into a cool, fresh current of air; frequently dashing 
cold water on the neck, face and breast; if the body be cold, applying 
warmth, etc., as above recommended in the case of drowning; infla- 
tion of the lungs, early and judicious application of galvanism or electric- 
ity—after life has been restored, Op., or Aeon., may be given with advan- 
tage. 

VERIFICATION OF DEATH. 

The prize of five thousand francs given by the Acadamy of Medicine, 
France, to be awarded to the discoverer of a simple and easy process by 
which any illiterate person might be able to ascertain, without a doubt, 
whether death had really and irrevocably taken place, was divided among 
four competitors. 

1. If a portion of the body be rubbed with a coarse wet towel, or with 
the back of a knife, and then be left exposed to the air, in the course of a 
few hours the skin will have become transparent and like parchment, if 
death has really occurred. 



728 ACCIDENTS OF VARIOUS KINDS. 

2. If a light be held to the back of a finger at a moderate distance a 
blister will be formed ; if this contain serosity, there is still life in the body, 
[f the skin be touched with a piece of burning charcoal, if death is com- 
plete, it will become livid, a blister will be raised filled with vapor and 
having no serosity nor appearance of reaction. Putrefaction is also satisfac- 
tory evidence of death, but this can not be waited for. 

CONCUSSION OF THE BRAIN. 

In concussion of the brain, which may arise from a violent shaking 
of the brain or of the whole body, without any direct violence having 
been offered, or with such as a severe blow or fall on the head, the symp- 
toms vary, according to the degree of injury which the brain has sus- 
tained. 

Symptoms. When the concussion is very severe, there is immediate 
deprivation of sense and power of motion, and death is the general result; 
but when slight, a temporary stunning or confusion, with more or less 
headache is produced, followed by increased action of the pulse, giddiness, 
and sickness. When, on the other hand, the violence done is greater than 
in the latter instance, though not so severe as to cause the fatal termina- 
tion alluded to above, we may divide the progress of the results of such 
accident into three distinct stages, as follows: 

The first stage, in which the patient is rendered insensible and inca- 
pable of movement; his limbs become cold; the pulse weak, slow and 
intermittent: the respiration laborious, but usually without snoring. 

The second stage, in which, as the patient begins to recover from this 
condition, the pulse and respiration improve, and warmth begins to be 
felt in the extremities; the sensibility to touch then returns, and the con- 
tents of the stomach are, in most cases, ejected; still, he continues to 
remain in a dull, contused state, and inattentive to, or almost unconscious 
of, slight external impressions. On the gradual subsidence of the first 
effects of the concussion, the patient becomes enabled to respond to ques- 
tions spoken in a loud tone. 

The third stage. When the stupor has considerably or entirely abated 
inflammation of the brain, of an active character, will, in many cases 
then begin to develop itself, with all its symptoms, and if not checked, 
suppuration or effusion of blood within the head, preceded by sudden 
coldness and shivering, will result. This stage needs very close watching 
and care, as it may terminate fatally. 

TREATMENT. Arnica is the specific remedy in all cases of injury 
arising from external violence, and its timely administration internally, 
simultaneously with its external application (if there be a wound,) in 
cases of concussion of the brain, will, in most instances, if the injury be 
not very severe, suffice to remove all traces and evil consequences of such 
misfortunes. 

Application {external) : Add twenty drops of concentrated Tincture of 
Arnica to two tablespoon fuls of water, and bathe the parts with this 
lotion three times a day until the dispersion of the bruise, swelling, 
etc. Should the swelling, pains, and other symptoms increase, 
after one or two applications, the lotion should be discontinued, 
until these symptoms of aggravation have subsided. 

Dose {internally) : A few drops in a little water every two or three 
hours, varying the time as the urgency of the case appears to demand. 



CONTUSION OF THE CHEST — SPRAINS. 729 

When the contusion has been serious, the following symptoms usu- 
ally characterize the case: — Extreme restlessness or jactitation and irri- 
tability of temper, with sensibilityof the eyes tolight; small, quick pulse; 
delirium ; or coldness and shivering. 

The treatment which is called for in cases of this nature, is identical 
with that which has already been detailed in the article on Inflammation 
of the Brain, to which the reader is referred for particulars. 

After an injury to the head, particularly if it has been of a somewhat 
severe character, the patient ought not to be allowed to partake of any 
stimulating liquids, such as wine, spirits, until at least three or four 
weeks have elapsed, even though he may appear to have entirely recov- 
ered from the effects of the accident. He ought, likewise, to be kept quiet, 
and not be permitted to expose himself to excitement of any kind, other 
wise the most serious consequences may result. 

COXCUSSIOX OB COXTUSIOX OF THE CHEST. 

TREATMENT. Arnica should be promptly employed, in those 
instances in which the chest has been injured by a contusion, or violent 
concussion, and when the following symptoms are the result: Soreness, 
or a sensation as if from incipient suppuration, with heat and throbbing, 
is experienced in some particular spot; fever, or alternate chilliness and 
heat followed by fever, which becomes aggravated in the evening; sleep- 
lessness or disturbed sleep, with general heat, and sometimes perspiration 
towards morning; short, dry cough which increases the pain, or cough 
with spitting of blood; further, when the pain in the chest is rendered 
more acute by taking a full breath, laughing or sneezing, or when prick- 
ing pains or a sensation of fullness or pressure, as if caused by extra va- 
sated blood, is experienced, together with a feeling of constriction that 
obstructs the freedom of breathing. If the fever symptoms should be 
very intense, a dose of Aconitum should be given, either at the commence- 
ment or as an intercurrent. 

Do.se: To be used as just directed for Concussion of the Brain. 

Quinine is not unfrequently of much service in completing the cure 
when a degree of delicacy of the chest remains behind, with tendency to 
suffer from shortness of breath, and a short dry cough, combined with 
paleness of the face, impaired appetite, and restless, unrefreshing sleep. 

Dove: A small powder or one half grain, night and morning, for six 
days (or until earlier change;) then pause four days, after which 
the course may, if necessary, be repeated as before, and so on. 



SPRAIXS— PARTIAL DISLOCATION. 

A sprain is sometimes very painful. Very often they are the result 
of momentary displacement of the bones, which strain or partially tear 
the ligaments which surround and hold the joint in its proper position. 
They are accompanied frequently with some constitutional disturbance. 
The injured part swells and the membrane covering ends of the bones 
within the joint is usually involved. 

TREATMENT. The treatment of sprains consists in restoring the 
bones to their natural position, (if necessary,) by extension and direct 
pressure, and applying a solution of Arnica to the part, which must also 
be bandaged to support the limb and prevent recurrence of the accident 



730 



ACCIDENTS OF VARIOUS KINDS. 



A few drops (two or three) of the same remedy, taken internally, will 
greatly assist in making a speedy recovery. Or if the sprain is attended 
with swelling and great pain Rhus-tox. may be taken alone or in alter- 
nation with Arnica, to great advantage. If a sprain originated by lifting 
heavy weights Rhus, will greatly assist. Use as directed for Arn. Petro- 
leum (coal oil) is a good remedy in many cases; apply externally. 

Aconite must interpose within not less than one hour after the pre- 
vious internal use of either of the other remedies here mentioned, when- 
ever the local pain, heat, and redness resulting from a severe sprain are 
attended with fever and restlessness. 

A small dose repeated every thirty minutes to two hours. 

In sprains and strains the recovery is usually very tedious, indeed, in 
many cases it is more so than even a broken bone, especially when by 
some unusual effort or sudden motion some of the fibers of a muscle have 
been ruptured. In this last named case, position and rest is all important. 
The position should be such as will relax the injured muscle and allow the 
ends of the ruptured fibers to come in contact with each other, when that 
must be maintained until the ends so brought in contact shall unite. 



HEMORRHAGE— MEANS OF SUPPRESSING. 

The word hemorrhage, of course, means the escape of blood from any 
vessel in any part of the body, but here we only propose to speak of those 
bleedings which occur as a consequence of some accidental cutting or 
rupture from some external cause, of a blood vessel, in other words, those 
cases which occur in " minor surgery." 

Hemorrhage is of frequentoccurrence and as a rule requires prompt action 
and presenceof mind in those present, to prevent it from becoming seri- 
ous, and even imperiling life itself. The means of preventing and sup- 
pressing the flow of blood from an artery that has been cut or broken in 
any way are few and simple. For temporary means to stop bleeding from 
any artery in the arms or legs, a handkerchief or something of the kind 
passed around the limb ( above the point of injury, through beneath which 
a small stick, nail or wire is passed and then twisted around until it produces 
a good degree of pressure, will stop almost any case. This is an always 
present substitute for the tourniquet used by surgeons in like cases. 

Another means, always present, is direct pressure by means of the 
hands. On the upper extremities the circulation may be readily arrested 
with the fingers, by grasping the arm as shown in this cut. 

If their points are so ap- 
plied over the artery, a very 
slight force is sufficient, and 
any part of the arm above 
the elbow may be selected, 
although that shown in the 
cut is usually most conven- 
ient. This fact should be 
impressed on the mind of 
all, especially the young of 
both sexes, as it will perhaps 
be the means of saving life 
in case of serious hemorrhage. 




HEMORRHAGE— WOUNDS. 



If the accident should occur in the lower extremity, resort to the hand- 
kerchief and stick may be had recourse to, or the flow may be effectually 
stopped by making pressure on the artery near its passage from the body 
by means of the thumbs, applied as shown in this cut. 

If the pressure is made much lower 
down on the leg, much additional force 
is necessary, and even then, if the thigh 
be fat and muscular, it may not always 
be entirely successful; but if this force 
is used as here directed and illustrated, 
there need be no fear of fatal hemor- 
rhage, even if all the arteries of the leg 
should be severed. 

As soon as possible, the end of the 
bleeding vessels should be secured by 
tying by means of any small, strong 
cord, as a thread of silk or strong spool 
cotton. We wish it to be distinctly un- 
derstood, that we do not mention these 
means as being superior to the means 
within the reach of the well prepared 
surgeon, but only as effectual means 
which will be present in any sudden 
emergency and so simple that any one 
may understand and apply them readily. 




WOUNDS. 

Wounds are generally divided into, or classified as (1) incised, (2) lacer- 
ated, (3) contused, (4) punctured, (5) gunshot, and ifi) poisoned wounds. 

(1.) By an incised wound is meant one which has been produced by a sharp 
instrument, as a sword, knife, etc., and is not accompanied with any con- 
tusion or laceration. Incised wounds, although more liable to be attended 
with a greater loss of blood, are, generally speaking, the least dangerous 
and the most easily healed. 

(2.) Lacerated wounds are those in which the muscular fibers, instead of 
being divided by a sharp-cutting instrument have been torn asunder with 
some violence ; the edges, in place of being even and regular, are jagged and 
unequal. They are commonly attended with little or no bleeding, rarely 
heal without suppurating, and are frequently succeeded by violent inflam- 
mation. 

(3.) The terms contused wounds or bruises, are applied to those injuries 
which are occasioned by some blunt instrument, or hard, blunt surface 
being brought in violent collision with a part of the body. When severe, 
they are dangerous, from being prone to terminate in mortification and 
sloughing. 

(4.) Punctured wounds are those which have been caused by pointed 
instruments; they partake more of the nature of lacerated than of incised 
wounds, and are dangerous from the great depth to which they frequently 
penetrate, and the serious consequences they often entail. 



732 ACCIDENTS OF VARIOUS KINDS. 

(5.) Gunshot wounds partake of the character of lacerated and contused 
wounds. 

Degree of the Injury. Wounds of the arteries are, for the most 
part, the moot serious: they are to be distinguished by the bright color of 
the blood, which, moreover, issues very rapidly and in jets; while that from 
a vein flows in a smooth, uninterrupted stream, and has a darker hue. 



INCISED WOUNDS. 

TREATMENT. (External.) In the treatment of wounds of a severe 
description, our first object is to arrest the flow of blood. By the tourniquet 
(an instrument used for this purpose), the ligature, compression, cold 
water or ice, and astringents, are all appliances to this end, variously ap- 
propriate according to the degree or source of the hemorrhage. 

When the iujured vessels are of a small size, they spontaneously cease to 
bleed, or do so, at all events, as soon as the wound is dressed ; but when the 
discharge of blood is considerable, one or more of the subjoined measures 
must be immediately resorted to for the purpose of arresting it. 

MECHANICAL MEANS— DRESSING. 

Wounds of Arteries and Veins. When, therefore, there is reason to 
conclude that an artery has been wounded, a tourniquet should be applied 
around the limb to check the flow of blood ; the external wound must then 
be closed, covered with a graduated compress, and firmly secured with a 
bandage. When a proper tourniquet is not at hand, its place may be toler- 
ably well supplied by a handkerchief secured around the limb, and tight- 
ened by two or three turns ol a stick passed under the handkerchief, until 
the discharge of blood ceases; or the substitute may consist of a cork cut 
longitudinally, and firmly fixed over the artery, the site of which is readily 
to be found at the inner surface of the limb, in spare or emaciated sub- 
jects, by its pulsation ; but as, in robust and muscular patients it is more 
difficult to find the artery, it will, in such cases, be advisable first to tie a 
handkerchief or non-elastic garter tightly around the limb, above the 
wound, which will have the effect of rendering the artery more prominent. 
In order to make the compression of the cork more effectual, several plies of 
lint or linen, or a piece sufficiently large to form a few inches square and 
one in thickness, should be placed over the cork, (which should be held 
firmly in the required position during the preparation of the compress,) and 
the whole then tightened, and retained as long as may be requisite. The 
application of ice to the wound is, also, of unequivocal service. Bleeding 
may, also, be arrested by twisting the divided ends of the artery firmly by 
a pair of forceps, if the vessel be of small size; or by the application of lint 
saturated with "Monsell's Solution" (Persulphate of Iron) to the wound 
secured with a compress and bandage. This latter method is also well 
adapted to the arrest of bleeding from wounded veins. When the discharge 
of blood comes from a large artery, it must sooner or later be stopped by 
ligature. 

It is to be remembered that when an artery is wounded, compression 
is to be made between the wound and the heart ; and vice versa when a 



INCISED WOUNDS. 733 

wounded vein needs compression, as the blood flows through the arteries 
fromthe heart, and through the veins, to the heart. It issometimes neces- 
sary, in cases of wounded arteries, to make compression both above and 
below the wound. 

Wounds in the Mouth. Bleeding from wound, etc., in the mouth, 
sometimes requires the application of styptics, such as alcohol, kreosote 
water, "Monsell's Solution," etc. The same may be said of slight superficial 
wounds, as also of fungous tumors, and other diseased surfaces, when cold 
water fails to answer the purpose. 

Copious discharge of blood after the extraction "of a tooth is, usually 
readily suppressed by pushing a compress of lint into the hollow space left ; 
or by the aid of styptics, when requisite. A simple, and sometimes extreme- 
ly efficacious mode of checking the flow of blood, is by replacing the extract- 
ed tooth, and keeping it in its former position, until the risk of further dis- 
charge of blood is obviated. 

The next step to be taken in wounds of every description, after the hem- 
orrhage is stopped, is to remove all extranous matter, such as sand, frag- 
ments of glass, splinters, etc. ; then to relax the muscles by placing the injur- 
ed limb or part, in such a position that the wound may not be made to gape ; 
finally, to bring the lips or sides of the wound in accurate contact, and ke^p 
them so by bandages, plasters, stitches, etc. Bandages are usually indis- 
pensable in deep, and even in small, superficial incised wounds ; but care 
must be taken not to apply them too tightly nor when there is excessive 
inflammation. 

Stitches are commonly found necessary in wounds of the face or belly, 
and sometimes of the hands, and in old people generally. In the young 
and vigorous they are seldom called for, and may be even improper and 
hurtful when the patient is of an irritable habit of body. Strips of adhe- 
sive plaster — cut narrow and sufficiently long to retain their hold as firmly 
as possible, and act with the required compressive power— form, in the 
majority of incised wounds, the most frequently useful means of bringing 
the sides into close approximation, and effecting adhesion. It sometimes 
happens, however, that even incised wounds, particularly when deep and 
of considerable magnitude, terminate in suppuration. It is consequently 
necessary to leave intervening spaces between the slips of plaster, to admit 
of the exit of the matter in such an event. Again, when it is found 
impracticable to cleanse the wound of all foreign substances, it ought to 
be only lightly, and so to speak, incompletely dressed, as it will be neces- 
sary to renew the dressings repeatedly. In some cases it is necessary to 
dilate the wound, to facilitate the abstraction of a splinter, etc. When it 
is necessary to dress the wound, and the compress is found adherent, it is 
advisable to remove it With caution and gentleness, in order to avoid tear- 
ing asunder the closing wound; the employment of tepid water will 
facilitate the separation of the linen. It is best to keep all wounds as 
much secluded from the external atmosphere as possible. 

TREATMENT (Internal or Constitutional.) Arnica is the first 
remedy in the constitutional treatment of wounds of all kinds, and its 
internal administration should commence as soon as the patient has been 
rendered as comfortable as circumstances will admit. 

Dose : Eight pills in a teaspoonful of water, to be repearted every two 
to six hours, if necessary. 



734 ACCIDENTS OF VARIOUS KINDS. 

Aconitum is found necessary, if the patient be robust and strong, and 
sympathetic fever runs high. 

Dose: Six pills in a teaspoonful of water, every one to three hours, 

until the fever indications have abated. 
China is required for the treatmentof thoseserious injuries by which 
very severe loss of blood is occasioned, resulting in all the signs of extreme 
exhaustion, characterized by severe and repeated faintingfits, with deadly 
paleness of the face or livid appearance of the countenance, twitching of 
the tendons, etc. In cases in which reaction does not speedily follow the 
first dose of this medicine, two or three teaspoonfuls of good wine should 
be administered, after which, if a general improvement takes place, the 
next medicine should be subsequently employed. But if, on the other 
hand, the wine only acts as a temporary stimulant, the dose of China 
must be repeated before proceeding with further treatment. 

Do.se. Six pills in a teaspoonful of water, followed in half an hour, if 
the patient does not rally, by the administration of a teaspoonful of 
wine (repeated three times, at intervals of five minutes). After 
which, if the patient sinks again, repeat the dose of China as before. 
But if the worst symptoms have subsided, proceed with the admin- 
istration of Arnica. 
When matter (pus) forms in incised wounds, the same treatment must 
be pursued as is described under the head of Lacerated Wounds. 



LACERATED WOUNDS. 

TREATMENT. (External or Local.) In the treatment of lacer- 
ated wounds, we must, after having carefully cleansed them, closely ap- 
proximate all the parts that will admit of the process, and retain them in 
their places by means of plasters and an appropriate position of the body 
or limb, for the purpose of endeavoring to unite them by the first intention. 
If the laceration be extensive, and arteries of any considerable magnitude 
have been divided, they must be secured by ligature. During the process 
of sloughing, which commonly ensues, the wound must be closely watched 
as secondary bleeding is liable to ensue. 

Arnica and Calendula (Concentrated Tincture) are of great impor- 
tance in the treatment of Lacerated, Contused, and other wounds. When 
the discharge of blood is profuse, and the wound is of such a character as 
threatens to leave a severe scar, or to terminate in extensive suppuration 
before healing, Calendula is found most efficacious, and will frequently 
greatly modify the severity of the symptoms. When, on the other hand, 
the parts are severely bruised, and show a disposition to turn black in the 
neighborhood of the wound, or when the wound is slight, Arnica is to be 
preferred, except in persons in whom it produces inflammation of the skin 
or is apt to develop a rash. Calendula has likewise been found to be a 
useful application, during the healing process, when the granulations are 
excessive or redundant. 

Application: To sixteen parts of water, add one of the concentrated 
Tincture of Arnica or Calendula (as the case may be.) and saturate 
therewith a pad made of linen rag, which place carefully over the 
wound, remoistening and reapplying the same as often as maybe 
necessary. 




MUSCLES and tendons of the hand liable to accident. 



CONTUSED WOUNDS OR BRUISES. 735 

CONTUSED WOUNDS OR BRUISES. 

TREATMENT. (External). In cases in which gangrene ensues from 
very severe injuries, by contusion, notwithstanding the appropriate treat- 
ment as below directed, the question of amputation is at once presented, 
and the services of a surgeon should be had without delay. 

In cases in which the membrane investing the bone (the periosteum) 
has been injured by a contusion, if effused blood or matter is evidently 
pent up beneath it, and the suffering attendant upon the injury is very 
intense, an incision may be necessary, whereby the effused fluid may be 
allowed to escape, the constitutional treatment being, at the same time, 
pursued as appropriate to the symptoms and conditions of the case. 

Hot Water.* In the first instance, the only external application in 
cases of contusion should consist of hot water. In those very severe cases 
in which the injured part has been squeezed out of shape, or otherwise 
absolutely disfigured, the application of the hot water should be continued 
simultaneously with the appropriate constitutional treatment, a remark 
which also applies to such cases as have demanded recourse to a surgical 
operation. 

Application: Bathe the part freely with hot water for five minutes, 
repeating the operation in the course of three hours ; or otherwise 
saturate a linen rag with hot water, place it over the part, covering 
the whole with oiled silk, and remoistening the rag as fast as it 
becomes dry. 
Arnica {Concentrated Tincture) should be applied, when there is con- 
siderable extravasation of blood, to promote absorption and otherwise 
forward the cure. 

Application : To ten parts of water add one of the concentrated Tinc- 
ture of Arnica, and bathe the parts well with this lotion every three 
hours, until evident indications of amelioration. 
Rhus-tox., (Concentrated Tincture) is to be preferred in cases in which 
the joints, synovial membranes, or tendons are injured by a contusion, 
and this remedy should be employed, simultaneously with its internal 
administration, at the onset in such instances. 

Application: To sixteen parts of water add one of the Concentrated 
Tincture of Rhus-tox., saturating a piece of linen rag with this lotion 
and applying it to the parts injured, covered with oiled silk, and 
remoistening this dressing as often as it becomes dry, until the pain 
and other symptoms abate (suspending the application, however, 
and substituting hot water, as above directed, if an eruption should 
be developed in the parts). 

TREATMENT. (Constitution ad.) Arnica. This medicine must 
be administered internally, during the first period, and whilst hot water 
or the Tincture of Arnica, only, is being applied externally to the parts. 
In very severe cases even, in which the contusion has been so violent as 
to squeeze the limb nearly flat, or otherwise to disfigure it, this medicine 
should be employed at the onset. When amputation has become neces- 
sary and has been performed, Arnica is generally to be recommended as 
the appropriate medicine for constitutional treatment. 
Dose : Six globules in a teaspoonful of water, repeated after two to four 
hours. 

*Tf watpr 13 applied as hoi as can be borne to any injury that is likely to caure a black eye, 
it will prevent it from becoming black. 



786 ACCIDENTS OF VARIOUS KINDS. 

Rhus-toxicodendron is to be preferred simultaneously with the 
external administration of the same medicine, for the treatment of cases 
in which the joints, synovial membranes, or tendons have been especially 
injured by the contusion. 

Dose: Six globules, as directed for Arnica. 

Arsenicum may be employed in those very severe cases in which 
gangrene threatens to ensue, and the skin has assumed a livid and black 
appearance, if indeed, amputation be not absolutely necessary. So long 
as there is a prospect of avoiding the loss of the limb, the employment of 
this and the successive medicines should not be neglected. 

Dose: Six globules in a teaspoonful of water, repeated at intervals of 
three hours until some degree of improvement or change becomes 
apparent. 



PUNCTURED WOUNDS. 

The external treatment of punctured wounds is the same as directed 
for wounds in general, but unless compression can be made by means of a 
bandage or adhesive plaster through the whole extent of the wounds, the 
effort should notbe made to obtain healing by first intention, (without the 
formation of pus). If the wound is deep or so situated as to be in danger 
of producing lock-jaw, it will be necessary to resort to such constitutional 
treatment as is recorded under the head of Lock Jaw, in this work. Ap- 
plications of cold water are always useful in cases where there is much 
fever in the wound. 



GUNSHOT WOUNDS— SPLINTERS, ETC. 

When splinters of bone, a ball or other foreign substances are lodged 
in the wound, they should be extracted with as little irritation as possi- 
ble, if they press upon some important organ or part. If they do not so 
rest as to endanger some important part, they may be allowed to remain 
(if deep seated and so difficult to reach as to necessarily occasion a high 
degree of irritation in the effort to extract them,) until loosened by suppur- 
ation, which will be hastened by appropriate treatment. 

Cold water constitutes one of the most generally useful of local appli- 
cations, in cases of gunshot or similar wounds. Saturate a linen or old 
cotton rag, or lint pad with cold water and apply it to the part, constant- 
ly remoistening the pad as it becomes dry or hot. If there is added a 
little Arnica Tincture to the water, the benefit will be marked. About 
twenty drops of tincture to each three tablespoonfuls of water. 

Calendula used in the same way is good, in many cases even better 
than Arnica, especially where the latter is known to irritate the skin of 
the patient. 



BANDAGES. 

Bandages are always necessary in fractures of bones, and often in 
sprains and in varicose veins and sores on the extremities, usually, although 



BANDAGES 



73: 



very improperly called " fever sores." Of all the different bandages none 
excel the " roller," and to make and apply it neatly is an accomplishment 
that all should have. It is to be prepared from a piece of muslin of the 
requisite length and width by tearing it from the piece, and then winding 
it into a neat cylindrical form by hand; this is accomplished by folding 
one end of the band five or six times on itself, so that it may form a sort 
of axis, then roll it a few turns on the thigh to give it size, then place the 
cylinder between the thumb and fore-finger of the left hand, allow the 
band to run over the right forefinger, holding firmly between the thumb 
and finger of that hand so as to make traction, and tighten the cylinder. 
Having thus arranged it, give a rotary motion to the hand, and cause the 
cylinder to revolve upon its axis by means of the fingers and thumb of the 
left hand, while at the same time the right thumb and forefinger are 
moved partially around the cylinder itself, which, by this movement, is 
soon formed of the required size. 

The spiral bandage is that which is most frequently used in the treat- 
ment of all affections, either of the extremities or trunk. In applying 
this bandage, each turn is made to cover about one-third of the one which 
preceded it, and as most parts to which it is applied are conical in shape, 
especially in the extremities, it is obvious that in ascending from the 
lower to the upper portion of them ,and in applying the spiral bandage it 
must be done so as to cause the pressure to be uniform through its whole 
extent; to accomplish this we make what we call reverse turns, which is 
done as follows: Apply the end of the band to the limb at the smallest 
part to which you wish to apply it, and continue to make simple spiral 
turns, until you approach the enlarged portion of the limb. Then apply 
two fingers of the free hand to that portion of the bandage which is alrea- 
dy in contact with the limb, not to assist in forming the reverse or to fold 
it down, but, to prevent the turns already applied from slipping or becom- 
ing relaxed while the reverse is being made. See that no more of the 
bandage is unrolled than will enable you to separate the cylinder a short 
distance (four or six inches) from the limb; let that portion of the band- 
age be loose which is between the fingers, holding the band to the limb 
and the body of the cylinder; turn the hand holding the roller from being 
squarely back down, to a point where the palm is down, by motion of the 
wrist alone without moving the fingers from the cylinder at all ;as shown in 
this cut. Take especial care to 
make no traction nor to sink 
the cylinder below the level 
of the limb, till the fold or 
reverse is made, when it 
may again proceed up the 
limb. 

It should always ascend 
spirally and only cover in 
about one third of the preced- 
ing turn. Keep each turn and 
each reverse parallel with its 
fellow. 




47 



738 



ACCIDENTS OF VARIOUS KINDS. 



FRACTURES— BROKEN BONES. 

As soon as a limb or other bones are discovered to be fractured, the 
patient ought to be placed on a litter of any kind which happens to be 
at hand, such as a shutter or board, and removed to some neighboring 
place of shelter, or to his own abode, if it be not too far distant, and a 
surgeon sent for at once. Great care and gentleness ought to be exercised 
in lifting and handling the patient, and in transporting him from one 
place to another; otherwise a fracture originally of the simple kind is 
liable to be converted into a compound, or at least into a complicated one; 
for laceration of the soft parts is likely to occur from the action of the 
sharp and jagged edges and ends of the broken bone or bones, whereby 
the probabilities of recovery will be made more doubtful and perhaps 
unfavorable, especially if the accident has happened to a debilitated or 
aged person. 

MECHANICAL MEASURES. 

For Simple Fractures. In the case of a simple fracture, the adjust- 
ment of the ends of the bones to their natural position should be effected 
by placing the limb in the position best calculated to relax the principal 
muscles attached to the broken bone; it should then be gradually exten- 
ded until the upper and lower fragments are brought into their proper 
position. After that is accomplished, splints of pasteboard or light wood 
held in position by means of carefully applied bandages, (see cut on page 
715) to remain until the union of the broken bone is well secured. 

For Compound Fracture. The ends of the bones have been forced 
through the flesh and must be carefully cleaned and returned to their 
natural position. The parts of bone should be held in their position by 
means of splints and bandages as directed above for simple fracture. 

In fracture complicated with a wounded artery or dislocated joint, 
the artery should be tied, to stop the hemorrhage, and the dislocation 
reduced before the bone is set. This variety requires more care and cool- 
ness than the other varieties do. It is always desirable that a good sur- 
geon should be secured in the case of any fracture. After fracture of the 
bones of the arms and legs, which is so readily known by any one, by 
means of the changed length and position of the affected extremity, as 
compared with the other, and by the hearing or feeling of the snap at the 
moment of accident, also by the grating sound and sensation produced by 
moving the one part of the bone against the other — fracture of the clavicle 

(collar bone) is the most frequent, or 
at any rate a very common occurrence. 
It usually takes place near its middle, 
and is the result of force applied either 
directly or indirectly. The fracture is 
easily discovered by passing the finger 
along the collar bone: the natural line 
of the bone is observed to be interrup- 
ted, and the broken ends are percep- 
tible; the shoulder falls forwards and 
inwards. Theouter fragment is drawn 
downwards by the action of the muscles; by pressing the shoulder 





THE 3IUSCLES OF THE BODY AS SEEN FROM THE FTtONT. 




TIIE MUSCLES OF THE BODY AS VIEAVED FROltf BEHIND, 
740 



BUKNS AND SCALDS. 



741 



upwards and outwards a grating (crepitus) can be felt at the point of frac- 
ture. Treatment of this fracture consists 
in adjusting the broken extremities of the 
bone, by forcing the shoulder upwards, 
outwards, and backwards, and retaining 
it in this position. 

The following mechanical appliance 
is a good and simple one for accomplishing 
this object. A padded belt is placed around 
each shoulder and drawn together on the 
back by a strap, and the arm below the 
elbow placed in a sling. Or, a folded towel 
is placed in the arm-pit and a bandage 
passed from shoulder to shoulder, forming 
a figure oo (see adjoining cut) across the 
shoulders. 




BURXS and scalds. 

There are several varieties. The first variety causes a mere redness of 
the skin and soon passes away without causing the skin to come off at all. 
The second variety causes the skin to rise in blisters, which are tilled with 
serum ; if slight these soon dry up and heal, but if the skin is much 
injured, may be followed by obstinate ulcers. The third variety causes the 
destruction of the parts and although perhaps not causing as much, if any, 
pain, is by far the most dangerous, and serious consequences may follow. 

The constitutional disturbances and the period of danger following 
deep burns or scalds have been divided into three stages. 1. Depression 
and Congestion, during the first four or five days; 2. Reaction and Inflam- 
mation, in which the patient may sink with an affection of the head, chest 
orabdomen; and, 3. Suppuration and Exhaustion which may continue from 
the second week to the close, and is often associated with hectic fever or 
pleurisy. The danger of burns and scalds often depend more on the extent 
of surface involved, than upon the depth of the injur}'. Burns or scalds in 
the trunk, neck, or head are far more dangerous than those of an equal 
extent in the extremities. Children suffer more severely from these acci- 
dents than adults. 

TREATMENT. A most important object to be kept in view and 
attained as nearly as possible, is to cover the injured part with some suit- 
able material that will exclude the atmospheric air, which covering should 
not be removed until the cure is complete. The following local applica- 
tions are recommended. A thin sheet of smooth (not glazed) cotton bat- 
ting should be applied to the denuded parts and not removed ; this may be 
saturated from time to time with a mixture of Carbolic Acid one part, to 
Olive Oil six parts; then cover this with several thicknesses of the same 
cotton batting. As a domestic remedy these should be kept on hand, always 
ready for burns and scalds. 

Another and a very excellent remedy is Extract of Witch Hazel (Ham- 
msemillas), Pond's Extract, which should be applied in the same manner as 
just directed for the Carbolic Acid and Olive Oil. 



742 ACCIDENTS OF VARIOUS KINDS. 

Tincture of Cantharides (Spanish Fly) ten drops to an ounce of 
water applied also by means of the cotton wool, is especially useful when 
blisters are forming or have just formed. See under the head of " Tincture 
of Cantharis " page 93. Also " Causticum or Lime Water," page 94; "Raw 
Cotton," page 94; " The Soap Plaster," page 94; "Flour,'' page 95. 



SUNSTROKE— SUN FEVER— COUP DE SOLEIL. 

This is a paralysis of all the functions of the brain, occurring either 
gradually or suddenly, excited by heat, generally following exposure to 
the direct rays of the sun, particularly when to this exposure is added the 
pressure of tight and unsuitable clothing. 

Symptoms. The affection is generally preceded by premonitory symp- 
toms, such as thirst, heat, and dryness of the skin, vertigo, congestion of 
the eyes, frequent desire to pass water; fainting follows and is often 
instantly fatal, or insensibility and loud (stertorous) breathing occur either 
with or without convulsions. In both varieties the number of deaths is 
proportionately great and a very unusual congestion of the lungs is the 
most common morbid condition found after death. 

TREATMENT. For medical treatment see "Congestion of the Brain" 
pages 117 to 122. 

HOME TREATMENT. It is now agreed that sunstroke results from a 
depressed, and not, as formerly supposed, from an excited or stimulated 
condition of the nervous system and its center. The treatment therefore 
is to apply cold water by pouring, or cold compresses constantly applied 
over the head, neck and chest, or by pounded ice applied to the same 
localities. 

Prevention. Clothes should be light and loose, especially about the 
neck. Green leaves in the hat or cool cloths applied to the head are good, 
and simple preventives. Another and very important means is to abstain 
from drinking any kind of spirits, as it undoubtedly predisposes to attacks 
of sunstroke by the depression which must and does always follow the 
first effects (i. e. stimulation). Seven tenths of all who die from sun- 
stroke are habitual drinkers and a much smaller percentage recover than 
among non-drinkers. 



STINGS OF INSECTS, 

Such as the Bee, Wasp, and Hornet, are sometimes very painful, but 
rarely dangerous, except when the part attacked is very sensitive, as the 
eye, or else a very important organ, or the number of insects attacking the 
person is so great as to produce general poisonous symptoms. 

TREATMENT. First, extract the sting, if it has been left in the wound. 
Second, apply slices of the common onion, each slice being removed as soon 
as it becomes saturated with the poison, and another applied in its place. 

Musquitoes may be prevented troubling in the night, by rubbing a 
little good soap on the hands and face before going to bed. A little Oil of 
Pennyroyal or Cedar so applied is also efficient. 



DROPSY. 743 

DROPSY. 

TVe have assigned this place to this class of diseases, because the treat- 
ment of dropsy is so uniformly the same that a separate description of the 
disease, as developed in special organs or systems would have led to many 
useless repetitions. 

Dropsy is never an independent or primary disease, but always follows 
or is properly a symptom or result of other diseases, although it sometimes 
appears to be of a primary character. In general, all conditions which, 
in the long run, interfere with the circulation, or retain the water in the 
blood, lead to dropsy; likewise any other conditions that result in a con- 
dition of surplus or want of blood. 

In most cases, however, something else has to become associated with 
these conditions, otherwise it would be difficult to comprehend why many 
conditions which we meet in practice should be able to continue so long 
before resulting in thedevelopment of dropsy. We are unacquainted with 
the nature of this something; whether it is a relaxation of the coats of the 
vessels, or a more copious supply of water in the blood, or whatever else, 
we have not yet been able to find out. Most likely it is from this unknown 
cause that dropsy, which is the result of a general wasting away of the 
flesh, without any special cause, takes place so frequently as seen in many 
cases. In accordance with the above-mentioned three classes of causes 
dropsy sets in, if the flow of the venous blood into the heart is interfered 
with ; if the circulation is obstructed by a clot in the larger trunks of the veins 
(as for instance in consequence of inflammation of the veins in the lower 
extremity, in the case of lying-in women; dropsy arising from inflamma- 
tion of the great portal vein ;) in the case of pulmonary affections imped- 
ing the circulation of the blood through the lungs; in consequence of 
affections of the liver resulting from obstructions of the circulation of the 
blood into the liver. In the case of kidney affections, if the function of 
the kidneys is very much interfered with; in chlorosis (green sickness) 
affections of the spleen, like fever and ague, after copious losses of blood, 
or after severe, debilitating diseases, in general in conditions of debility of 
a high order. 

Symptoms. At the onset dropsy is more or less local; as arule.it 
commences with a swelling around the the ankles, less frequently in the 
face ; dropsy of the abdomen takes place only when the liver is diseased. 
In this case, it may remain localized as such; in the former case it gradu- 
ally spreads over the whole body just beneath the skin, then unites with 
dropsy of the abdomen, and finally with oedema (dropsy) of the lungs or 
brain, in which case death soon results. 

Dropsical effusions are generally accompanied, and sometimes pre- 
ceded by prostration, and by decrease of the urinary secretions. The 
urine is dark, thick, becoming cloudy in a short time; the quantity is 
sometimes very scanty. All the other watery secretions are likewise less, 
or they are entirely suspended ; the stools are very dry, the skin is dry 
and cracks easily, appears incapable of perspiration; the mucous mem- 
branes are likewise dry, on which account the patient is often tormented 
by a distressing thirst. 

Dropsy at times develops itself very speedily and universally, some- 
times slowly and progressing very gradually. It is especially after nephri- 



744 FOOD FOR INFANTS AND INVALIDS. 

tis (inflammation of the kidneys) that water accumulates very rapidly; 
it collects most slowly in company with affections of the lungs. 

The course of the disease is at times uninterrupted, leading speedily to 
death, or else it makes pauses, a portion of the serum that had been poured 
out into the cavities, or beneath the skin being reabsorbed. This may 
result from a transitory cessation or diminution of the obstruction in the 
circulation, or from copious discharges of urine, watery discharges from 
the bowels, oozing through cracks in the skin, or from a general invigor- 
ationofthe whole organism. Death generally takes place by oedema (dropsy) 
of the lungs or brain. Recovery is attended with copious discharges of 
urine, very rarely with diarrhoea alone. (See Index.) 



CHAPTER XXXVI 



FOOD FOR INFANTS AND INVALIDS. 



FOOD FOR IXFAXTS. 

In is a sad fact, true nevertheless, that at least half the children at the 
present time are deprived of their proper sustenance and left to the tender 
mercies of wet nurses or the bottle. Between the two evils it is difficult to 
say which is the least, but unless a superior nurse can be found— one intel- 
ligent and thoroughly clean in her personal habits — we should say choose 
the last, and bring the child up by hand. 

It is our opinion, and the conviction is borne out by every mother's 
experience, that the moral, mental, and spiritual, as well as physical con- 
dition of a child is greatly influenced during its nursing period. Mothers 
who nurse their own children know that it is of the greatest importance 
to the quiet and healthful condition of the child, that they should be free 
from all sources of agitation, anxiety and irritability. 

Overwork, giving way to fretfulness, or being subjected to the unrea- 
sonable temper and caprices of others, frequently induces a state of mind 
that shows itself plainly in the uneasiness and disquiet it produces in the 
infant, and would be seen with still greater distinctness were women 
accustomed to trace results more strictly to their causes. 

If this is the case with the mother, if her mental and spiritual condi- 
tion finds itself reflected so minutely in the lights and shadows of the 
little life which is dependent upon her, why should it not receive a color- 
ing from the milk which it derives from a dull, coarse, appetite-loving 
wet nurse of the ordinary stamp? Two thirds of these nurses make a 
necessity of strong tea and coffee, and malt liquors two or three times a 
day; they are often anything but scrupulous in their personal habits, and 
so accustomed to the exercise of a violent will, by virtue of their office, as 
to be unwilling to bear the slightest control or contradiction. These are 
not the influences which a thoughtful mother would like to have her 
child drink in with its milk, and for reasons here mentioned, we would 



FOOD FOR INFANTS. 745 

all the more earnestly advise you to use the directions for the " Choice of 
a Nurse," on page 689. 

We believe it to be a misfortune, the extent of, which is not at all rea- 
lized, when the mother cannot nurse her own child. The mother's milk 
contains all the elements necessary for its proper growth in every direc- 
tion, and no substitute can be found for it;, but where this is impossible, 
unless, as before remarked, a very superior nurse can be obtained, it is 
safer to trust to the simple food which at least sustains life and does no 
hurt if given at right times and in proper quantities, leaving the mental 
and spiritual activities unimpeded, though probably subject to a slower 
growth than if aided by the sympathetic magnetism of the mother's 
nature. 

STARCHY FOOD. 

Such as arrowroot, sago, corn starch and the like is commonly held to 
be very healthy and nutritious for infants, yet the experience of every 
physician, furnishes numerous instances of feeble sickly children that are 
so fed, while the number is small that survive it. The reason of this is, 
that the digestive organs of infants are not sufficiently powerful to con- 
vert the starchy matter into nourishment; it therefore only serves to clog 
and impede the action of the system, while the little victim is gradually 
being starved on the trifle of sustenance which it can obtain from what- 
ever sugar and milk is given with the other food. 

ENGLISH "PAP." 

English and French babies, when brought up by hand, are fed almost 
altogether on " pap," which is made in England in the following way: 

Boiling water is poured on a small piece of the crumby part of white 
light bread. This is covered up for a moment, and then the water poured 
off. The softened bread is then put in a little porcelain stewpan, with a 
trifle more of water and allowed to boil up, and it is then a pulp. A lump 
of white sugar and a little cold milk added, brings it precisely up to the 
ideas of most young Britishers, who grow very stout and healthy upon it. 
This is excellent food where the mother is capable of partly nursing her 
child. 

French pap is made of flour instead of bread, which is decidedly 
objectionable, as it is not only less agreeable but much less easily digested. 

COW'S MILK. 

A diet of cow's milk exclusively, is not good; it is too rich and very 
apt to provoke eruptive diseases. But if the bottle is preferred to spoon 
feeding, good cow's milk may be given, diluted with one half to one third 
of boiling water and sweetened slightly with white sugar. Use only of 
one good cow's milk. An excellent change from this consists of a thin 
strained gruel from the best prepared barley, with a little milk and sugar 
added. 

A little sugar is necessary in infants' food, but be particularly careful 
not to make it sweet, as this causes continual thirst as well as disorders of 
the child's stomach. 

INFANT'S BROTH. 

After the baby is three months old, it may occasionally be treated to a 
little clear chicken or mutton broth, made in the following manner; Cut 



746 FOOD FOR INFANTS AND INVALIDS. 

up a pound of lean mutton into small pieces, and put them into a small 
jar, cover them with cold water, set the jar into a kettle of warm water 
and let it come to a boiling point, and simmer the mutton until the 
strength is extracted. One pound of meat should make a quart of broth. 
Simmer at least six hours, strain and put in a little salt, but no other spice. 
Treat part of a chicken in the same way for chicken broth. 

BABY PUDDING. 

Grate a little stale bread, pour some boiling milk upon it, cover, and 
when it becomes a pulp, stir into it the yolk of an egg and a grain of salt. 
The quantity should fill a teacup in which boil it fifteen minutes. 

ESSENTIALS FOR A BABY. 

Warm, sensible clothing, quiet, with food and sleep at regular inter- 
vals, are the essentials to health and comfort of babies. 

FOOD FOR YOUNG CHILDREN. 

The great danger in feeding young children does not lie so much in the 
food as in the preparation or want of preparation. A hard indigestible 
potato is bad for them, and a little tender stewed meat is good, but if the 
potato were mashed and mealy, and the meat hard and tough the case 
would be just the reverse. 

The principal danger is in their swallowing indigestible substances, 
and whether these are hard apples or lumpy potatoes, tough meat or sad 
bread, rich cakes or nuts, makes very little difference, the irritation and 
derangement produced is the same. 

Meat for children under the age of ten years, should be cooked very 
tender and cut up very small or given in the form of soup. 

Potatoes should be mashed, apples roasted or stewed, and, if very ripe 
andmellow,may be eaten raw, and if bread andmilkcould form their break- 
fast and some kind of mush with milk their supper, they would be all the 
better for it, for the rest of their lives. 

children's pie. 

Cover thebottom of a pie dish with slices of bread and butter, cover that 
with fresh berries sprinkled with sugar or with stewed fruit, fresh or 
dried. Set it in the oven fifteen or twenty minutes. Sift a little sugar 
over it when it comes out. 

BROWN MUSH FOR 'SUPPER. 

Stir into a quart of boiling water, a teaspoonful of salt, and Graham 
flour enough to make it as thick as corn meal mush. Let it boil gently 
half an hour, keeping it covered. Eat with cream, or milk and sugar. 

BREAD AND MILK. 

Cut or break up stale bread into small pieces and let them come to a 
boil in milk. It makes an excellent breakfast for children, with a slice of 
toast or without. 

CRANBERRIES. 

Should be stewed soft, strained through a colander which will pass 
everything but the skin; boil up a second time with the sugar and set 
away to cool. They may then be eaten with impunity by the most delicate 
children. 



FOOD FOR INVALIDS. 747 

FOOD FOR INVALIDS. 

The diet forinvalidsdependsso much upon the condition of the patient, 
that only the most general directions can be given ; the special application 
must be left in every case to the judgment of the nurse, provided she have 
good natural sense. 

Neatness,cleanliness, and promptitude, are the great requisites in asick 
chamber. The best prepared food is spoiled by want of care and punctu- 
ality in placing it before the patient. 

Where persons are ill their senses are often preternaturally acute; 
slight marks of neglect which would not be noticed at another time, 
become extremely offensive; and a few minutes delay, not only seems 
unpardonable, but is sometimes really injurious. Patience, tact, and nat- 
ural kindness of disposition are essential qualities in a good nurse, and 
when to these are added firmness and good judgment, the sum total in this 
line has been reached. As a general rule, however, one half of the nurses 
injure their patients by absurd restrictions, and the other half by foolisii 
indulgences. 

GRUEL. 

This simple refreshment is invaluable in sickness, and is made with 
little trouble and less expense, yet is very seldom prepared exactly right. 

One tablespoonful of fine Indian or oat meal, mixed smooth with cold 
water anda little salt; pour upon this a pint of boiling water, and turn into 
a sauce-pan to boil gently for half an hour; thin it with boiling water if it 
thickens too much, and stir frequently; when it is done a tablespoonful of 
cream or a little new milk may be put in to cool it after straining, but if 
the patient's stomach is weak, it is best without either. Some persons like 
it sweetened and a little nutmeg added, but to many it is more palatable 
plain. 

PANADA. 

Break into a bowl three good sized crackers (arrow root or oat meal 
are nice) broken into small pieces; pour upon them boiling water and 
cover close for a minute, then add a teaspoonful of white sugar and a little 
pure milk. It is an excellent breakfast or supper for a child or an invalid. 
Instead of the milk the juice of a lemon may be squeezed in and another 
teaspoonful of sugar added, if there is fever. 

"soft" toast. 

Some invalids like this very much indeed, and nearly all do when it is 
nicely made. 

Toast well but not too brown, a couple of thin slices of bread; put 
tliem on a warm plate and pour over boiling water; cover quickly with 
another plate of the same size and drain the water off; remove the upper 
plate, butter the toast, put it in the oven one minute and then cover again 
with a hot plate and serve at once. 

EGG TOAST. 

Make a soft toast and have ready one or more fresh eggs, which have 
been boiled twenty minutes; remove the shells, cut them in slices and 
place upon the toast, with a little butter, pepper and salt; without the 
butter they may be eaten with impunity by the most delicate invalid, as an 
egsr cooked for twenty minutes is really more easy of digestion than one 
that is termed "boiled soft." 



748 FOOD FOR INFANTS AND INVALIDS. 

SOFT BOILED EGGS. 

Fresh eggs for invalids who like them cooked soft, should be put in a 
pan of boiling water, and set on a part of the stove where they will not 
boil for several minutes. At the end of that time they will be like jelly, 
perfectly soft, but beautifully done and quite digestible by even weak 
stomachs. 

DRY TOAST. 

Cut your slices of bread even, and not too thick. Toast before a clear 
fire, a nice light brown. Cover with a napkin and serve quickly while it 
is hot. Dry toast is not always good for invalids, especially when the 
bowels are confined and it is desirable to keep them open. In this case 
Graham bread not toasted is much better. 

MILK TOAST. 

This is a favorite dish with nearly all sick people, when they are get- 
ting well. Cut stale bread in rather thin slices, toast a fine brown and lay 
them in a deep dish. Meanwhile boil a quart of new milk in a lined sauce- 
pan in which you have first put a very little cold water, to prevent burn- 
ing. As soon as it boils pour it over the toast, cover, and serve quick. For 
an invalid no butter should be put in the milk. Some people put in a 
thickening of flour, but this spoils it for many. 

THICKENED MILK 

With a little milk, mix smootli a tablespoonful of flour and a pinch 
of salt. Pour upon it a quart of boiling milk, and when it is thoroughly 
mixed put all back into the saucepan and boil up at once, being careful not 
to burn, and stirring all the time, to keep it perfectly smooth and free from 
lumps. Serve with slices of dry toast. It is excellent for diarrhoea; this 
alone will often cure it by scorching the flour before mixing with the milk 
which makes it into (Carb. V). 

MILK AND EGGS. 

Beat up a fresh egg with a grain of salt, pour upon it a pint of boiling 
milk, stirring it all the time. Serve hot with or without toast. It is good 
in case of weakness for an early breakfast, or for a traveler before starting 
on a journey. 

BEEF TEA. 

Cut up a pound of rump steak into small pieces, and put it into a bottle 
(wide mouthed fruit jar) putting a very small quantity of lukewarm water 
into the bottle with it, cork tightly and put the bottle into a kettle of warrn 
water; the water should be allowed to boil for a considerable time; the 
bottle should then be removed and the juice drained off. The tea maybe 
salted a little and a teaspoonful given at a time. 

OYSTER SOUP. 

Make a little broth of lean veal or mutton, simmer with it some root or 
essence of celery. Strain it, put on the fire and when it boils throw in the 
oysters with their liquor, and a trifle of pepper and salt. Serve it as soon 
as it comes to a boil, on little squares of toast. 

BROILED TENDERLOIN. 

This is a choice piece from a sirloin steak, and is highly enjoyed when 



FOOD FOR INVALIDS. 749 

the patient is becoming convalescent. Cut out the round piece from the 
inside of a sirloin steak, broil it quick over a bright fire, upon a small, 
heated gridiron, turn it, with its gravy, upon a piece of freshly made toast 
sprinkle with salt and pepper, but no butter, place between two hot plates, 
and serve directly. A tender mutton chop or half the breast of a chicken 
mav be served the same way, only the chicken will require longer, and 
somewhat slower cooking. 

ARROW ROOT GRUEL. 

Add a teaspoonful of arrow root to half a pint of boiling water; mix 
well, add half a pint of milk and boil together for two or three minutes; 
sweeten to the taste. A little lemon juice or wine may be added. 

MUTTON TEA. 

Take one pound of mutton, remove the fat and cut the meat in small 
pieces; pour half a pint of boiling water over it, and let it stand near a fire 
for half an hour, and then boilfor one hour,sirain through a sieve or cloth, 
add salt to suit the taste. A very nourishing diet. 

CHICKEN BROTH. 

Take half a chicken, remove all the fat, cut the meat up into small 
pieces, and break the bones ; put into a vessel with three pints of boiling 
water; boil for one hour, season with salt and strain. 

WATER GRUEL. 

Corn or oat meal two tablespoonfals, water one quart; boil for ten or 
fifteen minutes, and add sugar, or salt, if desired by the patient. 

RICE GRUEL. 

Ground rice one heaping tablespoonful, ground cinnamon half a tea- 
spoonful, water one quart; boil slowly for fifteen or twenty minutes, add 
the cinnamon when it is nearly done boiling, strain and sweeten. 

SAGO GRUEL. 

Sago, two tablespoonfuls, water one pint, boil until it thickens, fre- 
quently stirring. Wine, sugar, and nutmeg may be used, if desirable. 

TAPIOCA CUP PUDDING. 

This is very light and delicate for invalids. An even tablespoonful of 
tapioca soaked for two hours in nearly a cup of new milk. Stir into this 
the yolk of a fresh egg, a little sugar, a grain of salt and bake in a cup for 
fifteen minutes. A little jelly may be eaten with it or a few fresh straw- 
berries. 

INVALID CUP PUDDING. 

One tablespoonful of flour, one egg; mix with cold milk and a pinch of 
salt to a batter. Boil fifteen minutes in a buttered cup. Eat with sauce, 
fruits, or plain sugar. 

INVALID APPLE PIE. 

Slice up one or more nice, tart apples in a saucer, sweeten with white 
sugar and cover with a moderately thick slice of bread, buttered slightly 
on the under side. When the bread is nicely browned, the apples, if of a 
tender kind and thinly sliced, will be done. 



750 FOOD FOR INFANTS AND INVALIDS. 



ROAST APPLES. 



These can nearly always be eaten with safety, when they are eaten 
with relish. Choose good sized, fair apples of a tart and juicy, but not of a 
sour kind. Rub them off clean, and put them in rather a slow oven, which 
may increase in warmth, so that they shall be thoroughly done in an hour. 
When so soft that the savory pulp breaks through the browned skin in 
every direction, take them out, sift white sugar over them, and carry one 
at a time on a saucer to the patient. 

STEWED PRUNES. 

These are extremely good in small pox, measles, scarlet fever, and the 
like, both as food and medicine. Get the box prunes, as they will not need 
washing, and because they are generally of a much better quality than the 
open sort. Soak them for an hour in cold water, then put them in a porce- 
lain lined saucepan with a little more water if necessary and a little coffee 
or crushed sugar. Cover and let them stew slowly an hour, or until they 
are swollen large and quite soft. They are excellent as an accompaniment 
to breakfast for a sick woman. 

LEMONADE. 

This is invaluable in fevers and also in rheumatic affections. Rub the 
lemons soft, cut them half through the center and squeeze out the juice. 
Take out the seeds with a teaspoon. Put two tablespoonfuls of white 
sugar to each lemon and fill up with cold or boiling water according as you 
desire the lemonade hot or cold. Two medium sized lemons will make a 
pint or more. 

APPLE WATER. 

Roast two tart apples until they are soft, put them in a pitcher, pour 
upon them a pint of cold water and let it stand in a cool place an hour. It 
is used in fevers and eruptive diseases and does not require sweetening. 

TOAST WATER. 

Toast slightly a piece of bread and add to it boiling water ; it may be 
sweetened, if preferred, and flavored with a little lemon or orange peel. 

FLAX SEED TEA. 

Take an ounce of flaxseed and a little pounded licorice root and pour 
on a pint of boiling water; place the vessel near a fire for four hours; 
strain through a linen or cotton cloth. 

BARLEY COFFEE. 

Roast barley until well brown, and boil a tablespoonf ul of it in a pint 
of water for five minutes; strain and add a little sugar if desired. This is 
a nourishing drink toward the close of fever and during convalescence. 

OAT MEAL COFFEE. 

Mix common oat meal and water to form cake. Bake it until it is 
brown, then grind it in a coffee mill; take about a tablespoonful for one 
pint of water and boil it five minutes. This is good for checking obstinate 
vomiting or distress in the stomach, when caused by drinking too much 
ice water. 



FOOD FOR INVALIDS. 751 

RICE WATER. 

Take two ounces of rice and two quarts of water; boil an hour or so 
and add a little sugar; a little nutmeg- or lemon may be used to flavor, if 
the patient likes it. 

MUCILAGE OF ELM BARK. 

Place about a teaspoonful of ground elm bark in a pint of cold water; 
this may be drank after an hour or two. If more agreeable to the patient, 
it may be flavored with lemon juice or essence of lemon. Is very beneficial 
in cases of inflammation of the stomach or bladder, etc. 

ALUM WHEY. 

Take a pint of sweet milk and add a teaspoonful of powdered alum, 
then boil and strain; this is useful in diarrhoea, dysentery, and inflamma- 
tion of the stomach. The curd forms an excellent poultice for inflamma- 
tion of the eyes. 

MUSTARD WHEY. 

Take a tablespoonful of mustard seed, and one pint of sweet milk, boil 
together for a few minutes and separate the curd. This is a very useful 
drink in dropsy. 

VINEGAR WHEY. 

Take a pint of milk and one teaspoonful of good vinegar ; boil them 
together for a few minutes and separate the curd. 

RENNET WHEY. 

Take one quart of new milk and a large spoonful of rennet; heat the 
milk and then add the rennet, after which boil until the curd separates, 
which is to be skimmed. 

ORANGE WHEY. 

Take a pint of milk, the juice of one orange with a portion of the peel, 
boil the milk then add the orange to it and let it stand until coagulation 
takes place, then strain. 



TABLE OF REMEDIES. 



With the abbreviations used in writing prescriptions, the full Latin 
(Technical) names, and one or more of the common English names, 
with their antidotes on the opposite pages. Read across this and the next 
page after each number. 



ABBREVIATION, 

1 Abies Can 

2 Ac 

3 ^Escul G 

4 Agar M 

5 Agnus C 

6 Al Rub 

7 Alum 

8 Ambra G 

9 Amm C 

10 Amm Mur 

11 Anac 

12 Ant C 

13 Apis Mell 

14 Aralia R 

15 Arg Fol 

16 Arg Nit 

17 Arn Mont 

18 Ars Alb 

19 ArisVirg 

20 Arum T 

21 Asa 

22 Asarum 

23 Asclep I 

24 Asclep S 

25 Atrop 

26 AurumF 

27 Aur Mur 

28 Bap Tinct 

29 Baryta 

30 Bell 

31 Borax 

32 Bov 

33 Brom 

34 Broom 

35 BryAlb 

36 Chinca 

37 Cal Carb 

38 Cal Caus 

39 Cal Phos 

40 Calen Off 

41 Cac Grand 

42 Camph 

43 Cann Sat 

44 Canth 



LATIN. 

Abies Canadensis 

Aconitum Nai,ellus 

iEsculus Glabra 

Agricus Muscarius 

Agnus Castus 

Altius Rubra 

Alumina 

Ambra Grisea 

Ammoninm Carbonicum 

Ammonium Muriaticum 

Anacardium 

Antimonium Crudum 

Apis Mellifica 

Aralia Racemosa 

Argentum Foliatum 

Argentum Nitricum 

Arnica Montana 

Arsenicum Album 

Aristolochia Virginia 

Arum Triphylum 

Asafoetida 

Asarum Europaeum 

Asclepias Incarnata 

Asclepias Syriaca 

Atropin 

Aurum Foliatum 

Aurum Muriaticum 

Baptisia Tinctora 

Baryta Carbonica 

Belladonna 

Borax 

Bovista 

Bromium 

Spartium Scoparium 

Bryonia Alba 

Chinca 

Calcarea Carbonica 

Calcarea Caustica 

Calcarea Phosphorica 

Calendula Officinalis 

Cactus Grandirlorus 

Camphora 

Cannabis Sativa 

Cantharides 

752 



ENGLISH NAME. 

Hemlock Pine 

Monk's Hood, Wolf's Bane 

Ohio Buckeye 

Bug agaric, Amanita 

Chaste-tree 

Tag Alder 

Argilla, Clay, Ox. of Alumen 

Ambergris 

Carbonate of Ammonia 

Muriate of Ammonia 

Malacca Bean 

Crude Antimony 

Honey Bee 

Spikenard 

Silver Foil 

Nitrate of Silver 

Leopard's Bane 

Arsenic 

Virginia Snake root 

Indian Turnip 

Asafoetida 

Common Asarabacca 

Swamp Milkweed 

Common Milkweed 

Alkaloid of Belladonna 

Gold 

Muriate of Gold 

Wild Indigo 

Carbonate of Baryta 

Deadly Nightshade 

Biborate of Soda 

Puff-ball 

Bromine 

Broom 

White Bryony 

Chinca-root 

Carbonate of Lime 

Caustic Lime 

Phosphate of Lime 

Marsh Marigold 

Night-blooming Cereus 

Camphor 

Hemp 

Spanish Fly 



TABLE OF ANTIDOTES AND DISEASES. 



Before the appear the names of antidotes to the medicines 

named on the opposite page and after the in each line the name 

of a few of the diseases, diseased parts, or conditions, which the remedy 
named after the corresponding number on the opposite page is known to 
cure. Of course the few diseases named here does not, by any means, com- 
prise all which the remedy named will cure. 



ANTIDOTES. DISEASES. 

1 Coffee. — Dyspepsia, Palpitation of the heart. 

2 Vinegar, Coffee.— Fevers, Lungs, Croup, Heart Disease, Neuralgia. 

3 Nux Vom. — Piles, Lame Back, Constipation, Spasms. 

4 Salt, Ether. — Apoplexy, Chorea, Delirium Tremens. 

5 Wine, Coffee. — Impotence, Scanty Secretion of Milk 

6 Sulphur. — Skin Diseases. 

7 Ipecac, Soda. — Leucorrhcea, Lead Colic, Constipation. 

8 Camphor.— Hysterics, Hard hearing, Dry Cough. 

9 Camphor, Lemon-juice.— Syphilis, Dysmenorrhea, Spasms, Epilepsy. 

10 Oil, Elm Bark.— Catarrh, Consumption, Diarrhoea. 

11 Camphor. — Weakness of Mind, Heart Disease. 

12 Mercurius, Puis.— Weakness of Digestion, Scald Head. 

13 Arnica, Onion.— Diseases of the Kidneys, Dropsy. 

14 Cimicifuga. Nux.— Gravel, Leucorrhcea, Dry Cough. 

15 Pulsatilla, Merc— Melancholy, Rheumatism of Joints. 

16 Common Salt. — Gonorrhoea, Cracked Nipples, Epilepsy, Diarrhoea. 

17 Vinegar, Camphor.— Bruises, Swelling of the Glands, Lungs. 

18 Iron, Ipecac. — Diarrhoea, Fever and Ague, Obstinate Skin Diseases. 

19 Camphor. — Sick Headache, Piles, Dyspepsia. 

20 Onion. — Salivation, Inflammation of Mouth and Throat, Asthma. 

21 Camphor.— Hysterics, Dyspepsia, Premature Menses. 

22 Vinegar, Camphor. — Colic, Vomiting. 

23 Pulsatilla.— Asthma, Pleurisy, Diarrhoea, Cough, Catarrh. 

24 Bryonia. — Headache, Dropsy, Influenza, Rheumatism. 

25 Coffee.— Neuralgia, Spasms, Paralysis, Whooping Cough. 

26 Merc, White of Eggs. — Diseases of the bones, Sexual Organs, Glands. 

27 Nitric Acid. — Chronic Catarrh, Dropsy, Syphilis. 

28 Bryonia. — Typhoid Fever, Diphtheria, Dysentery. 

29 Soda or Magnesia in Vinegar. — Scrofulous swellings, Rickets. 

30 Vomit, Coffee — Diseases of Brain, Nerves, Glands, Lungs, Skin. 

31 .Mercurius. — Sore Mouth, Menses during Nursing, Liver Spots. 

32 Camphor. — Externally to stop bleeding, Headache. 

33 White of Egg.— Consumption, Croup, Dysentery. 

34 Rhus tox,— Nursing Sore Mouth, Mercurial Salivation , Childbed Fever. 

35 Coffee, Camphor.— Rheumatism, Pneumonia, Constipation, Typhus. 

36 Cantharis. — Eructations, Vomiting, Burning Urine. 

37 Camphor.— Scrofula, Slow Teething of Infants. Profuse Menses. 

38 Bryonia. — Coughs, Croup, Ulcers, Curvature of the Spine. 

39 Nitric Acid.— Herpes, Discharge from Ear, Chronic Bronchitis. 

40 — Wounds, Colic, Cancer. 

41 Verat Viride— Heart Disease, Pneumonia, Fever and Ague. 

42 Opium, Vinegar. — Cholera, Influenza, Hysterics, Headache. 

43 Lemonade. — Gall Stones, Burning Urine, Nose Bleed. 

44 Camphor.— Bloody Urine, Dysentery, Kidney Diseases. 

48 753 



754 



TABLE OF REMEDIES. 



ABBREVIATION. LATIN. 

45 Cap Ann Capsicum Annum 
Carbo Animals 
Carbo Yegetabilis 
Carduus Marise 



46 Carbo A 

47 Carbo V 

48 Cardu Mar 

49 Caul Thai 

50 Caus 

51 Cepa 

52 Cera Virg 

53 Cham 

54 Chel Maj 

55 Chim Urn 

56 Chi 

57 Chi Hy 

58 Cic Vir 

59 Cim Rac 

60 Cin 

61 Cist C 

62 Clem 

63 Coco 

64 Coc Cac 

65 CofT 

66 ColchiAu 

67 Col 

68 Collin Can 

69 Con 

70 Corn Flor 

71 Cro 

72 Crotal 

73 Crot Ole 

74 Cup Met 

75 Cupr Ac 

76 Cupr Sul 

77 Cyp Pub 

78 Daph 

79 Digi 

80 Dor T. Lin 

81 Dros 

82 Dulc 

83 Euc Glob 

84 Eup 

85 Euphor 
.86 Euphra 

87 Ferr 

88 Ferr Ace 

89 Ferr Mur 
:90 Fil M 

91 Gel Semp 

92 Graph 

93 Glo 

94 Hama 

95 Hede Pul 

96 Helleb 

97 Hep Sul 

98 Hy Acid 



ENGLISH. 

Cayenne Pepper 
Animal Charcoal 
Vegetable Charcoal 
Common Thistle 



CaulophyllumThalictroidesBlue Berry Root 



Causticum 

Cepa 

Cerasus Virginica 

Chamomilla Vulgaris 

Cheladonim Majus 

Chimaphila Umbellata 

China 

Chloral Hydrate 

Cicuta virosa 

Cimicifuga Racemosa 

Cina 

Cistus Canadensis 

Clematis Erecta 

Cocculus Indicus 

Coccus Cacti 

Coffea Cruda 

Colchicum Autumnale 

Colocynthis 

Collinsonia Canadensis 

Conium Maculatum 

Cornus Florida 

Crocus 

Crotalus Horridus 

Crotonius Oleum 

Cuprum Metallicum 

Cuprum Aceticum 

Cuprum Sulph 

Cypripedium Pubescens 

Daphne Indica 

Digitalis Purpurea 

Doryphora Ten Linae 

Drosera 

Dulcamara 

Eucalyptus Globulus 

Eupatorium 

Euphorbium 

Euphrasia 

Ferrum Metallicum 

Ferrum Aceticum 

Ferrum Muriaticum 

Filix Mas 



Caustic Tincture 

Common Onion 

Wild Cherry (red) 

Common Chamomile 

Garden Celandine 

Prince's Pine, Wintergreen 

Peruvian Bark 

Chloral 

Water Hemlock 

Black Snakeroot 

Worm-seed 

Rock Rose 

Virgin's Bower 

Seeds of Cocculus 

Cochineal 

Raw Coffee 

Meadow Saffron 

Bitter Cucumber 

Cure All, Richweed 

Spotted Hemlock 
Dogwood, Box Tree 

Saffron 

Rattlesnake Poison 

Croton Oil 

Copper 

Acetate of Copper 

Sulphate of Copper 

Bleeding Heart 

Indian Daphne 

Fox-glove 

Colorado Potato Bug 

Sun-dew 

Bitter-sweet 

Blue Gum Tree 

Boneset, Ague Weed 

Spurge 

Eye-bright 

Iron 

Acetate of Iron 

Muriate of Iron 

Male Fern 



Gelseminum Sempervirens Yellow Jessamine 



Graphites 

Glonoine 

Hamamelis Virginiana 

Hedeoma Pulegioides 

Helleborus Niger 

Hepar Sulphuris 

Hydrocyani Acidum 



99 Hydras Can Hydrastis Canadensis 



100 Hyos 

101 Hyp Perf 

102 Ign 

103 Indigo 

104 Iod 

105 Id 

106 Iris Ver 



Hyoscyamus Niger 

Hypericum Perforatum 

Ignatia Amara 

Indigo 

Iodium 

Ipecacuanha 

Iris Versicolor 



Black Lead 

Nitro-Glycerine 

Witch Hazel 

Penny Royal 

Christmas Rose 

Sulphuretof Lime 

Prussic Acid 

Golden Seal, Yellow Puccoon 

Black Henbane 

St. John's Wort 

St. Ignatius' Bean 

Indigo 

Iodine 

Ipecac 

Blue Flag 



TABLE OF ANTIDOTES AND DISEASES. 755 

ANTIDOTES. DISEASES. 

45 Camphor. — Chronic Dysentery, Fever and Ague, Dyspepsia. 

46 Arsenic. — Cancer, Goitre. Offensive breath or discharges. 

47 Arsenic. — Cardialgia, Ulcers, Burns, Flatulence, Dyspepsia. 

48 Nux V. — Jaundice, Gall Stones, Cough, Pleurisy. 

49 Pulsatilla. — False Pains, Tedious Labor, Dysmenorrhcea, Colic. 

50 Coffee. — Chronic Hoarseness, Cold Feet, Insanity. 

51 Coffee.— Stings of Insects, Poisoned Wounds, Frozen Parts. 

52 Ammonium. — Slow Fevers, Dyspepsia, Ulcers, Whooping Cough. 

53 Aconite, Coffee.— Children's Diseases, Spasmodic Pains, Neuralgia. 

54 Sulphur. — Headache, Warts, Eruptions, Jaundice. 

55 Cantharis. — Dropsy from Disease of the Kidneys, Constipation. 

56 Arsenic, Verat Alb. — For all diseases of Periodic Recurrence. Weakness. 

57 Ammonia. — Insanity, Sleeplessness, Neuralgia, Lock Jaw. 

58 Tobacco. — Epilepsy, Mania, Defective Eyesight. 

59 Coffee.— Menses too Profuse, Chorea, Rheumatism. 
CO Ipecac— AVorms, Whooping Cough, Spasms, Catarrh. 

61 Belladonna.— Foul Breath, Chronic Diarrhoea, White Swelling 

62 Mercurius— Orchitis, Old Foul Ulcers, Syphilis. 

63 Camphor. — Menstrual Colic, Sea Sickness, Nausea, Asthma. 

64 Tea, Wine, Ipic. — Vomiting, Cough, Palpitation of the Heart. 

65 Aconite. — Nervous Diseases, Cardialgia, Dyspepsia. 

66 Vinegar, Honey.— Gout, Burning Urine, Cramps of Calves of Legs. 

67 Camphor, Coffee.— Colic, Dysentery, Costiveness, Neuralgia. 

68 Nux Vom — Piles, Diarrhoea, Chronic Constipation. 

69 Coffee.— Apoplexy, Amenorrhcea, Catarrh. 

70 Quinine. — Sour Stomach, Intermittent Fever. 

71 Aconite. — Hysteria, Uterine Hemorrhage. 

72 Arsenic. Ammonia, Spirits.— Headache, Skin Diseases. 

73 Opium, Mucilaginous drinks.— Constipation, Eczema. 

74 Emetics, White of Eggs.— Epilepsy, Insanity, Vomiting, Asthma. 

75 Milk, Iron Filings.— Jaundice, Colic, Croup. 

76 Ipecac— Emaciation, Rage, Vertigo. 

77 Tea.— Excessive Mental Labor, St. Vitus' Dance. 

78 Vinegar, Camphor. — Itching Eruptions, Pains in Bones. 

79 Emetics, Wine, Ammonia.— Heart Disease, Bloody Cough, Dropsy. 

80 Jimson Weed.— Vomiting, Dysentery, Night-Mare. 

81 Camphor.— Whooping Cough, Consumption, Cough. 

82 Camphor. — Salivation, Hives, B right's Disease, Hoarseness. 

83 Quinine. — Intermittent Fevers, Asthma from Heart Disease. 

84 Ipecac, Nux.— Fevers: Intermittent, Spotted, Remittent. Influenza. 

85 Lobelia.— Spasms, Diarrhoea, Cholera Morbus. 

86 Belladonna.— Chronic Sore Eyes, Ophthalmia, Sneezing. 

87 Arsenic, China.— Nursing Sore Mouth, Diarrhoea, Chlorosis. 

88 Kreasote. — Consumption, Dropsy, Excessive Menstruation. 

89 Pulsatilla. Arsenicum.— Catarrh of the Bladder, Wetting the Bed. 

90 Lemon. — Tape Worms. 

91 Belladonna.— Headache, Dumb Ague, Convulsions, After Pains. 

92 Nux, W^ine.— Chronic Eruptions, Catarrh of the Ear, Salt Rheum. 

93 Coffee. — Sunstroke, Congestive Headache, Nervous Diseases 

94 Arnica. — Burns, Scalds, Bleedings, Varicose Veins. 

95 Turpentine. — Nausea, Whites, Amenorrhcea from a Cold. 

96 Camphor. — Dropsy of the Brain. Scanty Menses. 

97 Vinegar.— Typhus„Scrofula, Skin, Glands, Profuse Menses. 

98 Ammonia, Cold Affusion.— Epilepsy, Apoplexy, Cholera, Phthisis. 

99 Ammonia.— Headache, Catarrh, Constipation, Leucorrhcea. 

100 Coffee, Bell.— Hysterics, Hydrophobia, Brain Fever. 

101 Pulsatilla.— Congestion of the Blood to the Head, Painful Menses. 

102 Camphor, Lemon.— Hemicrania, Spinal Irritation, Convulsions. 

103 Belladonna.— Epilepsy, Chorea, Vomiting, Colic. 

104 Coffee, Starch.— Goitre, Enlarged Glands, Liver Complaints. 

105 Coffee. — Vomiting, Asthma, Diarrhoea, Fever and Ague. 

106 Veratrum Alb. — Summer Complaint, Morning Sickness. 



758 



TABLE OF REMEDIES. 



ABBREVIATION 

107 Jalap 

108 Jug- Cin 

109 Kali Bi 

110 Kali Car 

111 Kali Hi 

112 Kreaso 

113 Kousso 

114 Lach 

115 Laur 

116 Led Pal 

117 Lil Tig 

118 Lye 

119 Lob 

120 Mag Car 

121 Mag Mur 

122 Mangan 

123 Menis Can 

124 Meny 

125 Meph 

126 Mer Viv 

127 Mer Sol 

128 Mer Dul 

129 Mer lod 

130 Mer Corr 

131 Mez 

132 Morph 

133 Mosch 
184 Mar Ac 

135 Nat Car 

136 Nat Mur 

137 Nit Acid 

138 Nux Jug 

139 Nit 

140 Nux Mosch 

141 Nux Vom 

142 Olean 

143 Ol Jec 

144 Ol Ric 

145 Op 

146 Petro 

147 PhosAc 

148 Phos 

149 Phy 

150 Plat 

151 Plumb 

152 Plumb Act 

153 Pod Pel 

154 Poly Punc 

155 Puis 

156 Ran B 

157 Ran S 

158 Rhod 

159 Rhus Tox 

160 Rhus Glab 

161 Rum Cris 

162 Ruta G 

163 Sabad 

164 Sabin 

165 Samb 

166 Sang 

167 Scut Lat 
16S Sec 



LATIN. 

Jalapa 

Juglans Cinerea 

Kali Bichromicum 

Kali Carbonicum 

Kali Hidiodicum 

Kreasotum 

Kousso 

Lachesis 

Laurocerasus 

Ledum Palustre 

Lilium Tigrinum 

Lycopodium Clavatum 

Lobelia 

Magnesia Carbonica 

Magnesia Muriatica 

Manganum 

Menispermum Canadense 

Menyanthes Trifoliata 

Mephitis Putorius 

Mercurius Vivus 

Mercurius Solubil's 

Mercurius Dulcis 

Mercurius Iodide 

Mercurius Corrosive 

Mezereum 

Morphium 

Moschus 

Muriatis Acidum 

Natrum Carbonicum 

Natrum Muriaticum 

Nitri Acidum 

Nux Juglans 

Nitrum 

Nux Moschata 

Nux Vomica 

Oleander 

Oleum Jecoris 

Oleum Ricini 

Opium 

Petroleum 

Phosphori Acidum 

Phosphorus 

Phytolacca Decandra 

Platina 

Plumbum 

Plumbum Aceticum 

Podophyllum Pelltaum 

Polygonum Punctatum 

Pulsatilla 

Ranunculus Bulbosus 

Ranunculus Scelaratus 

Rhododendron Chrysanth m 

Rhus Toxicodendron 

Rtius Glabrum 

Rumex Crispus 

Ruta Graveolens 

Sabadilla 

Sabina 

Sambucus Nigra 

Sanguinaria Canadensis 

Scutellaria Laterflora 

Secale Cornutum 



ENGLISH. 

Jalap 

B utternut . White Walnut. 

Bichromate of Potash 

Carbonate of Potash 

Iodide of Potassium 

Creasote 

Kousso 

Snake Poison 

Cherry Laurel 

Marsh-tea 

Tiger-spotted Lily 

Club Moss 

Indian Tobacco, Asthma-weed 

Carbonate of Magnesia 

Muriate of Magnesia 

Manganese 

Sarsaparilla 

Buck Bean 

Skunk 

Mercury, Quicksilver 

Soluble Mercury 

Calomel 

Iodide of Mercury 

Corrosive Sublimate 

Mezereon 

Morphia 

Musk 

Muriatic Acid 

Carbonate of Soda 

Kitchen Salt 

Nitric Acid 

Walnut Shell 

Nitre, Saltpetre 

Nutmeg 

Vomic Nut 

Oleander 

Cod Liver Oil 

Castor Oil 

Opium 

Rock Oil 

Phosphoric Acid 

Phosphorus 

Poke Root, Poke Berry 

Platina 

Lead 

Acetate of Lead 

May Apple 

Smartweed, Water Pepper 

Wind Flower 

Buttercup 

Malignant Crowfoot 

Siberian Rose 

Poison Sumach 

Common Sii^acb 

Yellow Dock 

Rue 

Mexican BarLsv 

Savin 

Elder 

Blood Root 

Skull Cap 

Ergot 



TABLE OF ANTIDOTES AND DISEASES. 757 

ANTIDOTES. DISEASES. 

107 Rhubarb. — Constipation, Small Doses for Diarrhoea of Infants. 

108 Mayapple Root. — Quinsy, Camp, Diarrhoea, Salt Rheum. 

109 Iodine. — Croup, Cough, Bloody Catarrh. 

110 Vinegar, Wine.— Consumption, Whooping Cough, Dyspepsia. 

111 Tobacco. — Brain Fever, Sore Throat, Goitre, Cancer. 

112 Milk, Mucilage.— Diabetes, Foul Smelling Discharges, Burns. 

1 13 Coffee. — Tape Worms. 

114 Ammonia, Arsenic. — Fevers and Convulsions. 

115 Ammonia, Cold Affusions. — Pneumonia, Gangrene, Apoplexy. 
11(3 Camphor. — Insect Bites and Stings, Whooping Cough, Ague, 

117 Sepia. — Menses too profuse and too often. Sterility. 

118 Camphor. — Excoriations of Infants, Gravel, Bloating, Ulcers. 

119 Ipecac— Croup, Asthma, Vomiting, Sick Headache. 

120 Table Salt. — Menstrual Difficulties, Diarrhoea of Pregnancy. 

121 Calcarea. — Worms, Leucorrhcea, Uterine Spasms. 

122 Coffee, Ipecac— Excoriating Leucorrhcea, Fall of the Womb. 

123 Bryonia. — Liver Complaint, Skin Diseases, Dropsy. 
121 Camphor. — Malarial Diseases, Rheumatism. 

125 Camphor. — Sick Headache, Hysterics. 

126 Gold, Iodine. — Glands, Ulcers, Diarrhoea, Flux, Liver. 

127 Nitric Acid. — Diseases of Females, Sore Mouth and Throat. 

128 Chloride of Potash. — Putrid Sore Throat, Biliousness, Diseased Bones. 
12-J Hepar Sul. — Diphtheria, Goitre, Hardened Glands. 

Io0 White of Eggs. — Bloody Flux, Ophthalmia, Syphilis, Bowel Compl'ts 

131 Mercurius, Milk — Bones, Skin, Bowels, Hectic Fever. 

132 Quick Emetics. — Used to produce sleep and relieve pain. 

133 Camphor. — Hysterics, Nervous Headache, Asthma. 
131 Sulphur. — Scrofula, Diphtheria, Typhus, Ulcers. 

135 Vinegar. — Glandular Swellings, Scrofulous Sores. 

136 Nitrate of Silver. — Fever and Ague, Constipation, Hemorrhage. 

137 Camphor, Conium. — Syphilis, Fistula, Liver Complaint, Diabetes 

138 Arnica.— Boils, Fever and Ague, Leucorrhcea. 

139 Hepar Sul., Sulphur.— Dyspepsia, Cardialgia, Diarrhoeas, Gravel. 

140 Caraway Seed. — Hysterics, Dysmenorrhcea. 

141 Emetics, Coffee. — Cramps, Convulsions, Neuralgia, Diabetes, Ague. 

142 Camphor.— Paralysis, Vertigo, Insanity. 

143 — Wasting Diseases. 

144 — Is a mild Cathartic. 

145 Coffee. — Apoplexy, Mania, Lead Colic, Hernia, Sleeplessness. 

146 Nux. — Weakness of the Bladder, Chilblains, Herpes, Sore Throat. 

147 Camphor, Coff. — Onanism, Epilepsy, Diabetes, Consumption, Scurvy. 

148 Milk, Magnesia. — One of the most generally useful remedies. 

149 Bloodroot. — Salt Rheum, Diphtheria, Piles, Rheumatism. 

150 Pulsatilla. — Excessive Menses, Catalepsy, Falling of the Womb. 

151 Opium, Alum. — Paralysis, Colic, Dysentery, Sterility. 

152 Vinegar and Magnesia. — Headache, Convulsions, Loss of Sight. 

153 Arnica. — Bilious Headache, Dyspepsia, Colic, Diarrhoea, Piles, 

154 Pulsatilla.— Dysentery, Amenorrhoea, Sprains, Bruises. 

155 Coffee. — This remedy is the woman's friend. 

156 — External applications to old sores. 

157 Camphor. — Gangrene, Cancer of the Stomach, Dandruff. 

158 Lobelia. — Chronic Rheumatism, Asthma, Ophthalmia. 

159 Lobelia; internal and external. — Erysipelas, Pneumonia, Typhus. 

160 Borax. — Rheumatism, Night Sweats, Scurvy, Bleeding, Piles. 

161 Belladonna. — Epistaxis, Diarrhoea, Colic, Itch. 

162 Camphor.— Worms, Uterine Irregularities, Weak Eyes from Reading* 

163 Cina. — Tape Worm, Neuralgic Rheumatism, Fever. 

164 Elm Bark.— Miscarriage, Uterine Hemorrhage, Dysuria. 

165 —Cold in the Head, of Infants; Externally for Burns. 

166 Bryonia.— Sick Headache, Vomiting, Jaundice, Croup, Pneumonia. 

167 Coffee. — Delirium Tremens, Chorea, Sunstroke. 

168 Camphor. — Tedious Labor, Blood Diseases Generally. 



758 



TABLE OF REMEDIES. 



ABBREVIATION. 

169 Sen 

170 Sen Aur 

171 Sep 

172 Sil 

173 Spig 

174 Spong 

175 Squi 

176 Stan 

177 Staph 

178 Stram 

179 Sul 

180 Sul Ac 

181 Symp 

182 Tabac 

183 Tarax 

184 Tar Em 

185 Tereb Ol 

186 Teu M V 

187 Tbu 

188 Trios Perfo 

189 Urt U 

190 Val Off 

191 Vari 

192 Verba 

193 Ver Alb 

194 Yer Vir 

195 Viburn Pru 

196 Vine 

197 Vio Tri 

198 Xanthoxl 

199 Zin Sul 

200 Zinc 



LATIN. 

Senega 

Senecio Aurans 

Sepia 

Silicea 

Spigelia 

Spongia Tosta 

Squilla Maritima 

Stannuni 

Staphysagria 

Stramonium 

Sulphur 

Sulphuris Acidum 

Symphitum Officinale 

Tobacum 

Taraxicum 

Tartarus Emeticns 

Terebinthina Oleum 

Teucrium Marum Verum 

Thuya Occidentalis 

Triosteum Perfoliatum 

Urtica Urens 

Valeriana Officinalis 

Varioiin 

Verbascum Thapsus 

Veratrum Album 

Veratrum Viride 

Viburnum Prunifolium 

Vinca Minor 

Viola Tricolor 

Xanthoxylnm Fraxincum 

Zincum Sulphas 

Zincum 



ENGLISH. 

Rattlesnake Root 

Bagweed 

Cuttle Fish Juice 

Silica 

Pink Root 

Burnt Sponge 

Squills 

Tin 

Stave's Acre 

Jimstown Weed 

Sulphur 

Sulphuric Acid 

Common Comlrey 

Tobacco 

Dandelion 

Tartar Emetic 

Spirits of Turpentine 

Cat Mint 

Tree of Life, Arbor Vita 3 

White Ginseng 

Nettle 

Valerian 

Cowpox Virus 

Mullein 

White Hellebore 

Black Haw 

American Hellebore 

Periwinkle 

Pansy 

Prickly Ash 

Sulphate of Zinc 

Zinc 



TABLE OF ANTIDOTES AND DISEASES. 759 

ANTIDOTES. DISEASES. 

169 Am,, Bell. — Diabetes, Chronic Cough. 

170 Pulsatilla — Hay Asthma, Coryza, Bright's Disease, Dropsy. 

171 Lemon Juice.— Menstrual Difficulties, Sick Headache, Ozena. 

172 Camphor.— Old Ulcers, Diseased Bones. 

173 Coffee. — Nervous Sick Headache, Neuralgia, Worms, Toothache. 

174 Camphor. — Croup, Hoarseness, Spitting Blood. 

17o Camphor. — Hemopthysis, Bronchitis, Diabetes, Cough. 

176 Pulsatilla.— Cardialgia, Mucous Consumption. 

177 Camphor. — Toothache, Rheumatism of Joints and Muscles. 

178 Lobelia. — Brain Fever, Spasms, Hydrophobia, Asthma. 

179 Aconite, Puis. — Useful in Scrofulous and Skin Diseases. 

150 Magnesia, Lemon Juice.— Night Sweats, Bed Sores, Mercurial Salivat'n 

151 —Applied Externally for old Ulcers. 

152 Lobelia, Coffee.— Hernia, Sea Sickness, Renal Colic. 

153 Vinegar. — Torpid Liver, Flatulence, Hives* 

184 Tannin, Ipecac. — Croup, Smallpox, Cough, Pneumonia, Yellow Fever. 
1S5 Coffee. — Bloody Urine, Rheumatism, Typhus, "Worms. 

186 Camphor. — Coiic and Wakefulness of Infants. 

187 Sassafras. — Cancer of the Womb, Syphilis, Gonorrhoea. 

188 Ipecac. — Bilious Colic, Asthma, Rheumatism, Bilious Fever. 

189 Belladonna. — Hives, Burns, Gravel, Dysentery. 

190 Coffee. — Nervous Pains, Epilepsy, Rheumatism. 

191 Smallpox. — This is the only reliable article for Vaccination. 

192 — Piles, Varicose Veins, Fever Sores. 

193 Camphor.— Cholera, Cramps, Vomiting, Colic. 

194 Coffee. — Female Diseases, Fevers, Use instead of Aconite. 

195 Pulsatilla.— Hysteria, Cancer, After Pains, Prevents Miscarriage. 

196 Sulphur. — Eruptions and Skin Diseases. 

197 —Scald Head, Fetid Urine. 

198 Ammonia. — Salivation, Amenorrhea, Catarrh. 

199 Hepar Sul., Ignatia. — Somnambulism, Nervous Diseases. 

200 Hepar Sul., Ignatia.— Red Eyelids, Spasms, Paralysis, Pimples. 



PART SIXTEENTH, 



CHAPTER XXXVII. 



A LIST OF ALL THE SYMPTOMS DEVELOPED BY DIFFERENT DIS- 
EASES; ARRANGED IN RELATION TO THE PART OF THE 
BODY AFFECTED AND THE SYMPTOMS OF 
EACH PART FOLLOW EACH OTHER 
IN ALPHABETICAL ORDER. 



THE REPERTORY. 



This Repertory is to be used in selecting a remedy to cure some disease 
or symptom of disease. It can be almost as well used when you do not 
know any name for the trouble, as when you do, having only to learn all 
of the symptoms you can, both those that can be seen and those which can 
only be felt, and writing each symptom on a lineby itself, youproceed to find 
each symptom in the Repertory, and then note on the slip of paper you 
have your symptom down on, on the same line with each symptom the 
abbreviated names of the remedies that appear in this Full Faced Black 
Type. If you do not find any of that type following your symptom, take the 
remedies appearing in Italics, and if none of them, then the Roman or com- 
mon type. (For dose, etc., of remedy selected, see Page 83-84 and Index). 

Full Faced Type indicates remedies which are known to be the most 
certain to cure the symptom they follow. 

Italic type indicates remedies that are good, but not so good as those in 
full faced type. 

Roman, or common type, are used for remedies having a very general 
reference to the symptoms which they follow. Here is an example of a 
case of scarlet fever arranged and the remedy selected ; by reference to 
the pages of the Repertory named you will be able to understand it easily : 



1. Throat (Pharynx) Redness of, page 26. . 

2. Throat Swelling, page 26 

3. Urine Red (Scanty) page 81 

4. Palate, Redness of, page 25 

5. Headache as if head would burst, p. 6. . 

6. Delirium, page 2. • , , 

7. Skin Red, Burning, page 122 

8. Scarlet Rash, page 124 



Aeon. 
Bell.. 

Can... 
Ars... 
Bell.. 
Ars... 
Bry... 
Aeon. 



Apis.. 
Bry.. 
Bell.. 
Bell.. 


Bell.. 
Chi... 
Bry.. 


Merc- 




ian... 
Carbv 


Merc 


Calc.. 
Bell.. 

Aeon 


Sil... 
Bry.. 
Bell.. 
Bell.. 


Spiff,- 
Op.... 
Sil . . . 


. .. 


Bry.. 


Dulc. 





In the above case you will readily see that Belladonna is the only remedy 
that appears in full faced type after every symptom , and it may be relied on to 
cure the case, withoutfail. Sometimes there will be no remedy in the full 
faced type after every symptom, then take the one that approaches most 
nearly to it, being careful to get all the symptoms down. 

760 



L MIND AND DISPOSITION. 



CONDITION OF THE MIND AS CAUSED BY DISEASB. 



General Symptoms. 

AMOROUS : Ant crad. Canth. 

Graph. Hyosc. Ign Lye. Nux vom. 

Phosph. Plat. Puis. Sil. Stram. Ve- 

ratr. 
ANXIETY, FEAE: Aco. Arn. Ars. 

Aur. Bell. Bry. Calc. Carb. veget. 

Cham. Cocc. Graph. Hell. Tgn. Lye. 

Nux vorn. Puis. Ehus. Sep. Strarn. 

Sulph. Yeratr. 
BOLDNESS : Ign. Op. Puis. 
DISTBUSTFUL : Bar. BeU. Caust. 

Cic. Dros. Hell. Hyosc. Lye. Ph. 

ac. Puis. Sulph. ac. 
FITFUL MOOD: Aur. Carb. an. 

Ferr. Graph. Ign. Kali. Plat. Stram. 

Sulph. ae. Zinc. 
GENTLE : Cocc. Croc. Ign. Lycop. 

Puis. Sil. Sulph. 
GEEEDY: Ars. Lye. Natr. c. Puis. 

Sep. 
HAUGHTY: Lycop. Plat. Stram. 

Yeratr. 
HOPELESS : Ars. Aur. Calc. Caust. 

Cham. Con. Graph. Ign. Lye. Puis. 

Ehus. Sulph. 
INDIFFERENT : Chin. Cocc. Con. 

Ign. Natr. mur. Phos. Ph. ac. Puis. 

Sep. 
IRRITABLE MOOD: Aeon. Aur. 

Bell. Bry. Cham. Coif. Ign. N. mur. 

M. vom. Phosph. Puis. Sep. Sulph. 

Veratr. 
JOCOSE MOOD: Aur. Bell. Cann. 

Carb. an. Coff. Croc. Hyosc. Natr. c. 

Op. Phosph. Plat. Puis. Stram. 

Veratr. Zinc. 
PEEYISH : Alum. Aur. Calc. Caust. 

Cham. Con. Ign. Lye. Merc. Natr. c. 

Nitr. ac. Phosph. Plat. Puis. Sil. 

Sulph. 
SAD : Aeon. Bellad. Cham. Graph. 

Ign. Lye. Natr. m. Plat. Puis. 

Bhxuk 



SEEIOUS MOOD: Cocc Led. 

Sulph. ac. Thuj. 

Cloudiness. 
CLOUDINESS: Bell. Bry. Cann. 

Canth. Caps. Chin. Cocc. Carb. 

veg. Caust. Hyosc. Ign. Lpec. Kali. 

N. vom. Op. Yeratr. 
CONFUSION: Ant cr. Ars. Beil. 

Bry on. Canth. China. Euphr. Ferr. 

Ign. Kali. Natr. carb. Nux vom. 

Phosph. Ph. ac. Puis. Ehus. Sec. 

corn. Spig. Staph. Zinc. 
DIZZINESS: Aeon. Alum. Anac. 

Ars. Aur. Bell. Bry. Calc. Carb. 

veg. Caust. China. Coloc. Con. 

Graph. Lye. Natr. mur. Nitr. ac. N. 

vom. Op. Phosph. Phos. ac. Puis. 

Sep. Sil. Sulph. Veratr. 
DULLNESS: Aeon. Calc. Canth. 

Hyosc. Petr. Sep. Stram. Sulph. 

Zinc. 
INTOXICATION: Agaric. Antim. 

crud. Ai'g. Ars. Asar. Aur. Bell. 

Bry. Camph. Caps. Caust. Cham. 

Cic. Cocc. Coff. Con. Croc. Ferr. 

Graph. Hyosc. Ign. Ipec. Led. N. 

vom. Ph. ac. Op. Puis. Rhus. Sec. 

corn. Sil. Stram. Veratr. 
LOSS OF CONSCIOUSNESS: 

Ars. Bell. Calc. Canth. Hyosc. 

Nitr. ac. N. vom. Ph. ac. Rhus, 

Stram. Veratr. 
STUPEFACTION : Aeon. Ars. Asa 

Bell. Bry. Calc. Camph. Caps. 

Caust. Cham. Coff. Con. Cupr. 

Dulc. Ferr. Graph. Lye. Hell. Hy* 

osc. Ipec. N. vom. Opium. Phosph. 

Ph. ac. Rhus. Sepia. Stram. Sulph. 
VANISHING OF SENSES: Ars. 

Bell. Calc. Camph. Cic. Cupr. 

Graph. Hyosc. N. vom. Stram. 
Y'EETIGO : Ars. Bell. Bry. Camph. 

Cann. Caps. Cham. Chin. Op. Ph. 



MIND AND DISPOSITION. 



ac. Puis. Rhus. Sep. Sec. corn. Sil. 
Spong. Sulph. Veratr. 

Mental Weaknesses. 
ABSENCE OF MIND : Anac. Am. 

Bell. Caust. Cupr. Hell. Hep. Hy- 

osc. Ign. Lye. Merc. Natr. mur. 

Op. Ph. ac. Rhus. Sep. 
AVABICE: Puis. 
COMPKEHENSION, ready: Coff. 

Op. Valer. 
— heavy: Ambra. Camph. Cham. 

Con. Lye. Nitr. ac. Op. Ph. ac. 

Zinc. 
DELIRIUM: Ars. Aur. Bell. Bry. 

Campjliora. Canth. Cham. Cina. 

Con. Cupr. Dulc. Hyosc. Op. 

Phosph. Phosph. ac. Plat. Rhus. 

Sec. cor. Strain. Sulph. Teratr. 
— with frightful specters : Bell. 
— nocturnal, raving about the day's 

business: Bry. 
— without consciousness : Hyosc. Puis. 
— loquacious, with open eyes : Coloc. 

Op. Yeratr. 
— quiet, with stupefaction : Ph. ac. 
— with anxiety, fear of death, over- 
estimation of one's self : Plat. 
— bland, with loss of recollection: 

Rhus. 
— without consciousness, often ter- 
minating in rage : Sec. corn. 
— various, shameless, haughty : Stram. 
— religious, haughty : Veratr. 
— with disposition to escape: Bry. 

Cocc. Stram. 
DERANGEMENT, mental: Bell. 

Canth. Cupr. Hyosc. Op. Plumb. 

Stram. Teratr. 
EXCITEMENT of the fancy : Aeon. 

Ambr. Anac. Ant. Crud. Am. Bell. 

Chin. Coif. Hyosc. Lachesis. Op. 

Phosph. Phosph. ac Pulsat. 

Stram. 
EXHAUSTION from mental labor: 

Aurum. Cham. Colch. Natr. Kux 



yom. Phosph. Puis. Sil. Spig. 

Spong. Staph. 
— nervous : Aur. Bell. Calc. Dig. Iod. 

Natr. c. N. yom. Phosph. Sep. 

Staph. Sulph. Zinc. 
FOREBODINGS : Aeon. Spig. 
FOREBODING of death: Stram. 

Veratr. 
ILLUSIONS OF THE FANCY: 

Bell. Bryon. Caust. Hell. Op. 

Phosph. Rhus. Staph. Stram. 
ILLUSIONS OF SENSE: Bell. 

Op. Phosph. Ph. ac. Plat. Sec 

Stann. Stram. 
— slow flow of : Cann. Chin. Ipec. N. 

vom. Op. Rhus. Euta. Spig. Veratr. 
INSENSIBILITY: Hell. Hyosc. Op. 

Ph. ac. Sec. Corn. Stram. 
INSANITY: Aeon. Agar. Ant. 

crud. Ars. Bell. Cann. Canth. 

Coccul. Con. Cupr. Dulc. Hyosc. 

Opium. Sec. corn. Stram. Sulph. 

Veratr. Zinc. 
— -with haughtiness : Hyoscyam. 

Stram. Veratr. 
— mirthful : Crocus. Ign. Stram. 
— mild: Croc. Veratr. 
— religious : Veratr. 
— talkative: Stram. 
— furious : Hyosc. Stram. 
LAUGHTER: Bellad. Crocus. Hy- 
osc. Stram. Veratr. 
LOSS OF RECOLLECTION: 

Aeon. Alum. Anac. Arg. Arn. Bar. 

Bell. Bry. Calc. Camph. Cannab. 

Cham. China. Con. Cupr. Dig. 

Hell. Hyosc. Ign. Natr. mur. N. 

vom. Opium. Phosph. Plat. Rhus. 

Ruta. Sep. Silicea. Stann. Staph. 

Stram. 
LOSS OF CONSCIOUSNESS: 

Agar. Bell. Bryon. Canth. Cham. 

Cocc. Cupr. Hyosc. Ipec. Nux 

vom. Op. Rhus. Stram. Verat. 
MISTAKES IN TALKING: Cham. 

Chin. Con. Croc. Ign. Lach. Lye. 



MIND AND DISPOSITION. 



Natr. mur. N. vom. Puis. Sep. Sil. 
RAGE: Aeon. Agar. Ars. Bell. 

Canrph. Cann. Canth. Cham. Coc- 

cul. Croc. Cupr. Drosera. Hyosc. 

Opium. Petr. Plumb. Euta. Sec. 

corn. Strain. Yeratr. 
SHAMELESSNESS : Hyosc. N. 

vom. Op. Stram. Verat. 
WANDERING OF THE MIND: 

Aeon. Am. Aur. Bell. Canst. 

Cham. Cocc. Croc. Hell. Ign. Kali. 

Natrum mur. Phosph. Ph. ac. 

Plat. Sep. Stann. Sulphur. Yerat. 
WEAKNESS OF MIND : Bar. Bell. 

Defects of Memory. 
FORGETFUL : Aeon. Alum. Anac. 

Arn. Ars. Bar. Bell. Colchic. 

Coccul. Digit. Hell. Hyosc. Ign. 

Laches. Lye. Natr. mur. Petr. 

Phosph. Plat. Rhus. Rhododend. 

Sec. corn. Silic. Spig. Staph. 

Stram. Sulph. Yeratr. Viol odor. 
MEMORY, involuntary: Hyosc. 
— quick: Aeon. Coff. Hyoscyam. 

Lach. Op. Viol. odor. 
— defective : Aeon. Anac. Arn. Bell. 

Bryon. Calc. Camph. Cocc. Graph. 

Hyosc. Puis. Sep. Spigel. Stram. 

Sulph. Yeratr. 
— feeble: Aeon. Alum. Ambr. Anac. 

Ars. Aur. Bell. Bryon. Calc. Caust. 

Colch. Cupr. Dig. Graph. Hep. 

Hyosc. Ign. Lye. Natr. mur. Op. 

Plat. Pulsat. Rhus. Sep. Spigel. 

Staph. Stram. Sulph. Yeratr. 
— loss of : Bell. Camph. Con. Hyosc. 

Nat. mur. Op. Stram. Yeratr. 
MEMORY, decrease of: Anac. Ars. 

Aur. Bell. Hell. Hyosc. Op. Stram. 

Yeratr. 

Mental Derangements. 

ANGER, also with vehemence: 

Cham. 
— with fright. Aeon. 
— with f eeling of coldness : Ars, 



— with subsequent ill-humor : Bry. 

— with silent grief : Ign. 

— with irascible mind : N. vom. 

— with pushing away that which one 

holds in one's hand : Staphis. 

— with mental derangement: Yera- 
trum. 

ANXIETY AND FRIGHT. 

— with joyful surprise : Coff. 

— with subsequent starting during 
sleep : Hyosc. 

— followed by grief or spasms : Ign. 

— followed by anxiety or nocturnal 
pains : Merc. 

— with fear, heat of the head, and 
spasms: Op. 

— followed by mental confusion: 
Plat. 

— followed by diarrhoea : Puis. 

— with suffocative fits and blueish 
face : Samb. 

— with involuntary stool and icy 
coldness : Yeratr. 

GRIEF. 

— caused by mortification and fol- 
lowed by mental confusion : Bell. 

— with shame and suppressed anger : 
Ign. 

— with nocturnal anxiety and com- 
plaints : Merc. 

— followed by spasms : Op. 

— with emaciation, drowsiness, and 
morning-sweats : Ph. ac. 

GRIEF, with apprehensions for the 
future and day-drowsiness : Staph. 

HOMESICKNESS. 

— with flushed face and sleepless- 
ness: Caps. 

— with noctural anxiety and sweat: 
Merc. 

— with emaciation and morning- 
sweat, drowsiness : Ph. ac. 

JEALOUSY. 

— with vehemence and delirium : Hy- 
osc. 

— insane, with distrust : Lach. 



MIND AND DISPOSITION. 



UNFORTUNATE LOVE. 
— with thoughts of suicide : Aur. 
— with jealousy and loquacity: Hy- 
osc. 

— with silent grief : Ign. 

— with desponding mood : Lach. 

— with emaciation and morning- 
sweat : Ph. ac. 

— with unmerited mortification : 
Staph. 

WRATH. 

— with cries, hsemoptisis, palpitation : 
Arn. 

— with loss of consciousness or delir- 
ium : Bell. 

— with flushed cheeks, thirst : Bry. 

— hot sweat about the head, spasms : 
Cham. 

— thirst, vomiting of bile, chilliness 
heat : Nux yoiii. 

— laughter, weeping, anxiety: Plat. 

— with internal chilliness, no thirst, 
but dizziness : Puis. 

— on account of unmerited humilia- 
tion, whole body sore : Staphis. 

Mental Derangement. 

FOREBODINGS OF DEATH. 

— with foretelling of the day of 
death : Aeon. 

FOREBODINGS OF DEATH, 
with anxiety and restlessness : Bell. 

— alternating with fits of rage: 
Strain. 

HYSTERIA AND HYPOCHON- 
DRIA, 

— with anxiety, disposition to sui- 
cide: Aur. 

— caused by suppression of the sexu- 
al instinct: Con. 

— with fitful mood, sleeplessness: 
Ign. 

— of those who lead a sedentary life 
and revel at night, with consti- 
pation: N. vom. 

— after unmerited insults, with flatu- 
lency: Staph. 



— with tremulous and excessive sensi- 
tiveness: Valer. 

RAGE, 

— timorous, with frightful spectra: 
Bell. 

— amorous, with shameless gestures : 
Canth. 

— with haughty manners and spasms : 
Cupr. 

— with furious jealousy : Hyosc. 

— with amorous tenderness and jeal- 
ousy: Lach. 

— silent, with religious melancholy: 

Lye. 

— with frightful visions, alternating 
with stupor : Op. 

— censorious, with trembling and 
spasms: Plat. 

— raving, with frightful spectra: 
Strain. 

— w. wicked imprecations : Veratr. 

SUICIDE, DISPOSITION TO, 

— with amorous fancies : Ant. crud. 

— with nocturnal anguish and despair : 
Ars. 

— w. religious melancholy: Aur. 

— w. anxiety, restlessness, frightful 
spectra: Bell. 

SUICIDE, DISPOSITION TO, 
with silent anguish, fear of deatli : 
Puis. 

— with stupefaction of the head, rest- 
lessness: Rhus. 

SOMNAMBULISM, 

— with prediction of the day of death : 
Aeon. 

— with intense fancy, and dullness of 
feeling: Op. 

— with clairvoyance, increased sensi- 
bility: Phosph. 

Vertigo. 

According to its nature. 

GENERALLY: Aco. Ambr. Arn. 

Bell. Bry. Calc. Camph. Cann. 

Garb. veg. Cic. Core. Coif. Cupr. 

Dig. Graph. Hell. Hep. Ipec. Merc. 



HEAD. 



Mosch. Lye. Natr. Natr. mur. 
Nitr. Kltr. etc. N. vom. Op. Petr. 
Phosph. P/i. ac. Plat. Ptofe. Rhus. 

Sec. Corn. Splc. Staph. Stram. 
Stann. Sulpfy. Thuj. Verat. Zinc. 
AS IF FALLING : Aeon. Am. Ars. 
Cann. Cham. Clc. Con. Croc. Hep. 
Ign. Ipec. A T ifr. ac. N. vom. Op. 
Puis. See. cor. Sil. Spig. Sulph. 
Staph.. Stram. 

AS IF FALLING BACKWARD: 

Bry. Camph. Chin. N. vom. Ph. ac. 

Rhus. Spig. Stram. 
AS IF FALLING SIDEWISE: 

Arsen. Cann. Caust. Con. Enphr. 

N. vom. Puis. Staph. Sulph. 

AS IF FALLING TO RIGHT 

SIDE: Aeon. Ars. Calc. Ehus. 

Ruta. 
AS IF FALLING TO LEFT 

SIDE : Aur. Bell. Spig. Zinc. 
AS IF FALLING FORWARD: 

Am. Caus. Cic. Cupr. Ferr. Graph. 

Natr. mur. Petr. Ph. ac. Puis. 

Rhus. Sil. Spig. Sulph. 

TURNING: Aeon. Am. Bell. Bry. 
Calc. Carb. veg. Caust. Chel. Cic. 
Cocc. Croc. Cupr. Ferr. Merc. 
Mur. ac. Natr. mur. N. vom. Ph. 
acid. Puis. Rhod. Rhus. Sep. Sil. 

TURNING IN A CIRCLE : Aconlt. 
Bell. Bry. Calc. Caustic. Cic. Con. 
Ferr. Hell. Kali. Merc. Nux. vom. 
Op. Puis. Rhus. Sep. Staph Veratr. 



Vertigo. 
With accompanying ailments. 

ANXIETY: Ignat. Op. Rhus. Rho- 

dod. 
ERUCTATIONS : N. vom. 
EYES, gauzy before : Laur. Sabin. 
COLIC : Coloc. Petr. Spig. Stram. 
DEAFNESS : N. vom. Puis. 
DIM SIGHT : Stram. 
DIARRHOEA : Cham. Stram. 
CHILLINESS: Cocc. Plumb. Rhus. 

Veratr. 

FAINTING: Bar. Bryon. Canth. 

Chamom. Croc. Hep. Ign. Laur. 

N. vom. Plat. Sabacl. 
HEAT: Aeon. Arg. Bry. Croc. Ign. 

Laur. Led. Merc. Nux yoiu. Puis. 

Stram. 
HEADACHE : Aur. Bar. Calc. Con. 

Canth. Cupr. Ferr. Graph. Hep. 

Ign. Lach. N. vom. Puis. Stram. 
NAUSEA: Aeon. Ant. cruel. Arg. 

Arn. Bar. Bell Bry. Chin. Coff. 

Calc. Coccul. Ferr. Hyosc. N. vom. 

Puis. Petr. Phosph. Sil. Spig. 
NOSE, BLEEDING: Aeon. Ant. 

crud. Sulph. 
OBSCURED VISION: Aeon. Arg. 

Bell. Canth. Cham. Cic. Croc. 

Dulc. Ferr. Hyosc. N. vom. Natr. 

mur. Nit. ac. Op. Puis. Phosphor. 

Merc. Sec. cornut. Stram. Sulph. 
PALE FACE: Puis. 
SWEAT: Rhus. 
— cold: Ign. Veratr. 
VOMITING: Calc. Graph. Hyosc. 
YAWNING : Agar. Petr. 



II. HEAD. 



Internal. 
MENINGITIS: Aeon. Arn. Bell. 
Bry. Camph. Canth. Crotal. Cupr. 
Glonoin. Hell. Hyos. Laches. 



Mercur. Op. Phosph. Stram. (See 
general Index). 
CONCUSSION OF BRAIN: Am. 
Bell. Cic. Merc. Ph. ac. Sep. 



6 



HEAD. 



HYDROCEPHALUS. 

— acute : Aeon. Bell. Bry. Hell. Merc. 

Op. Sulph. 
— chronic: Ars. Hell. Sulph. 
HEADACHE. 

Sensations as if the brain were 

distended: Bell. Caps. 
— like a band around the head : Aeon. 

Carb. veg. Mercur. Nitr. ac. Plat. 

Spig. Sulph. 
BEATING: Aco. Ars. Asar. Aur. 

Bell. Bryon. Calc. Caps. Carb. veg- 

et. Caust. Cham. Cocc. Hyosc. Ign. 

Ipec. Lycopod. Nitr. ac. Phosph. 

Puis. Rhus. Sep. Silic. Sulph. Ye- 

ratr. 
— as if the brain were moved : Aeon. 

Ars. Bell. Bry. Croc. Kali. Rheum. 

Spig. 
—rush of blood: Aeon. Ambr. Ant. 

crud. Am. Asa f. Bar. Bell. Bry. 

Camph. Cann. Canth. Chin. Coff. 

Calc. Carb. veg. Caust. Coloc. Dig. 

Ferr. Graph. Hell. Hyosc. Ign. Iod. 

Kali. Lach. Lye. Merc. Natr. Nitr. 

ac. Nux vom. Op. Plumb. Pulsat. 

Phosph. Rhus. Sep. Sil. Sulph. 

Spong. Staph. Stram. Thuj. Valer. 

Veratr. 
— boring : Ant. crud. Bell. Arg. Calc. 

Cocc. Chin. Dulc. Hepar. Ipec. Ign. 

Plat. Staph. Phosph. ac. Rhodod. 

Sep. Sil. Spig. Stram. Sulph. 
— as if bruised: Aeon. Ars. Aur. 

Camph. Cham. Chin. Coff. Euphr. 

Hell. Ignat. Ipec. Phosph. Nux 

vom. Puis. Rhus. Sep. Veratr. 
— as if it would burst: Ant. crud. 

Asar. Bar. Bellad. Calc. Caps. 

Cham. Chin. Coff. Con. Ign. Natr. 

mur. Nux vom. Phosphor. Rhus. 

Sep. Sil. Spig. Spong. Sulph. 
— burning: Aeon. Am. Bell. Bry. 

Cupr. Hell. Ipec. Merc. Natr. N. 

vom. Phosph. Ph. ac. Rhus. Sec. 



com. Spig. Staph. Stann. Yeratr. 
— buzzing : Caust. Cocc. Phos. Sulph. 

Yeratr. 
— crawling : Aconit. Am. Bar. Cocc. 

Hyosc. Puis. Rhus. Sulph. Thuj. 
— digging: Agar. Aur. Bar. Bry. 

Dulc. Ign. N. vom. Spig. 
— drawing: Aeon. Aur. Bell. Calc. 

Carb. veg. Cham. Cina. Coloc. 

Cupr. Dulc. Graph. Hell. Lye. 

Ipec. N. Tom. Nitr. ac. Petr. Plat. 

Puis. Rhus. Sep. Sil. Sulph. 

Veratr. 
DULL HEADACHE : Antimon. 

crud. Bry. Calc. Carb. veg. Chin. 

Camph. Cocc. Coff. Dulc. Hell. 

Ign. Natr. mur. Ph. ac. Plat. Puis. 

Veratr. Zinc. 
HEAVINESS OE HEAD: Aeon. 

Arn. Asa f. Agar. Alum. Ars. 

Bell. Bry. Camph. Cann. Cham. 

Chin. Cic. Coccul. Coff. Croc. 

Cupr. Calc. Carb. veg. Caust. 

Con. Digit. Dulc. Bros. Euphr. 

Ferr. Hell. Hyosc. Ign. Ipec. Kali. 

Lye. Merc. Natr. mur. Nitr. acid. 

N. vom Opium. Petr. Plumb. Puls- 
at. Phosph. Ph. ac. Plat. Sabin. 

Spig. Spong. Staph. Stram. Silic. 

Stann. Sulph. Thuj. Veratr. 
HAMMERING: Calc. Chin. Coff. 

Lach. Natr. mur. Phosph. Sil. 

Sulph. 
HEAT : Aconit. Alum. Arn. Bell. Bry. 

Calc. Canth. Caustic. China. Coff. 

Dig. Dros. Dulc. Euphr. Hell. 

Hyosc. Ign. Ipec. Lycop. Merc. 

Natr. mur. Nitr. ac. N. vom. Petr. 

Phosphor. Plumb. Puis. Rhus. Sep. 

Sil. Stann. Stram. Sulph. 
HEMICRANIA : Asar. BRY. Chin. 

Coloc. Ign. Ipec. N. vom. Rhus, 

Sep. 
AS AFTER INTOXICATION: 

Bryon. Merc. Natr. mur. Puis. 
JERKS: Ambr. Bell. Bry. Calc. 



HEAD. 



Dig. Mur. ac. Natr. xnur. N. Yom. 

Puis. Peir. Phos. Spic. Spong. Sep. 

Stann. Thuj. Valer. 
SIMPLE PAIN: ,4«m. Ars. Bar. 

Bell. Calc. Canth. Carb. veg. Chin. 

Core. Croc. Cupr. Hell. Hyosc. loci. 

Lacli. Lycop. Merc. Mur. ac. Natr. 

c. Natr. mur. Nitr. Nux vom. Op. 

Ph. acid. Plumb. Puis. Ehus. Sep. 

Sil. Spig. £Jrfl??i. Sulph. Valer. 
AS FEOM A NAIL (clavus :) Aeon. 

Agar. Coff. Hep. Xgn. N. voui. Ruta. 

Thuj. 
PRESSING ASUNDER: Aeon. 

Bar. Bell. Bry. Calc. Ign. Lye. 

Merc. Natr. mur. Nitr. Nux vom. 

Sep. Sil. Spig. Stann. Staph. 
PRESSING TOGETHER: Alum. 

Asa feet. Bry. Calc. Cina. Cocc. 

Graph. Hell. Phosph. ac. Sil. 

Staph. 
PULSATING: Bell. Bryon. Chin. 

Petr. Phosph. Puis. Rhus. Sulph. 
PRESSURE : Aeon. Ambr. Arg. Am. 

Asaf. Asar. Anac. Ars. Aur. Bell. 

Bryon. Calc. Caps. Cham. Chin. 

Cic. Cina. Cocc. Coff. Croc. Dig. 

Hell. Hyosc. Iod. Ign. Ipec. Lach. 

Merc. Mur. ac. N. vom. Natr. carb. 

Natr. mur. Nitr. ac. Petr. Pulsat. 

Phosphor. Phosph. ac. Plat. Spig. 

Sep. Sil. Stann. Staph. Sulph. 

Valer. Zinc. 
ROARING: Aur. Ferr. Graph. 

Phosph. Sulph. 
STINGING : Aeon. Ambr. Arg. Arn. 

Asa f. Alum. Ars. Bar. Bell. Bov. 

Bry. Canth. Caps. Chamom. Chin. 

Cic. Calc. Caust. Con. Dulc. Ferr. 

Hep. Ign. Ipec. Natr. mur. H. vom. 

Petros. Phosph. Plumb. Puis. Ph. 

ac. Rhus. Sabad. Selen. Stajjh. 

Sep. Sil. Sulph. Thuj. 
STUPEFYING: Anac. Ars. Ant. 

crud. Arn. Bell. Bov. Cann. Cic. 

Cina. Calcar. Hyosc. Ign. Mur. ac. 



Phosph. Natr. carb. Nitr. Ph. ac. 

Plat. Ruta. Sabad. Sepia. Stann. 

Staph. Verb. Zinc. 
TEARING: Alum. Ambr. Anac. 

Ant. crud. Arg. Arn. Asar. Bell. 

Bry. Ca!c. Camph. Canthar. Caps. 

Carb. veget. Caust. Cham. Chin. 

Cocc. Coff. Coloc. Con. Ign. Ipec. 

Lycop. Mur. ac. Natr. mur. N. vom. 

Ph. ac. Puis. Ehus. Sil. Spig. Sulph. 
TWITCHING: Arn. Bell. Bry. Carb. 

veg. Caust. Chin. Ign. N. vom. Ph. 

ac. Staph. Sulph. 
VIBRATING: Lye. Nitr. ac. Nux 

vom. Sil. Stann. 



According to the Part of 
the Head 

FRONT PART OF THE HEAD: 

Aeon. Alum. Ambr. Anac. Antim. 

crud. Arg. Arn. Arsen. Asafoet. Asar. 

Aur. Bar. Bell. Bry. Camph. Calc. 

Cann. Canth. Caps. Carb. veg. 

Caustic Cham. Chin. Cicc. Cina. 

Cocc. Coff. Colch. Coloc. Con. Croc. 

Cupr. Dig. Bros. Dulc. Euphr. Ferr. 

Graph. Hell. Hyosc. Ign. Iod. Ipec. 

Kali. Lye. Merc. Natr. mur. Nux 

vom. Op. Phosph. Plat. Plumb. 

Puis. Rhodod. Ehus. Sabin. Samb. 

Sep. Sil. Spig. Spong. Staph. Stann. 

Sulph. Veratr. Zinc. 
TEMPLES : Aeon. Agar. Alum. Ant. 

crud. Arg. Arn. Asaf. Asar. Bell. 

Bry. Calc. Camph. Cann. Canth. 

Caps. Chamom. Chin. Cina. Cocc. 

Con. Cupjr. Dig. Euphr. Hell. 

Hep. Ign. Lach. Nitr. ac. Op. 

Phosph. Phos. ac. Eheum. Rhus. 

Ehodod. Sabin. Spig. Spong. 

Stann. Staph. 

VERTEX: Aeon. Ambr. Ant. crud. 
Arg. Arn. Asa f. Aur. Bell. Bry. 
Cann. Canth. Caps. Caust. Chin. 
Cina. Cocc. Coff. Coloc. Con. Croc. 



8 



HEAD. 



Cupr. Ferr. Graph. Hell. Ign. Iod. 

Ipec. Lach. N. vom. Phosph. Ph> 

ac. Plat. Sabin. Samb. Sep. Sil. 

Spig. Spong. Stann. Staph. Strain. 

Sulph. Thuj. Yeratrum. 
OCCIPUT : Aeon. Ambr. Arg. Arn. 

Asa f. Asar. Aur. Bar. Bell. Bry. 

Calc. Camph. Cann. Canth. Caps. 

Carb. veg. Chin. Cic. Coff. Colchic. 

Croc. Cupr. Dig. Bros. Hell. Hy- 

osc. Ign. Ipec. Lye. Mercur. 

Mosch. Mir. Nux Tom. Op. Petr. 

Plat. Puis. Rhus. Sabin. Samb. 

Spig. Spong*. Staph. Stann. Sulph. 

Thuj. 
EIGHT SIDE: Aeon. Alum. Ant. 

crud. Arg. Arn. Asa f. Bell. Bry. 

Camph. Canth. Caust. Chin. Cm. 

Coccul. Colchic. Croc. Big. Bros. 

Graph. Hep. Ign. Kali. Lach. Lye. 

Nux vom. Phosph. Ph. ac. Plumb. 

Puis. Ehus. Sabad. Sabin. Sil. 

Spig. Spong. Sulph. Thuj. 
LEFT SIDE: Aeon. Ambr. Ant. 

crud. Argent. Arn. Asa f. Asar. 

Aur. Bell. Bry. Calc. Camph. Cann. 

Caps. Carb. veg. Chin. Cic. Cin. 

Cocc. Coloc. Croc. Cupr. Big. Dulc. 

Dros. Euphorb. Ferr. Hell. Hyosc. 

Iod. Lach. Merc. JSfitr. Nitr. ac. 

Nux vom. Plumb. Puis. Petr. Plat. 

Rhodod. Ehus. Sabin. Samb. Sec. 

cor. Sep. Spig el. Spong. Staph. 

Stann. Sulph. Veratr. 

External. 

BLOTCHES : Ant. crud. Ars. Aur. 

Hep. Natr. mur. Nux vom. Phosph. 

Sil. Thuj. 
BLOATING : Ars. Sulph. 
BOILS : Bell. Khus. Arn. 
BURNING: Arn. Ars. Bar. Bell. 

Bry. Caps. Carb. veg. Coloc. Dulc. 

Dros. Graph. Phosph. Plat. Sabad. 

Sil. Spig. Spong. Staph. Stann. 

Sulph. Veratr. 



CHILLINESS: Bar. Calcar. Carb. 

veg. Dulc. Kali. N. vom. Ph. acid. 

Spig. Staph. Veratr. 
COLDNESS: Agaric. Alum. Bar. 

Calc. Phosph. Ph. ac. Rhod. Ve- 
ratr. , 
— feeling of : Asar. Cann. Lach. Ve- 
ratr. 
DRAWING: Agar. Bar. Bell. Calc. 

Canth. Chin. Ignat. N. vom. Ph. 

ac. Puis. Rhus. Staph. 
ERUPTION: Anac. Ars. Aur. Bar. 

Calc. Carb. veg. Cic. Con. Graph. 

Hep. Kali. Merc. Natr. mur. Petr. 

Rhus. 
GNAWING: Caps. Dros. Thuj. 
HAIR FALLING OUT: Ambr. 

Ant. crud. Ars. Aur. Bar. Bell. 

Calcar. Canth. Carb. veg. Caust. 

Con. Ferr. Graph. Hep. Ign. Iod. 

Kali. Lye. Merc. Natr. mur. Nitr. 

ac. Petr. Phosph. Plumb. Sec. cor. 

Sep. Sil. Staph. Sulph. 
HAIR AS IF PULLED: Aeon. 

Alum. Arn. Bar. Bry. Canth. Kali. 

Lye. Mur. ac. Nitr. Phosph. Ph. ac. 

Rhus. 
HERPES: Alumina. Graph. Petr. 

Rhus. 
ITCHING : Agar. Alum. Arg. Arn. 

Ars. Asar. Aur. Bar. Bell. Bry. 

Calc. Caps. Carb. veg. Caustic. 

Chin. Conium. Dros. Graph. Hep. 

Kali. Merc. Lye. Mur. ac. Natr. 

mur. Petr. Phosphor. Puis. Rhod. 

Rhus. Ruta. Sabad. Sep. Sil. Spig. 

Staph. Sulph. Thuj. Veratr. Zinc. 
LICE: Oleand. Sabad. Staph. Fine 

Comb. 
PAIN AS IF CONTUSED: Am. 

Ipec. Ehus. Euta. 
PAINFULNESS: Arsen. Bell. Calc. 

Caust. Hell. Merc. N. vom. Rhod. 

Ehus. Thuj. 
PIMPLES: Ars. Bar. Bell. Kali. 

Mur. ac. Natr. c. Petr. Rhus. Sil. 

Zinc. 



EYES. 



9 



SCALES OX THE SCALP: Cal- 

car. Phosph. Rhus. Staph. 
SCURFS: Ars. Bry. Calc. Ferr. 

Graph. Hep. Lye. Merc. Natr. niiir. 

Petr. Rhus. Rata. Sil. Staph. 

Sulph. 
AS IP THE SKIN ADHERED: 

Am. 
SWEAT : Bar. Bell. Bry. Calc. Cham. 

Chin. Coloc. Ipec. Graph. Hepar. 

Nux vom. Mere. Natr. mur. Nitr. 

ac. Op. Petr. Phosph. Phosph. ac. 

Plumb. Puis. Rheum. Rhus. Ruta. 

Sec. corn. Sep. Silic. Spig. Sulph. 

Taler. 
STINGING: Agar. Alum. Ant. cr. 

Am. Asa f. Aur. Bar. Bell. Canth. 

Caust. Chin. Digit. Hep. Iod. Kali. 



Natr. mur. Nitr. ac. Phosph. Phos. 

ac. Sabad. Spigel. Staph. Sulph. 

Thuj. Veratr. 
SWELLING: Ars. Bell. Cham. 

Caust. Cup. Dig. Euphorb. Op. 

Phosph. Puis. Rhus. Sep. Strain. 

Sulph. 
TEARING: Agar. Alum. Ambr. Bar. 

Bell. Calc. Digit. Graph. Lycop. 

Merc. Natr. Rhus. Ruta. Sabin. 

Sep. Staph. 
TENDENCY TO COLD: Kali. 

Natrum mur. 
TINGLING: Aeon. Am. Arsen. 

Carb. veg. Ferr. N. vom. Rhod. 

Sabad. Spig. 
TREMBLING OF HEAD- Cic. 
Coc. Ign. 



Ill EYES. 



Visual Power. 
AMAUROSIS: Bellad. Calc. Cann. 

Chin. Cocc. (Con.) Dig. Dulc. Sy- 

osc. (N. Torn.) Mercur. Nitr. ac. 

Phos. Plumb. Puis. Rhus. Ruta. 

Sec. corn. Sil. Spig. Stram. Sulph. 
— incipient: Aurum. China. Caust. 

Dulc. Hyosc. Natr. niur. Puis. 

Sulph. 
BLINDNESS: Ant. crud. Phosph. 

Sil. Yeratr. 
BLURRED : Bell. Bry. China. Dros. 

Graph. Hyoscyam. Lycopod. Natr. 

mur. Sil. Stram. 
CATARACT: Baryta. Cann. Caust. 

Conium. Euphr. Hyosc. Nitr. acid. 

Op. Puis. Ruta. Sil. Sulph. 
DAZZLING: Con. Dig. Dros. Ign. 

Kali. Lye. Merc. Nitr. ac Ph. ac. 

Sil. Stram. Sulph. 
GLAUCOMA : Phosph. 
HEMERALOPIA : Bellad. Dig. Hy- 
osc. Merc. Veratr. 

40 



ILLUSIONS OF COLOR: 

— pale: Dig. * 

— blue: Bellad. Stram. Sulph. Zinc. 

— checkered : Euphorbium. Kali. Nitr. 
Sulph. 

— colored streaks : Con. 

— fiery yellow : Ph. ac. 

— yellow: Ars. Canth. Dig. Kali. 
Sulph. Santon. 

— gold-colored: Bell. Hyosc. 

— green : Dig. Merc. 

— red: Bell. Cann. Con. Croc. Dig. 
Hep. Hyosc. Spig. Stram. Sulph. 

— black : Caps. Chin. Cic. Cocc. Merc. 
Phosph. Staph. 

— white : Cann. Dig. Kali. Ph. ac. 

— halo around the light, many-col- 
ored: Bell. 

— gray: Phosph. Sep. 

— green : Phosph. Sep. Zinc. 

— bright: Calc. 

— ruin-bold: Nitr. 

—red: Bell. 

— black: Phosph. 



10 



EYES. 



ILLUSIONS OF SIZE, SHAPE, 

DISTANCE. 
— seeing double: Agar. Aur. Bell. 

Oic. Digitalis. Euphorb. Graph. 

Hyosc. Nitr. acid. Merc. Petr. Puis. 

Secale corn. Sulph. Yeratr. 
— seeing things half : Aur. Calc. Lye. 

Mur. ac. Natr. mur. 
VISION, false: Hyosc. 
— larger: Hyosc. Staph, 
—brighter: Camph. Hyosc. N. vom. 
— smaller: Hyosc. 
— slanting: Stram. 
— confused: Stram. 
OPTICAL ILLUSIONS OF 

THINGS NOT PKESENT: 
— flashes : Croc. Natr. Spig. 
— flashes, black : Staph. 
— gray covering : Phosphor. Sil. 
— threads: Con. 
— feathers: Calc. Lye. Natr. Natr. 

mur. Spig. 
— fire: Bar. Bell. Bry. Dig. Dulcam. 

Natr. mur. Ph. ac. Spig. Staph. 

Stram. Veratr. 
— spots, dark: Calcar. Carb. veg. 

Caust. Con. Dig. Kali. Lye. Natr. 

mur. Nitr. ac. Petr. Phosph. Sec. 

corn. Sep. Sil. Sulph. 
— gauze: Asa f. Alum. Ars. Aur. 

Bryonia. Caust. Cina. Croc. Drosera 

Euphorbium. Euphr. Hyosc. Tgn. 

Lye. Natr. mur. Opium. Petr. 

Phosph. Plat. Ehod. Rhus. Sabin. 

Sec. corn. Sep. Stram. Sulphur. 

Thuj. 
— sparks: Arsenic. Aur. Bar. l5eli. 

Bry. Calcarea. Caust. Coloc. Croc. 

Dig. Dulc. Kali. N. vom. Op. Petr. 

Sil. Spig. Veratr. 
— cobwebs : Agar. Caust. 
— figures: Camph. Samb. 
— mist : Aeon. Agar. Alumina. Ambr. 

Arg. Bell. Bry. Cann. Caust. Croc. 

Dig. Graph. Kali. Merc. Natr. mur. 

Ph. ac. Plat. Plumbum. Puis. Ruta. 



Sec. com. Spig. Staph. Stram. 

Sulph. 
— point : Calc. Con. Dig. Kali. Merc. 

Natr. mur. Nitr. ac. N. vom. Petr. 

Phosphor. Sulph. 
— halo around light : Staph. 
LONG-SIGHTED: Alum. Bell. Bry. 

Calc. Caustic. Con. Di~os. Hyosc. 

Lye. Natr. mur. N. vom. Petr. Sil. 

Spigelia. Sulph. 
AS IF THINGS WERE MOVING: 

Bell. Con. Cic. Euphr. Hyosc. Ign. 

Merc. Sabad. Stram. 
PHOTOPHOBIA : Aeon. Alum. Am. 

Ars. Bellad. Bry. Camph. Cham. 

China. Cic. Cina. Coff. Con. Croc. 

Euphras. Graph. Hell. Hep. Ign. 

Kali. Lycopod. Merc. Mur. ac. 

Nitr. ac. N. vom. Ph. ac. Puis. Sep. 

Sil. Sulph. 
SQUINTING: Alumina. Bellad. Hy- 

osc. Puis. Sec. corn. 
SENSITIVENESS: Aeon. Antim- 

crud. BeU. Chin. Coff. Hell. Ign. 

N. vom. Spig. 
SHORT-SIGHTEDNESS : Agar. 

Anac. Calcar. Carb veg. Chin. Con. 

Euphr. Graphites. Hyosc. Natr. 

mur. Nitr. ac. Phos. Ph. ac. Plumb. 

Puis. Ruta.- Stramon. Yaler. Thuj. 
STARING AT ONE POINT : Cicn- 

ta. Cocc. Ruta. Strain. 
VIBRATIONS: Arsen. Bell. Calc. 

Carb. veg. Caust. Cham. Con. Dig. 

Graph. Hell. Ign. Lye. Mur. ac. 

N. vom. Petr. Phosph. Ph. ac. 

Pulsat. Sec. corn. Sep. Staph. 

Sulph. 
VISION, sudden blackness of : Aeon. 

Alum. Arg. Ars. Asa feet. Atrc. 

Aur. Bell. Bry. Calc. Carb. veg. 

Caust. Canth. Caps. Cham. Cic. 

Cina. Croc. Dros. Dulcam. Ferr. 

Graph. Hepar. Hyosc. Lye. Merc. 

Natr. mur. Nitr. Nitr. ac. N. vom. 

Op. Phosph. Plumb. Puis. Sabin. 



EYES. 



11 



Sec. cor. Staph. Strain. Sep. Sulph. 
VISION, dim: Alum. Bellad. Cham- 

om. Chel. Eheum. Ruta. Sabad. 
— pale : China. Croc. Dros. Petr. Puis. 

Rhus. Sil. 
— obscured: Aeon. Agar. Arn. Ars. 

Asar. Aur. Bar. Bell. Bryon. Calc. 

Camph. Caps. Caustic, (ham. Cic. 

Con. Cupr. Dig. Dros. Euphr. Ferr. 

Hyosc. Iod. Kali. Lye. Natr. mar. 

Nitr. ac. Xux vom. Op. Phosphor. 

Plat. Pulsat. Ruta. Sil. Spig. 

Stram. Sulph. Thuj. 
— vanishing of : Agar. Bell. Calc. Cic. 

Con. Hep. Hyosc. Merc. Natr. m. 

Nitr. N. vom. Op. Phosph. Puis. 

Sec. corn. Spig. Staph. Stram. 

Yeratr. 
— weak : Asar. Agaric. Alum. Ars. 

Bar. Bell. Calc Can. Caps. Carb. 

veg. Chin. Con. Croc. Dros. Graph. 

Hep. Iod. Lye. Hyos. Ign. Natr. 

mm*. Nitr. ac. Petr. Phosph. Ph. ac. 

Plumb. Khus. Ruta. Sec. corn. 

Sep. Sil. Staph. 

Sensations. 
In the eye-balls and eye generally. 
AGGLUTINATION : Alumina. Bell. 

Bry. Calcar. Carb. veg. Caustic. 

Croc. Euphorb. Hep. Ign. Kali. 

Lye. Nat. mur. Nitr. ac. Nux vom. 

Phosph. Plumb. Pulsat. Rhus. Ru- 
ta. Sep. Silic. Stann. Staph. Sulph. 

Thuj. 
BURNING : Aeon. Agar. Alum. Ars. 

Arn. Aur. Asa f. Bar. Bell. Bry. 

Calc. Canth. Col. Con. Caps. Cham. 

Chin. Cic. Croc. Birr. Dros. Ferr. 

Graph. Hell. Ign. Kali Lye. Mur. 

ac. Nitr. ac. Nux vom. Phosph. 

Plumb. Pulsat. Rhod. Rhus. Ruta. 

Sep. Sil. Spigel. Spong. Staph. 

Stram. Sulph. Thuj. 
CORNEA, spots on : Apis. Ars. Aur. 

Calc. Can. Chel. Con. Euphr. Hep. 

Lye N. vom. Sep. Sil. 



— obscuration of : Ang. Cann. Caps. 

Chel. Chin. Nitr. ac. Op. Plumb. 

Puis. Sulph. 
— ulcers on : Euphr. Ruta. 
DRYNESS : Agar. Asa f. Asar. Bar. 

Bell. Bry. Caust. Croc. Euph. Kali. 

Lye. Natr. mur. Nux vom. Phosph. 

Puis. Spig. Staph. Sulph. Yeratr. 
DISTORTION: Aeon. Arnic. Ars. 

Bell. Bry. Camph. Canth. Cham. 

Cic. Cocc. Cupr. Hell. Hyosc 

Opium. Petr. Plat. Plumb. Pulsat. 

Sec corn. Spig. Stan. Stram. 

Sulph. Yeratr. 
ECCHYMOSIS: Arn. Cham. Nux 

vom. Plumb. 
EYE-GUM. Agar. Alum. Calcar. 

Caust. Cham. Chin. Con. Dros. 

Euphorb. Graph. Hep. Lye. Nitr. 

ac. Phosph. ac. Sil. Spig. Sulph. 
EYES, blood flows from: Cham. 

Euphr. N. vom. Euta. 
— gum : Euphr. Ign. Puis. 
FUNGUS HLEMAT: Apis. Bell. 

Calc Lye Sep. Sil. 
GLAZED: Bell. Cocc. Croc. Op. 

Ph. ac. Spig. 
HEMORRHAGE : Bell. Cham. 

Euphr. N. vom. 
INFLAMMATION : Aeon. Ambr. 

Apis. Arn. Ars. Bar. Bell. Bry. 

Calc Camph. Canth. Carb. veg. 

Cham. Chin. Coloc. Con. Cupr. 

Dig. Dulc. Euphras. Euphorb. Ferr. 

Graph. Hep. Hyosc. Ignat. Ipec. 

Kali. Lye. Merc Natr. mur. Nitr. 

ac N. vom. Opium. Phosph. Ph. 

ac. Plumb. Puis. Rhus. Sep. Sil. 

Spig. Staph. Sulph. Yeratr. 
LACHRYMATION : Aeon. Agar. 

Alum. Ambr. Anac. Arn. Ars. 

Asar. Bar. Beil. Bry. Calc. Camph. 

Canth. Caps. Carb. veget. Caust. 

Chelid. Chin. Cina. Coff. Coloc 

Con. Croc. Digit. Euphr. Fer. 

Graph. Hell. Hep. Ign. Kali, c 

Lach. Lye Merc Natr. mur. Nux 



12 



EYES. 



vom. Op. Petr. Phosph. Ph. ac. 

Plat. Puis. Rhodod. Rhus. Ruta. 

Saoadilla. Seneg. Sep. Sil. Spig. 

Spong. Stan. Staph. Strain. Sulph. 

Yaler. Yeratr. Zinc. 
L ACHRYMATION, smarting : Aeon. 
- Bell. Calc. Carb. veg. Con. Dig. 

Euphr. Graph. Lycop. Natr. mur. 

Phosph. ac. Rhus. Sabin. Spig. 

Staph. Sulph. 
LOOKS, anxious: Stram. 
— staring : Aeon. Arn. Bryon. Camph. 

Canth. Cic. Cina. Cocc. Cupr. Hell. 

Hyosc. Nux vom. Op. Sec. corn. 

Spig. Stram. Veratr. 
— disturbed: Camphor. Cupr. Op. 

Sec. corn. Stram. Yerat. 
— wild: Cupr. Hyosc. Opium. Sec. 

corn. 
MOTIONS, convulsive : Canthar. 

Cham. Cupr. Hyosc. 
— involuntary: Spig". Stram. 
PAIN, simple: Aeon. Arnic. Bar. 

Bell. Bry. Calc. Canth. Carb. veg. 

Cin. Croc. Dig. Euphr. Petr. 

Phosph. Plat. Plumb. Fulsat. 

Rhus. Ruta. Sabin. Sep. Sil. Spig. 

Stann. Staph. Veratr. 
PELLICLE ON EYES : Cann. Eu- 

phras. Puis. Ruta. 
PRESSURE, outward: A.con. Asa 

feet. Asar. Aur. Calc. Camph. 

Cann. Canth. Con. Hell. Ign. N. 

vom. Rhus. Spig. Staph. 
— inward: Agaric. Anac. Aur. Bry. 

Calc. Caust. Kali. Ph. acid. Spig. 
—as from a foreign body: Ambr. 

Anac. Arn. Ars. Asa f. Aur. Bar. 

Bell. Calc. Caps. Carb. veg. Caust. 

China. Cina. Cocc. Con. Croc. 

Ferr. Hyosc. Ign. Merc. Natr. 

mur. Nitr. ac. Petr. Phosph. Ph. 

ac. Plat. Plumb. Puis. Rhus. Sep. 

Sil. Spig. Stann. 
— together : Arg. Sabin. Yerat. 
PROTRUDED: Aeon. Arn. Ars. 

Aur. Bell. Canth. Caps. Cin. Cocc. 



Con. Cupr. Hep. Hyoscyam. Op. 

Rhus. Spigel. Spong. Staph. Stram. 

Verat. 
PUPILS, dilated: Aeon. Agar. Anac. 

Arn. Ars. Asa f. Aur. Bell. Calc. 

Camph. Canth. Caps. Caust. Chin. 

Cina. Con. Croc. Cupr. Dig. Dros. 

Hell. Hep. Hyosc. Ign. Ipec. Mur. 

ac. Nitr. ac. Nux vom. Petr. Ph. 

ac. Plumb. Pulsat. Sec. corn. Spig. 

Stann. Staphys. Stram. Yeratr. 

Zinc. 
— contracted: Aeon. Agar. Anac. 

Arn. Ars. Aur. Bell. Calcar. 

Camph. Canthar. Capsic. Cham. 

Chin. Cic. Cina. Cocc. Croc. Dig. 

Dros. Hell. Hyosc. Ign. Mur. ac. 

Natr. carb. Ph. ac. Plumb. Puis. 

■Sec. corn. Staph. Stram. Stann. 

Sulph. Thuj. Yeratr. 
— immovable : Aeon. Baryt. Bell. 

Cham. Chin. Cupr. Dig. Ferr. 

Hyosc. Op. Plumb. Seneg. Spig. 

Stram. 
— suddenly dilating and contracting : 

Bar. 
PUS: Ars. Bry. Euphorb. Hep. N. 

vom. Ruta. 
RUSH OF BLOOD TO EYES: 

Aur. Bell. Plumb. Sep. Spig. 
SMARTING: Ambr. Agar. Alum. 

Ars. Bell. Bry. Calc. Canth. Carb. 

veg. Caust. Chin. Con. Croc. Droser. 

Euphr. Graph. Hell. Hep. Kali. 

Lye. Merc. Mur. ac. Nitr. ac. Nux 

vom. Phosph. Ph. ac. Rhus. Sep. 

Sil. Staph. Sulph. Thuj. Yal. 
SPARKLING : Aeon. Bell. Bry on. 

Hyosc. Op. Stram. 
SPOTS ON EYES: Euphr. Nux 

vom. Puis. Ruta. 
SQUINTING: Alum. Bell. Hyosc. 

Puis. Sec. corn. 
SUNKEN: Ambra. Camph. Chin. 

Cic. Cupr. Dros. Ferr. Hyosc. Op. 

Sec. corn. Spong. Staph. Yeratr. 
SWELLING: Ars. Bry. Carb. veg. 



EYES. 



13 



Hep. N. vom. Phospli. Plumb. 

Rhus. Kuta. Strain. Sulphur. 
ULCEEATION: Ambr. Am Calc. 

Caps. Cham. Lye. Phosphor. Sil. 

Spong. Staph. Sulph. 
VEINS ENGORGED : Aeon. Ambr. 

Spig. 
VEINS, red: Euphr. 
WHITES, blueness of: Veratr. 
WHITES, yellowness of: Aeon. 

Ambr. Aut. crud. Arseuic. Bell. 

Bry. Canth. Cham. Chin. Coee. Con. 

FeiT. Ign. S. vom. Op. Phosph. 

Ph. ac. Plumb. Puis. Rhus. Sep. 

Sulph. 
— "without lustre : Asa f . Asar. China. 

Ferr. Hyosc. Merc. Ph. ac. Sabin. 

Yeratr. 

In the eye-brows. 
DRAWING : Bell. Caust. Dros. HeU. 
Rhus. 

ERUPTION: Cuprum. Kali. Selen. 

Sil. Spong. Stann. Thuj. 
FALLING OF LASHES : Agaricus. 

Plumb. Selen. 
ITCHING: Agar. Alum. Caust. 

China,.\Selen. Silic. Spigelia. Sulph. 
SWELLING: Kali. 
TWITCHING: Caustic Kali. Zinc. 
WARTS: Caust. 

At the eye-lids. 

(u. signifies upper, 1. lcrsver lid ; r. right, 1. left ; 
wh?re these signs are -wanting, both lids are 
meant.) 

EYE-GUM: Dros. Ferr. Rheum. 

Rhus. Staph. 
AGGLUTINATION: Aeon. Agar. 

Bell. Bry. Calc. Causticum. Cham. 

Con. Dig. Drosera. Euphr. Ferr. 

Graph. Ign. Kali. Mur. ac. Natrum. 

mur. >'ux vom. Phosphor. Plat. 

Puis. Rhus. Sep. Silicea, Spigel. 

Staph. Stramonium. Sulph. Veratr. 
BLUENESS : Dig. 
BURNING : Ambr. Asar. Ars. Bell. 

Bry. Caps. Con. Graphit. Kali. 



Xux vom. Ph. ac. Rhus. Seneg. 

Spig. Stann. 
ECCHYMOSIS: Apis. Arn. 
INFLAMMATION : Aco. Apis. Ars. 

Bell. Bryonia. Calc. Carb. veg. 

Caust. Cham. Dig. Euphr. Hep. 

Hyosc. Ign. Lye. N. vom. Pulsat. 

Rhus. Sep. Spig. Spong. Staph. 

Stramonium. Sulph. Thuj. Yeratr. 
ITCHING: Ambr. Ars. Bellad. Bry. 

Calc. Camph. Carb. veg. Caustic. 

Cocc. Drosera. Euphorb. Euphrasia. 

Lye. Nnx vom. Phosph. Rhus. 

Spong. Staph. Sulph. Veratr. 
— u. : Bar. Carb. an. Cin. Croc. Sil. 

Staph. 
— 1. : Caust. Lach. Petr. Euta. 
PARALYSIS: Bellad. Cocc. Nitr. 

ac. Rhus. Sepiae. Spig. Strain. Ye- 
ratr. 
PIMPLES : Hep. Lye. Petr. Rhus. 

Sulph. 
— u. : Hep. 
— u. r. : Canth. Lye. 
— u. 1. : Chel. 
— 1. : Natr. mur. Seneg. 
—1. 1. : Alum. 
SMARTING: Camph. Carb. veg. 

Caust. Ign. Rhus. Spig. 
— u. r. : Rhus. 
— u. 1. : Aur. 
SPASMS. Alum. Ambr. Bell. Croc 

H30SC. Rhododendr. Sep. Sil. 
STYES: Ambr. Apis. Digit. Ferr. 

Lye. Puis. Rhus. Sep. Stann. 

Staph. 
SWELLING: Aco. Arn. Ars. Bar. 

Bell. Bry. Calcarea. Caust. Cham. 

Euphr. Ferr. Hyosc. Ign. N. vom. 

Phosphor. Pulsatilla. Rhus. Ruta. 

Sen. Spong. Stram. Sulph. Yaler. 
— u. : Aco. Asar. Natr. c. Sep. SiL 

Sulph. 
— 1. : Ars. Aur. Bell. Bry. Croc. Dig. 

Lach. Op. Ph. ac. Rhus. Sep. 
AS IF SWOLLEN: Aconitum. 

Croc. Rhus. Valer. 



u 



EARS. 



TETTEK: Bry. Ehus. Sep. 
ULCEBATION: Colch. Croc. Ign. 

Lye. Nux vom. Phosph. Puis. 

Ehus. Silicea. Spig. Staph. Stram. 
— 1. : Colch. Natr. mur. 

In the canthi. 

(Corners of the eye 
ABSCESS, int.: Bry. 
AGGLUTINATION : Phosph. Staph 
BLUEISH, int. : Aur. Sassap. 
BUBNING: Alnm. Stann. Staph. 
— int. : Agar. Asar. Aur. Bar. Bell. 

Calc. Graph. Hell. Natr. mur. 

Phosph. Ph. ac. Bhodod. 
— ext. : Carbo anim. Cina. Kali. Sep. 

Spig. Stront. Sulph. 
EYE-GUM: Agar. Ant. crud. Calc. 

Caust. Coif. Dig. Euphr. Graph. 

Ipec. N. vom. Staph. Thuj. 
— ext. : Chin. Euphorbium. Ipec. 

Sabad. Staph. 
— int. : Agar. Euphras. Helleb. Ehus. 

Sil. Staph. 
FISTULA LACHEYM: Calc. Chel. 

Petr. Pulsatilla. Euta. Stann. 

Staph. 



GUM: Natr. mur. 
INFLAMMATION : Aco. Alum. Ars. 

Cham. Euphr. Ign. N. vom. Phosph. 

Puis. 
— int. : Agar. Merc. 
— ext.: Calc. 
STYE : Puis. Sep 
— int. r. : Natr. mur. 
ITCHING: Arg. Am. Calc. Caust. 

Cina. Hell. Hyosc. Natr. mur. Plat. 

Puis. 
— int: Bellad. Caust. Con. Lye. 

Nitr. ac. Nux vom. Pulsatilla. Buta. 

Sep. Staph. 
LACHEYMATION : Petr. Silicea. 

Thuj. 
PBESSUBE, as from a foreign body, 

1. : Agar. Bar. Con. Ignat. Nitr. ac. 
PUS: Cham. Cina. Graph. N. vom. 

Puis. Staph. 
SMAETING : Carb. veg. Mur. ac. 

N. vom. Sep. Sil. 
—int.: Con. Graph. Hell. Kali. N. 

vom. Puis. Staph. 
— ext. : Camphora. Ign. N. vom. 

Sulph. 



IV. EARS. 



On the Ears. 
BOEING: Alum. Aur. Baryta. Bell. 

Caust. Euphr. Helleb. Plat. Plum- 
bum. Sil. Spigel. Stann. 
DISCHABGE, of blood: Bryonia. 

Cic. Graph. Mercurius. Petr. 

Phosph. 
— of pus: Alum. Aur. Bellad. Bov. 

Calc. Caustic. Kali. Lye. Merc. 

Petr. Pulsat. Sep. Sulph. 
— humor: Asa feet. Caust. Mercur. 

Natr. mur. Phosph. Sep. 
EEUPTION: Agar. Bar. Cic. Chin. 

Kali. Petr. Phosphor. Pulsatilla. 

Sep. Sil. Spongia. Sulph. 



— behind the ears: Antim. crud. 
Canth. Chin. Puis. Sabad. Staph. 

E AE-WAX, liquid : Merc. 

— blood-red: Con. 

— hard: Selen. Soft water. 

— pappy: Lach. 

— deficient : Calcar. Carb. vegr. 

— increased: Agar. Calc. Con. Selen. 
Sep. Sil. 

HEAT : Aco. Alum. Ars. Asar. Bel- 
lad. Bry. Calc. Cantharis. Capsic. 
Carb. veg. Chin. Hep. Ignat. Kali. 
Merc. Natr. mur. Petr. Ph. ac. 
Puis. Sabin. Sep. Sil. 

ITCHING: Agar. Alum. Ambr. 



EARS. 



15 



Ant. cr. Arg. Bar. Bell. Calc. Garb. 

veg. Caust. Coloc. Con. Caps. 

Graph. Hep. Ign. Kali. Lycop. 

Mur. ac. Natruin miir. Nitr. ac. 

Nux vomica. Petr. Phosphor. 

Phosphor, ac. Plat. Pulsat. Bhod- 

od. Bhus. Sambuc. Selen. Sep. 

Sil. Spigel. Stann. Sulph. 
ITCHING of external ear: Arg. 

Spiff. 
— of lobule: Argent. Sabadilla. Ve- 

ratr. 
INFLAMMATION: Aeon. Bryon. 

Kali. Lye. Merc. N. vom. Pli. ac. 

Puis. SU. Spong. 
PABOTID GLANDS, pains on: 

Arg. Bry. Cham. Chin. Cocc. 

Hyose. Ign. Merc. Phosphor. Puis. 

Rhus. Sabacl. 
— pressure: Merc. 
— inflammation : Chamom. Rhus. 
— swelling: Bar. Bell. Bry. Carb. 

veg. Chamom. Chin. Cocc. Con.* 

Dulc. Hyosc. Ign. Merc. Nitr. ac. 

Phosph. Puis. Rhus. Sepiae. Sil. 

Snlph. 
— hardness: Bhus. 
— painfullness : Puis. 
— stitches: Bell. China. Con. Ign. 

Nitr. ac. Pulsat. Sep. Sulph. 
STITCHES: Alum. Ant cr. Arn. 

Ars. Bar. Bell. Bry. Calc. Cann. 

Canth. Capsic. Carbo. veg. Caust 

Chamom. China. Colch. Coloc. Con. 

Bros. Dulc. Ferr. Graph. Hell. 

Hep. Ign. Ipec. Kali. Lycopod. 

Merc. Nati*. mur. Nux vom. Petr. 

Platin. Plumb. Ph. ac. Puis. 

Bhodod. Sep. Sil. Spigel. Spong. 

Stann. Staph. Sulphur. Veratr. 

Zinc. 
SWELLING : Ant. crud. Calcarea. 

Caust. Kali. Lycop. Merc. Natr. 

mur. Nitr. ac. Ph. ac. Puis. Rhus. 

Sep. Silic. Spong. Zinc. 
TEABING: Aconit. Agar. Alum. 



Ambr. Anac. Arn. Aur. Bar. Bel- 
lad. Camph. Cantharis. Capsic. 

Cham. Chin. Carbo. veg. Caust. 

Con. Cupr. Dros. Dulcam. Graph. 

Hyosc. Kali. Lye. Merc. Mur. ac. 

Nitr. ac. N. vom. Plat. Plumb. Pit. 

ac. Pulsat. Stann. Spigelia. Sulph. 

Zinc. 
— behind the ears: Alumina. Ambr. 

Arg. Bar. Belladonna. Canth. Cops. 

Plumb. Bhus. Sep. Sil. 
TENESMUS : Ambr. Anacard. Arn. 

Ars. Asar. Bell. Carb. veg. Caustic. 

Coloc. Conium. Cliam. Cina. Colch. 

Croc. Dros. Dulc. Hell. Kali. Lye. 

Merc. Mur. ac. Nitr. ac. N. vom. 

Phosph. Plat. Puis. Rhodod. Bhus. 

Sabad. Sep. Spig". Spong. Stann. 

Sulph. Thuj. 

ULCEBS: Alum. Camph. Kali. 
Merc. Puis. Ruta. Spongia. Stann. 



Hearing. 

DEAFNESS: Ambr. Ant. crud. 

Arn. Plumb. Puis. Sec. corn. 

Veratr. 
FLUTTEBING: Bell. Cupr. Merc. 

Plat. Spig. 
GBOANING: Puis. Sabad. 
H^MOBBHAGE: Bell. 
HAMMERING: Spig. 
HABD HEABING: Ambr. Anac. 

Ant. crud. Am. Arsen. Asar. Aur. 

Bar. Bell. Bry. Calc. Caust. Cham- 
om. Chin. Cic. Coceul. Croc. Dulc. 

Bros. Graph. Hyosc. Ign. Iod. Kali. 

Lye. Merc. Natr. m. Nitr. ac. Petr. 

Phosph. Ph. ac. Puis. Ruta. Sabad. 

Sec. cor. Sep. Sil. Spig. Spong. 

Stram. Stann. Sulph. Veratr. 
— to human speech : Ars. Phosph. 
HUMMING: Aur. Bell. Bryon. 

Caust. Con. Laches. Lycop. Natr. 

mur. N. vom. Puis. Sabad. Sep. 

Spig. Sulph. 



16 



NOSE. 



Illusions of Hearing. 
ROARING: Aeon. Ambr. Ant. crud. 

Arn. Ars. Asar. Aur. Bell. Bryon. 

Calc. Cann. Carb. veg. Caust. Cic. 

Cocc. Colonic. Con. Graph. Ignat. 

Kali. Lye. Merc. Nitr. ac. N. vom. 

Op. Phosph. Ph. ac. Plat. Puis. 

Rhus. Sec. corn. Sep. Sil. Staph. 

Suiph. Thuj. Veratr. 
INTOLERANCE OF MUSIC : 

Aeon. Cham. Coif. Ign. Viol. od. 
REPORTS: Graph. Kali. Natr. c. 

Rhus. Sabad. Sil. Staph. Zinc. 
RINGING: Alum. Arsen. Calc. 

Clemat. Kali. Lycop. Phosph. 

Rhod. Sil. Sulph. Valer. Zinc. 
RUSHING: Aur. Bar. Bell. Cocc. 

Con. Cham. Dulc. Kali. Natr. mur. 

Nux vom. Puis. Rhodod. Stann. 
RINGING : Aeon. Agaric. Anac. Arn. 

Ars. Asa f. Aur. Bar. Bell. Bry. 

Calc. Camp. Cann. Canthar. Carb. 

veg. Caustic. Cham. Chin. Cic. 



Con. Dulc. Graph. Kali. Ignat. 

Lye. Mercur. Natr. mur. N. vom. 

Op. Petr. Plat. Ph. ac. Puis. Rhus. 

Sep. Silic. Stann. Staph. Sulph. 

Veratr. 
SENSITIVE HEARING, excessive: 

Anac. Bell. Carb. veg. Coff. Graph. 

Ign. Lye. Nux vom. Phos. Ph. ac. 

Sep. Sulph. 
SENSITIVENESS TO SOUND: 

Aco. Bell. Chin. Coff. Colch. Con. 

Ign. Iod. Merc. Natr. carb. Nitr. 

ac. N. vom. Ph. ac. Puis. Sil. Spig. 

Zinc. 
SENSITIVENESS TO MUSIC: 

Aeon. Cham. Coff. Ign. 
WHIZZING: Aeon. Agar. Alum. 

Anac. Arn. Ars. Asar. Aur. Bar. 

Bell. Bry. Calc. Canth. Carb. veg. 

Caust. Chamom. Chin. Cupr. Ferr. 

Hep. Kali. Lye. Merc. Natr. mur. 

Nux vom. Op. Petr. Phosph. Puis. 
4 Rhod. Ruta. Sec. corn. Sep. Spig. 

Sulph. Verat. Zinc. 



Y. NOSE. 



On the Nose. 

BLACK PORES : Nit. ac. Sulph. 
BLOOD BLOWN FROM THE 

NOSE : Agar. Alum. Ambr. Ars. 

Asar. Bar. Cauth. Caps. Caust. 

Dros. Graph. Hep. Kali. Lach. 

Lye. Natrum mur. Nux vom. 

Petr. Phosph. Phos. ac. Puis. Sep. 

Silic. Sulph. 
BOILS : Alum. Carb. an. Arnica. 
BONE-PAIN: Aur. Hyosc. Lach. 

Merc. 
CANCER: Aur. Calcar. Sep. Sulph. 
COLDNESS: Arn. Bellad. China. 

Dros. Ign. N. vom. Plumb. Veratr. 
DISCHARGE OF PUS : Aur. Cina. 

Lach. Phosph. ac. Puis. 



DULL : Anac. Calc. Caps. Carb. an. 

Ipec. Kali. Nux vom. Puis. Rhodod. 
HAEMORRHAGE : Acou. Cann. 

Conium. Croc. Led. Rhus. Sabin. 
INFLAMMATION: Agar. Arnica. 

Ars. Aur. Bellad. Cann. Canth. 

Lach. Merc. Natr. mui\ Plumb. 

Rhus. Sulph. 
ITCHING: Agar. Alumina. Arn. 

Bell. Bov. Calc. Carbo veg. Caust. 

Cannab. Caps. Coloc. Con. Chel. 

Chin. Cina. Kali. Lye. Hell. Ign. 

Laches. Merc. Mur. ac. Nux vom. 

Platina. Plumb. Phosph. Phosphor. 

ac. Santon. Sambuc. Selen. Seneg. 

Sep. Silic. Spig. Staph. Zinc. 
NOSE BLEED: Aconit. Agaric. 



FACE, 



17 



Aluni. Ambr. Ant. crml. Arg. Arn. 

Ars. Bar. Bell. Bry. Calc. Cann. 

Canth. Caps. Carb. veg. Causti- 

cum. Cham. Chin. Cina. Coff. 

Colch. Con. Croc. Cupr. Dig. Dros. 

Dulcamara. Ferr. Graphlt. Hep. 

Hyosc. Ipec. Kali. Lack. Lycop. 

Merc. Mosch. Natr. mur. Nitr, ac. 

N. Yom. Petr. Phos. Ph. ac. Pulsat. 

Rhod. Rhus. Ruta. Sabad. Sabin. 

Sambuc. Sassap. Secale corn. 

Seneg. Sep. Silicea. Spong. Stan- 

num. Sulphur. Tliuj. Veratr. 
POLYPI: Teucr. mar. 
SCURFS IN NOSE : Alumina. Ant. 

cruel. Am. Aur. Bry. Cantli. Cham. 

Cic. Cocc. Hepar. Hyosc. Ignat. 

Kali. Lachesis. Merc. Nux Yom. 

Ph. acid. Puis. Selen. Sil. Spigelia. 

Staph. Thuj. 
— under the nose : Bar. Kali. 

Smell. 

SMELL, of blood: Sil. 

— sensitive : Aeon. Aur. Bar. Bell. 

Cham. Chin. Cocc. Colch. Graph. 

Kali. Lijcop. A r . vom. Phosph. 

Plumb. 
— putrid: Aur. Beliad. Calc. Merc. 

Sulph. 



— fine, extremely : Aeon. Agar. Aur. 

Bell. Chin. Cocculus. Coff. Con. 

ST. vom. 
— of lime: Sulpk. 
— of foul cheese : N. vom. 
— deficient : Anac. Bell. Hep. Hyosc. 

Nat. mur. Op. Plumb. Pulsat. 

Ruta, Sec. corn. Sep. Sil. Zinc. 
— catarrhal: Graph. Merc. Puis. 

Sulph. 
— fetid: Belladonna. Phosph. Sep. 
SWELLING: Arn. Ars. Aur. Bell. 

Bry. Calc. Cann. Canth. Caust. 

Chain. Chel. Cocc. Lye. Merc. Natr. 

mur. Nitr. ac. Phosphor. Ph. acid. 

Puis. Rhus. Sep. Spigelia. Stann. 

Stram. Zinc. 
SWELLING OF BONES : Aur. 
TETTER : Rhus. Spig. 
TWITCHING: Agar. Arnica. Aur. 

Caps. Con. Hyoscyam. Plat. Puis. 
ULCERATED NOSTRILS: Anac. 

Ant. crud. Arn. Aur. Bell. Bry on. 

Calc. Cham. Cocc. Graph. Hep. 

Hyosc. Ign. Lach. Lye. Merc. Natr. 

mur. Nitric acid. N. vom. Phosph. 

Phosph. ac. Puis. Sep. Spig. Stann. 

Staph. Zinc. 
— exter. nose : Puis. 
WARTS: Caust. 



YL FACE. 



Color and External Ap- 
pearance. 

ACNE ROSACEA (red pimples): 

Arsenic. Cann. C. an. Veratr. 
— blue: Aco. Ars. Asar. Bryon. 

Camph. Cham. Cic. Cina. Con. 

Cupr. Dros. Hyosc. Ig-n. Ipecac. 

Mercurius. Op. Samb. Spongia. 

Stramon. Teratr. 
— margins around eyes : Anac. Arsen. 



Calcar. Cham. China. Cina. Cocc, 

Cupr. Graph. Hep. Ignat. Ipecac. 

Kali. Lach. Lycop. Merc. Phosph. 

Phosph. acid. Rhus. Sabad. Sabin. 

Sec. corn. Staph. Stram. Sulphur. 

Veratr. 
— brown, changing to : Bry on. Hyosc. 

Iod. Op. Sec. corn. Stram. 
— bloated: Aco. Arnic. Aur. Bar. 

Bell. Bry. Cham. China. Cina. 

Cocc. Cupr. Dig. Dros. Dulcamara. 



18 



FACE. 



Ferr. Hyosc. Ipec. Kali. Led. Lye. 

Merc. Natr. c. Nux voni. Op. 

Phosph. Plumbum. Bhus. Sep. 

Spig. Spongia. Staph. Stram. 
COMPLEXION, changing: Aco. 

Bell. Bov. Capsic. Cham. Chin. 

Cilia. Crocus. Hyosc. Ign. Led. 

Opium. Natr. c. Phosph. Ph. ac. 

Veratr. Zinc. 
— jaundiced : Aeon. Ainbra. Ant. crud. 

Arn. Ars. Bry. Calc. Causticum. 

Canth. Cham. Chel. Chin. Cina. 

Con. Croc. Ferr. Graph. Hell. Hep. 

Ign, Jod. Kali. Lye. Merc. Natrum. 

mur. Nitr. ac. N. Yom. Op. Petr. 

Plumb. Puis. Bhus. Secale corn. 

Sep. Spigelia. Veratr. 
r— shining: Aurum. Plumbum. Bhus. 

Selen. 
— sallow: Bry on. Carb. veg. Ferr. 

Merc. Phosphor. Sec. corn, 
—sickly: Anac. Bry on. Calc. Canth. 

Caust. Chin. Cina. Colch. Cupr. 

Kali. N. vom. Plumb. Phosph. Ph. 

ac. Puis. Bhus. Sec. corn. Silicea. 

Spigel. Stann. Staph. Sulph. Ve- 
ratr. Zinc, 
wed : Aeon. Arg. Arnica. Ars. Bar. 

Bell. Bryon. Calcar. Camph. Cann. 

Canth. Capsic. Caustic. Cham. 

China. Cic. Cina. Cocc. Coff. Croc. 

Cupr. Drosera. Euphr. Dig. Bulc. 

Ferr. Hyosc. Hep. Ign. Ipec. Laur. 

Lye. Merc. Mur. ac. Natr. c. N. 

vom. Op. Petr. Phosph. Plat. 

Plumb. Puis. Bhus. Buta. Sabad. 

Sabina. Sep. Sil. Secale cornut. 

Spigel. Spong*. Stannum. Stramon. 

Sulphur. Thuj. Veratr. Zinc. 

red and bluish: Aco. Bell. Bry. 

Hep* Merc. Opium. Phosphor. 
— red, burning cheeks: Aeon. Arn. 

Bellad. Bry. Cannab. Caps. C. an. 

Cham. China. Cina. Cocc. Coffea. 

Bulc. Hell. Ign. Kali. Lijcop. Merc. 

N. yom. Op. Plat. Sabad. ScmK 

Stann. Stram. Valer. 



— red on one side: Aeon. Am. Cann. 

Canth. Cham. Chin. Ig'n. Ipec. N. 

vom. Pulsat. Bheum. 
— red, erysipelatous : Bellad. (Cal- 
car.) Camphor. Cham. Lach. Khus. 

Buta. Stram. 
— sallow: Arsen. Bry. Canth. Chin. 

Cic. Euph. Ferr. Hyosc. Ignat. 

Ipec. Merc. Natr. mur. Nux vom. 

Op. Plumb. Phosph. Sec. corn. Sil. 
EYES, sunken: Ambr. Arsen. Cal- 
car. Camph. China. Cic. Cupr. 

Coloc. Dros. Ferr. Hyosc. Jod. Lye. 

Nitr. ac. Op. Phosphor. Ph. acid. 

Sec. corn. Spong ia. Stannum. 

Staphys. Sulph. Verat. 
FEATUBES, altered: Ars. Bellad. 

Camph. Canth. Chamom. Colch. 

Bhus. Spig. Veratruin. 
EBECKLES: Calc. Kali. Lye. 

Natr. c. Phosph. 
PALE: Aconitum. Ambr. Anac. 

Arn. Ars. Bell. Bry. Calc. Camph. 

Cann. Canth. Caps. Carb. veg. 

Cham. China. Cic. Cina. Coloc. Con. 

Cocc. Cupr. Dig. Euphorb. Euphr. 

Ferrum. Graphit. Helleb. Hyosc. 

Ign. Jod. Ipec. Kali. Laches. Led. 

Lye. Merc. Nux vom. Op. Plum- 
bum. Petr. Phos. Ph. ac. Puis. 

Rhus. Sabin. Sec. com. &ep. Sil- 
icea. Spigelia. Spong. Stann. Stram. 

Sulph. Teucr. mar. Veratr. Zinc. 
SPOTS, yellow: Calc. Hell. Lye. 

Natr. c. Phosph. Sepia. 
— red: Alumina. Ambr. Bellad. 

Canth. Croc. Lye. Merc. Nux vom. 

Op. Phosph. Sabadilla. t3amb. Sil. 

Sulph. Zinc. 
— white : Ars. Merc. Natr. c. 
SWELLING: Alum. Ars. Bell. Bry. 

Calc. Canth. Carb. veg. Chamom. 

Bulc. Graph. Hell. Hyosc. Kali. 

Lycop. Natr. mur. Nitr. ac. Op. 

Petr. Phosph. Bhus. Samb. Sep. 

Stram. 



FACE. 



19 



Sensations. 
In the face generally. 

BLOTCHES: Antiin. crad. Canth. 

Cic. Hell. Lach. Led. N. vom. Op. 

Puis. Yiol. tr. 
BOILS: Alum. Am. Bell. Bry. 

Cliin. Laur. Led. 
BONES, inflamiiiation of : Staph. 
— swelling of : Sil. Spig. 
— pains of : Asa f . Caps. Chel. 
COLDNESS : Asar. Camphor. Canth. 

Cham. Cina. Dros. Hyosc. Ign. 

Ipecac. Khus. Teratr. 
CONVULSIONS: Bell. Calcarea. 

Camphora. Canth. Chain. Cupr. 

Dig. Ipec. Phosphor. Rheum. 

Strain. Sulph. 
CRAMPY FEELING : Bellad. Cina. 

Cocc. Dig. Dulc. Hyosc. Kah. 

Nitric acid. Platina. Rhus. 

Spongla. Stannum. Thuj. Va- 
leriana. 
CRUSTA LACTEA: Ambr. Arsen. 

Bar. Bellad. Bry. Hep. Ledum. 

Mercur. Rhus. Sassap. Staple. 

Viol. tr. 
ERUPTION : Alum. Anac. Ars. Aur. 

Bar. Calcar. Carb. veg. Caust. 

Cltamom. Cic. Colch. Coloc. Con- 

ium. Dulc. Graph. Kali. Lachesis. 

Led. Lye. Merc. Natr. mur. Petr. 

Plumb. Ph. ac. Rhus. Sep. Silic. 

Stann. Staph. Yeratr. Viola, tr. 
— on the lips: Aco. Ant. cr. Arn. 

Bar. Bell. Bov. Bry. Ca?m. Canth. 

Caps. Caustic. Chin. Coloc. Con. 

Dulc. Hep. Hyosc. Ignat. Ipec. 

Kali. Led. Mur. acid. Nux vom. 

Rhus. Samb. Scill. Spigelia. Spong. 

Staphys. Sulphur. Veratram. Zinc. 
— around the mouth : Ant. crud. Bar. 

Bov. Calc. Carbo veget. Cocc. 

Gra2)h. Petr. Phosphor. Ph. ac. 

Rhod. Rhus. Sep. Sil. Staph. 

Yeratr. Zinc. 



— around the ears: Ant. crud. Mur. 

ac. Petrol. Phosphor. Sulph. 
— on the forehead : Agar. Ambr. Ant. 

crud. Arn. Baryta. Bov. Calc. 

Canthar. Carbo veget. Chamom. 

Clem. Coccul. Euphorb. Hell. Hep. 

Led. Mur. ac. Natrum mur. Rheum. 

Rhod. Rhus. Sep. Sil. Staph. 

Sulph. 
ERYSIPELAS : Rhus. Bell. 
PEELING OF COLDNESS : Arn. 

Bar. Merc. Mosch. Phosph. Flat. 

Rhod. Ran. seel. 
FLASHES OF HEAT: Ambr. 

Arnica. Asa feet. C. an. Cocc. 

Graph. Lye. Nitr. acid. Petr. 

Sulph. Teucr. mar. Thuj. Valer. 
HEAT : Aeon. Agar. Alumina. Ambr. 

Anac. Arn. Ars. Asaf. Asar. Bar 

Bellad. Bov. Bry. Calc. Camph. 

Cann. Canthar. Caps. Carbo veget. 

Caust. Cham. Chin. Cina. Cocc* 

Coffea. Coloc. Con. Croc. Cupr. 

Digital. Drosera. Dulcam. Euphr. 

Ferr. Graphit. Hell. FLepar. Hyosc. 

Ign. Ipec. Kali. Led. Lye. Merc. 

Mur. ac. Natrum mur. Nitr. ac. 

Nux vom. Op. Petr. Platina. Plumb. 

Phos. Ph. ac. Puis. Rheum. Rhod. 

Rhus. Ruta. Sabad. Sabina. Samb 

Sassap. Senega. Sep. Scill. Sil. 

Spig. Spong". Stann. Staph. Stram- 

on. Tar. Thuj. Veratr. Viol. tr. 
HERPES: Bar. Bov. Calc. Carbo 

veg. Caustic. Chel. Graph. Led. 

Natr. c. Nitr. ac. Pet. Phosph. 

Rhus. Sabad. Sep. Sil. 
— on the cheek : Ambra. Anac. Bar. 

Bov. Bryon. Caustic. Merc. 
— on the chin : Bov. Chel. N. vom. 
— on the lips (cold blisters) : Rhus. 
— on the temples : Alum. 
ITCHING: Agar. Alumin. Ambr. 

Arg. Arnic. Asa f. Aur. Bry. Bov. 

Calc. Caps. Carbo veg. Caustic. 

Clem. Coloc. Con. Dulc. Graph. 



20 



PACE. 



Kali. Lach. Lye. N. vom. Opium. 

Petr. Phosph. Ph. ac. Plat. Plumb. 

Rhus. Euta. Sabadilla. Sabin. Sas- 
sap. Sep. Sil. Sulph. Veratrum. 

Zinc. 
MUSCLES, twitching of: Bell. 
PEOSOPALGIA: Aconit. Alumina. 

Asa f. Aur. Bar. Bell. Bry. Calc. 

Caps. Chin. Cina. Colch. Coloe. 

Con. Daph. Graph. Kali. Lye. Mur. 

ac. Nitr. ac. Nux vomica. Phosph. 

Sep. Spigelia. Stann. Staph. Valer. 

Veratr. Verb. 

PULSATIONS : Agar. Cann. Cham. 
Clem. Croc. Hell. 

TEARING: Agar. Alum. Ambr. 

Arg. Aur. Bell. Bry. Calc. Carb. 

veg. Chel. Cina. Colch. Con. Daph. 

Dig. Dulcam. Euphorbium. Graph. 

Kali. Led. Lye. Merc. Mur. ac. 

JSfatr. c. Nitr. ac. Phosph. Plumb. 

Rhus. Sassap. Senega. Sejyise.Stilig. 

Spigelia. Spong. Staph. Sulphur. 

Thuj. Teucrium mar. Zinc. 
PIMPLES : Agar. Ambra. Ang. Ant. 

crud. Arsen. Bar. Bellad. Bov. 

Calc. Caps. Carbo veg. Caust. Cocc. 

Con. Drosera. Graph. Kali. Lye. 

Natruin mur. Nux vom. Nitr. ac. 

Petr. Phos. Ph. ac. Ehus. Sassap. 

Sep. Sil. Sulph. Stann. Staph. Ve- 
ratr. Zinc. 
— around the eyes: Calc. Hep. Ign. 

Mere. Petr. Sil. Staph. Sulph. 
— on the cheeks : Ant. crudum. Arn. 

Calc. Canth. Carbo veg. Caust. 

Cham. Cina. Dulcam. Hyosc. Nux 

vom. Phosphor. Sassap. Sabina. 

Sep. Staph. Valer. Veratr. 
— on the chin: Ambr. Antimon. 

crudum. Bellad. Calc. Canth. Caust. 

Cic. Clem. Con. Dros. Dulc. Hep. 

Hyosc. Lye. Nitr. ac. Nux vom. 

Rhus. Sabina. Sil. Spigelia. Spong. 

Sulphur. Thuj. Veratr. 
SENSATION OF HEAT: Arn. 



Asa f. Bar. Bell. Bry. Camph. Croc. 

Dros. Euphr. Ipec. Merc. Nux 

vom. Petr. Platina. Bheum. Ehus. 

Euta. Sabadilla. Spong. Stramom. 

Thuj. 
SPASMS: Ambr. Carbo vegetab. 

Camph. Cann. Cham. Cocc. Cupr. 

Dig. Hep. Op. Sepise. Stram. 
STITCHES : Agar. Arg. Asa f. Asar. 

Aur. Bar. Bry. Calad. Canth. 

China. Cocc. Con. Dig. Graph. Ign. 

Kali. Lye. Merc. Natr. mur. Nitr. 

ac. Petr. Phosph. Plat. Plumbum. 

Rhod. Rhus. Sabad. Sabin. Sep. 

Sil. Spigelia. Spongia. Staph. 

Stann. Sulph. Thuj. Veratr. Verb. 
SWEAT: Aeon. Ambra. Arg. Arn. 

Ars. Asa f . Bell. Bry. Calc. Camph. 

Cann. Capsic. Carb. veg. Cham. 

China. Cina. Coccul. Coif. Con. 

Croc. Cupr. Dulc. Drosera. Hell. 

Hep. Hyosc. Ignatia. Ipic. Laur. 

Led. Lycop. Merc. Natr. mur. N. 

vom. Op. Petrol. Plat. Pulsat. 

Rheum. Rhus. Sambucus. Sassap. 

Sep. Spong. Staph. Stram. Stann. 

Sulphur. Thuj. Valer. Veratr. 
— cold, on the forehead: Bry. Cin. 

Cupr. Ipec. Eheum. Veratr. 
TENSION: ' Aconit. Alum. Arn. 

Asa f. Aur. Bar. Bry. Calc. Canth- 

aris. Chel. Colch. Con. Euphorb. 

Laurocer. Led. Lye. N. vom. Petr. 

Platina. Phosph. Ph. ac. Pulsatilla. 

Eheum. Rhus. Sabad. Samb. Sep. 

Spong. Veratr. Verb. Viol. od. 
THROBBING: Arn. Bellad. Calc. 

Sabad. Staph. 
TITILLATION : Bell. Cann. Coloc. 

Laur. Phosph. 
ULCEES : Ars. Bry. Merc. 
VESICLES: Alum. Ant. cr. Bar. 

Cantharis. C. an. Caust. Euphorb. 

Graph. Nitric acid. Petr. Plumb. 

Phosph. Rhus. Sepias. Silicea. 

Sulph. Valer. Zinc. 



FACE. 



21 



WARMTH, feeling of: Asa feet. 
Asar. Conn. Cantharid. Chin. 
Cocc. Coff. Croc. Laur. Phos. ac. 
Pills. Sarnb. Sencg. Yaler. 

On the lips. 

fu. signifies upper lip ; 1. lower lip, and c. cor- 
ner of tb.e mouth.) 

BLACK : Aconit. Bryon. Chin. Mer- 

cur. Phosph. acid. Yeratr. 
BLUE : Agar. Ars. Canst. Cina. Con. 

Cupr. Big. Op. Phosph. Stramon. 

Yeratr. 
BLISTEES, bloody: Natr* mur. 

Bry. Ign. Ph. ac. Plat. 
— u. : Kali. Rhus. 
— 1. : Ars. Bry. Rhus. 
BURNING: Agar. Anac. Arnica. 

Ars. Bry. Gaps. C. an. Chin. Hyosc. 

Kali. 3Ierc. Muriatic ac. N. vom. 

Phosph. Ehod. Bhus. Sabad. 

Snlph. Thuj. 
— u. : Ant. crnd. Bar. Caustic. Daph. 

Graph. Merc. Natr. c. Bhus. Sa- 
bad. Sep. Spigel. Staph. Yeratr. 
—1. : Asa f. Bar. Bellad. Boy. Bry. 

Clem. Daph. Graphit. Kali. Phosph. 

Phosphor, acid. Sabad. 
— c. : Arn. Coloc. Daph. Dros. Natr. c. 

Zinc. 
CANCER : Ars. (Bryon.) Clem. Con. 

Sil. 
CHAPPING : Alum. Am. Bry. Calc. 

Caps. Carbo veg. Cham. Chin. 

Colch. Croc. Ign. Nux vom. Phos. 

Pulsatilla. Staph. Yeratr. Zinc. 
— u. : Caust. >"atr. mur. Sab. Selen. 
— 1. : Cham. Chin. Daph. Dros. 

Graph. Natr. mur. Nux vom. 

Phosph. Ph. ac. Puis. 
CONTRACTION: Calc. Sec. corn. 
DEADNESS, u. : Calc. 
DISTORTION: Bellad. Graphit. 

Nux vom. Sec. corn. 
DRY : Aco. Agar. Alum. Ambr. Anac. 

Arn. Ars. Bar. Bell. Bry. Calad. 

Cann. Canth. C. an. Cham. China. 



Con. Croc. Cycl. Dros. Graphites. 

Hyosc. Ign. Merc. Mur. ac. Nux 

vom. Phosph. Plat. Puis. Bhodod. 

Bhus. Strain. Thuj. Yeratr. Zinc. 
— u. : Amm. Plat. Sulph. 
— 1. : Daph. Merc. Sabin. 
ERUPTION, vesicular: Alumina. 

Canth. Laur. Natrum mur. Rhus. 
— u. : Amm. mur. Ars. Carbo veg. 

Cic. Con. Graph. Hell. Laur. Mur. 

ac. Plat. Seneg. Sil. Stront. Yaler. 
— 1. : Aur. Bell. Bry. Carbo veg. 

Clem. Kali. Laur. Mur. ac. Natr. 

mur. Phos. Plat. Rhodod. Sassap. 

Sepia. Staph. Sulph. 
— c : Caust. Daph. Laurocer. Seneg. 
GLANDS, indurated: Con. Sulph. 

Zinc. 
— ulcerated: Ign. 
HEAT: Ambr. Arn. BeU. Canth. 

Carbo an. Daph. Hep. Sevj. 
HERPES : Anac. Ars. Rhus. Sep. 
— u. : Phosph. Sep. 
— 1.: Sep. 

— c. : Carbo veg. Phosph. Sep. 
PALE : Ferr. Kali. Lye. Yaler. 
PEELING OFE : Alum. BeU. Canth. 

Caps. Cham. Con. Daphne. Nux 

vom. Platina. Plumb. Puis. 
— u. : Sulph. 

— 1. : Daph. Kali. Natrum mur. 
PIMPLES: Cann. Caps. China. 

Dulc. Hyosc. Ipec. Kali. Mur. ac. 

Nux vom. Rhus. Spong. 
— u. : Aco. Ant. crud. Am. Bell. Calc. 

Carbo veg. Capsicum. Caust. Dig. 

Kali. Led. Lycop. Nux vom. Rhus. 

Sassap. Sep. Scill. Silicea. Staphys. 

Thuj. Zinc. 
— 1. : Bell. Bry. Calc. Capsic. Caust. 

Ign. Merc. Mur. acid. Natrum c. 

Bhu* Samb. Sil. Spig. 
— c. : Antim. crud. Bar. Bellad. Calc. 

Cann. Canth. Caustic. Coloc. 

Phosph. Rhod. Rhus. Yeratr. 
PRESSURE, u. : Sulph. ac. 
—1. : Yaler. 



22 



FACE. 



BHAGADES: Arn. Bryonia. Cann. 

Caps. Croc. Ign. Plat. Puis. 
— u. : Agar. Kali. Natr. nmr. Ph. ac- 

Sabad. 
— 1. : Bry. Cham. Nux vomica. Puis. 

Plat. Sulph. 
— c. : Ant. crud. Merc. 
ROUGH: Anac. Calc. Mur. acid. 

Plat. 
— u. : Calc. Sulph. 
— 1. : Merc. Natr. mur. 
SCURFS: Ars. Bar. Bryon. Cann. 

Cham. Ign. Mur. ac. N. vom. Staph. 

Sulph. 
— u. : Ars. Cic. Kali. Mercur. Petr. 

Sil. Staph. Sulph. 
— 1. : Alum. Calc. Natrum mur. Ph. 

ac. Sulph. 
— c. : Calc. Graph. Ign. Sil. 
SPASM: Ambr. Bellad. Caust. Kali. 

Merc. Plat. 
SWELLING : Arn. Alum. Aur. Bell. 

Bry. Carbo veg. Caps. Chin. Dig. 

Natr. mur. Opium. Rhus. Stram. 
— u. : Argent. Bar. Bell. Bov. Canth. 

Carbo veg. Con. Daph. Graph. Hep. 

Kali. Lye. Merc. Natr. mur. Nitr. 

ac. Petr. Phosph. Bhus. Staphys. 

Sil. Sulph. Thuj. Zinc. 
— 1. : Alum. Asa f . Calc. Caust. Daph. 

Lye. Mur. ac. Natrum mur. Puis. 

Sep. Sil. 
TREMBLING: Stram. Sulph. 
• -1. : Arn. Con. 

TWITCHING : Arsenic. Cham. Dulc. 
— u. : Carbo veg. Natr. c. Plat. Sabad. 

Thuj. Zinc. 
— 1.: Bry. 
TUBERCLES: Bell. Caust. Con. 

Sep. Sil. Sulph. 
— u. : Arsenicum. Bar. Graphit. 

Magnes. c. 
— 1. : Ign. Sep. 
— c. : Bry. Stront. 
ULCERATION, c. : Calc. 
ULCERS: Ars. BeUad. Capsic. 

Cham. Chin. Cic. Con. Dulc. Graph. 



Natr. mur. Nitr. ac. N. vom. Staph. 

Sulph. 
— u. : Caps. Caust. Daph. Kali. Merc. 

Staph. 
— 1. : Bry. Caps. Ign. Lye. Merc. 

Nux vom. Fhosphor. Phos. ac. 

Buls. Sep. Sil. Staph. Zinc. 
— c. : Arn. Bell. Graph. Hep. Ign. 

Merc. Nux vom. Natr. mur. Phosph. 

Sil. Zinc. 
Lower jaw and articulation of the 
jaw. 

BONE, swelling of: SO. 
CONTRACTION : Nux vom. Puis. 

Stann. 
CRAMP : Alum. Asa feet. Asar. Bell. 

Chamom. Cocc. Colch. Ignat. Kali. 

Merc. Mur. ac. N. vom. Flat. Rhus. 

Spig. Spong. Stann. Sulph. 
— in the joint: Aeon. Arnica. Bell. 

Bry. Calc. Camph. Canthar. Cic. 

Colchic. Con. Hyosc. Ign. Laur. 

Merc. N. vom. Op. Phosph. Plat. 

Plumb. Rhus. Sec. corn. Spig. 

Stram. Sulph. Verat. 
CRACKING: Nitr. acid. Rhus. Sa- 
bad. 
DEPRESSION: Op. 
DISLOCATION: Ign. Petr. Ph. ac. 

Bhus. Staph. 
PAIN, arthritic : Caust. 
— crampy : Digit. Plat. Sassap. Spong. 

Stann. 
PRESSURE: Ambr. Arn. Asar. 

Aur. Bry. Chin. Cofif. Cupr. Bros. 

Ign. Led. Phosph. Sabin. Sassap. 

Spig. Veratr. 
RIGIDITY: Bellad. Caust. Cocc. 

Euphr. Graph. Hyosc. Merc. Nux 

vom. Petr. Sassap. Sep. Thuj. 
SWELLING : Aeon. Arn. Ars. Staph. 

Veratr. 
TEARING : Agar. Anac. Arn. Aur. 

Bar. Bell. Bov. Bry. Canth. Carb. 

anim. Chin. Cocc. Coff. Colch. 

Droser. Graph. Laur. Mercur. Nux 



TEETH AND GUMS. 



23 



vom. Phosphor. Plumb. Puis. Sas- 

sap. Spig. Staim. Sulph. 
TWITCHING: Am. Bell. Bryon. 

Canth. Chin. Cina, Con. Ign. Khus. 

Sabin. Yaler. 

Chin. 
BUBNING: Anao. Ant. crud. Bov. 

Canth. Caust. Rhus. Spong. 
COLDNESS : Yeratr. 
CRAMP : Bell. 
DRAWING: Caust. Cupr. 
HEBPES: Boy. Chelid. Natr. mur. 

Nux vom. Sil. 
ITCHING: Alum. Con. Dig. Kali. 

Lye. Natr. mur. Op. Phosph. Plat. 



Puis. Sassap. Scill. Spig. Stront. 

Sulph. Zinc. 
NUMB PEELING: Asa f. Plat. 
PIMPLES: Ambr. Anac. Ant. cr. 

Bell. Calc. Canth. Caust. Cic. Clem. 

Con. Dros. Dulc. Graph. Hyosc. 

Lye. Merc. N. vom. Nitr. ac. Khus. 

Sabin. Sassap. Sil. Spig. Spong. 

Sulph. Thuj. Yeratr. Zinc. 
PUSTULES : Merc. Oleand. Sabin. 

Zinc. 
SWELLING : Carb. veg. 
TEAEING ; Aur. Caust. Plat. 
ULCEES : Hep. 
VESICLES: Hep. 



VI. TEETH AND GUMS. 



Teeth. 

BLACK : Ignat. Merc. Plumb. Sep. 

Staph. 
BLEEDING: Ambr. Bar. Graph. 

Phosph. Ph. ac. Sulph. Zine. 
BEITTLE: Lach. Plumb. Sabad. 

Staph. 
DECAY: Amm. Carb. an. Sil. 
DULL : Agar. Caps. Nitr. acid. Puis. 

Spong. Staph. 
FALLING OUT: Ars. Bry. Merc. 

N. vom. Plumb. Sec. corn. 
FETID: Calc. Carb. veg. Daph. 

Graph. Kali. 
GEITTING: Aeon. Ant. crud. Ars. 

Bar. Bellad. Canth. Caust. Chamom. 

Cic. Coff. Con. Hyosc. Ign. Merc. 

Plumb. Sec. corn. Sep. Stram. 

Yeratr. 
HOLLOW: Asar. Calcar. Daph. 

Hyosc. Plumb. Phosph. Sabad. 

Selen. Sep. Sil. Staph. 
LOOSE: Aeon. Arn. Bry. Camph. 

Cham. Chin. Cocc. Hyoscyam. N. 

vom. Op. Puis. Bheum. Rhus. 



Staph. Yeratr. 
MUCUS ON TEETH: Alum. Arn. 

Bov. Bry. Cham. Daph. Iod. Plumb. 

Selen. 
SMOOTH: Phosph. Selen. 
TEETHING: Aeon. Arn. Bryon. 

Chamom. Cic. Cina. Coff. Cupr, 

Hyosc. Ign. Ipec. N. vom. Op. Puis. 

Rhus. Stram. 
TOOTHACHE, see Index. 
YELLOW: Iod. Lye. Nitr. ac. 

Gums. 
BLUE: Sabad. 
BLEEDING: Agar. Alum. Ambr. 

Ang. Bar. Bellad. Bov. Calc. Carb. 

veget. Caustic. Con. Euphr. Graph. 

Iod. Kali. Lycop. Merc. Natr. mur. 

Nitr. ac. N. vom. Phosph. Ph. ac. 

Euta. Sep. Staph. Sulph. Zinc. 
BUENING: Bell. Chamom. Merc 

Mur. ac. N. vom. Petr. Puis. Ehue. 

Sep. 
COEEODED : Merc. Staph. 
FISTULA : Calc. Canth. Canst. Natr, 

mur. Petr. Puis. Sil. 



24 



MOUTH. 



GROWTHS: Staph. 

HEAT: Bell. Lye. 

INDENTED : Merc. 

INFLAMED : Bov. Iod. Natr. mur. 

N. vom. Petr. Phosph. Sil. 
PALE: Carb. an. Merc. Nitr. acid. 

Plumb. Sabin. Staph. 
PUTRID: Ambr. Nux. vom. Staph. 
EECEDING : Bov. Carb. veg. Graph. 

Merc. Natr. carb. Phosph. Ph. ac. 

Rhus. Sep. Staph. 
REDNESS: Carbo an. Iodine. Merc. 

Nitr. Sep. 
SENSITIVE: Amm. Ang. Arsen. 

Carbo veg. Caust. Natr. mur. 

Phosph. Puis. 
SPONGY: Ang. Bry. Graph. Merc. 

N. vom. Staph. 
SCURVY: Cic. N. vom. Staphys. 

(See Index.) 



SUPPURATION: Canth. Caust. 

Lach. Merc. Petr. 
SWOLLEN: Alum. Ambr. Ang. 

Bar. Bellad. Bism. Bov. Calc. Carbo 

an. Carbo veg. Caps. Caust. Cham. 

Chin. Cocc. Graphites. Hep. Hyosc. 

Joel. Kalic. Lach. Lye. Merc. Mur. 

ac. Natr. mur. N. vom. Nitr. ac. 

Petr. Phosph. Plumb. Puis. Sabin. 

Sep. Sil. Spig. Spong. Staph. Sulph. 
TUBERCLES: Caust. Phosph. ac. 

Plumb. Staph. 
ULCERATED : Alum. Aurum. Bov. 

Calcar. Kali. Kali bichr. Lye. Merc. 

Millef. N. vom. Phosph. Sabin. 

Stann. Staph. Zinc. 
VESICLES: Bellad. Calc. Canth. 

Daph. Nux vom. Petr. Sep. Staph. 
WHITE : Merc. Staph. 



VIII. MOUTH. 



Buccal Cavity. 

APHTHAE : Bry. Caust. Cham. Chin. 

Ipec. Merc. Nitr. ac. Nux vom. 

Sulphur. Sulph. ac. 
BLISTERS: Ambr. Anac. Canth. 

Calc. Caps. Jod. Merc. Nitr. acid. 

Phosph. Spong. Staph. Thuj. 
BLUE : Cic. Merc. 
BLEEDING : Bell. Canth. Mancin- 

nella. Millefol. 
BURNING: Asa f. Asar. Bellad. 

Bov. Carbo veget. Cantharis. 

Cham. Cupr. Merc. Petr. Phos. 

Plumb. Spong. Sulph. Veratr. 
BREATH, sour : Nux vom. 
— bad. Aeon. Ambr. Arn. Agar. Aur. 

Bar. Bell. Bry. Camph. Canth. 

Capsic. Calc. Carbo anim. Carbo 

veget. Cham. Chin. Croc. Digital. 

Perr. Graphit. Kali. c. Hyosc. Ign. 



Ipec. Merc. N. vom. Petr. Plumb. 

Puis. Sepiso. Spig el. Stram. Sulph- 
ur. Zinc. 
DRYNESS : Aco. Ambr. Amm. Ars. 

Aur. Antim. crud. Am. Asa f. 

Asar. Bar. Bell. Bry. Calc. Carbo 

veg. Cann. Canth. Capsic. Cham. 

China. Cina. Cocc. CorTea. Colch. 

Croc. Fen*. Hyosc. Ign. Ipec. 

Kali c. Kali bichr. Lye. Mur. ac. 

Merc. Natrum c. Nitr. Nitr. ac. 

N. vomica. Petr. Phosph. Phosph. 

ac. Ehod. Plumb. Puis. Sabad. 

Sassap. Seneg. Sep. Sil. Spig. 

\ Stram. Sulph. Thuj. Veratr. Zinc. 

FOULNESS: Arn. Ars. Aur. BeU. 

Bov. Bryon. Capsic. Carb. veg. 

Cham. Chin. Crotal. Graph. Hyosc. 

Iod. Merc. N. vom. Nitr. ac. Puis. 

Ruta. Sabin. Spigelia. Staph. 
GROWTHS: Staph. 



MOUTH. 



25 



HEAT: Amm. Cale. Cam.ph.oia. 

Carbo veg. Chain. Mercur. Natr. c. 

Phosph. Plumb. Sil. Sulph. 
INFLAMED : Aeon. Bismuthum. 

Brom. Calad. Canth. Colch. Ign. 

N. vom. Yeratr. 
KOUGH : Carbo veg. Caustic. Cina. 

Cocc. Dig. Ix^ec. Millefol. Ph. ac. 
SKIN DETACHED : Merc. 
SWELLING : Amm. Causticmn. 

Cautli. Merc, Sep. Zinc. 
TRISMUS: Calc. Con. Phosphor. 

Sulph. 
ULCERS: Arg. Graphites. Kali 

bichr. Merc. Natr. mur. Nitr. ac. 

N. vom. Opium. Petr. Phosph. 

Plumb. Sepise. Sil. Staph. Zinc. 

Palate. 

BLISTERS: Iod. Nux vom. Nitr. 

ac. Phosim. Spig. 
BURNING: Carbo veget. Camph. 

Cann. Canth. Caustic. Cocc. Mur. 

ac. Phosph. Phosph. ac. Rhodod. 

Seneg. Spig. Staph. Thuj. 
DRYNESS: Camph. Cann. Cina. 

Cocc. Hell. Merc. Nux vom. Op. 

Plumbum. Samb. Sepise. Staph. 

Strain. Sulph. Yeratr. 
INFLAMMATION : N. vom. 
PEELING OFF: Amm. Euphorb. 
REDNESS : Ars. Bell. Canth. 
SMARTING: Carbo veget. Coloc. 

Canth. Cham. China. Kali c. Merc. 

Seneg. Zinc. 
SORE: Daph. Nitr. ac. Phosph. 

acid. 
STINGING: Bar. Camph. Caust. 

Coloc. Ign. Kali c. Phosphor. 

Staph. Zinc. 
SWELLING: Apis. Ars. Bell. Caps. 

Chin. Merc. Natr. inur. N. vom. 

Seneg. Stram. 
ULCERS: Apis. Aur. Kali bichr. 

Merc. Natr. mur. Nitr. ac. Ph. *v*. 

Sil. 

50 



WHITE: Merc 

Pharynx. 
(Compare Larynx.) 
APHTH/E : Spong. Staph. 
BALL, hysteric: Calc. Causticurn. 

Graph. Ign. Kali c. Natrum mur. 

Plumb. Sej). Sil. Sulph. Valer. 
BURNING : Aco. Alum. Amm. Ars. 

Arn. Asa feet. Bellad. Calc. Camph. 

Cannabis. Canth. Carbo veg. Caus- 
ticurn. Cham. Cocc. Con. Digital. 

Dros. Euphorb. Graphites. Hyosc. 

Iod. Merc. Nitr. ac. N. vom. Petr. 

Phosphor. Puis. PJiod. Sabad. 

Seneg'. Stram. Sec. corn. Spongia. 

Sulph. Yeratr. 
CONTRACTION : Aco. Alum. Arg. 

Ars. Asa feet. Bellad Calc. Caus- 
ticurn. Chin. Cic. Daph. Hyosc. 

Merc. Natrum muriat. Phos. Sabad. 

Stram. Sulph. Yeratr. 
CROUP, gangrenous : Ars. Chin. 
— membraneous: Aco. Brom. Cham. 

Dros. Hep. Iodine. Phosph. Samb. 

Spong. 
— disposition to: Lycopod. Phosph. 
DEGLUTITION DIFFICULT: 

Aconit. Arg. Arn. Asar. Bell. Bry. 

Calc. Canth. Carbo vegetab. Cham. 

Chin. Hyosc. Ign. Ipec. Kali bichr. 

Merc. Natr. mur. -Nitr. Nux vom. 

Op. Phosph. Ph. ac. Puis. Pyro c. 

Sabad. Spong. Stramon. Sulph. 

Thuj. 
— desire for : Bell. Caust. Con. Ipec. 

Merc. Seneg. Sabad. Thuj. 
— painful: Aeon. Alum. Arg*. Ars. 

Asa f. Bar. Bell. Bry. Calc. Camph. 

Canthar. Caps. Carbo veg. Causti- 
curn. Cham. China. Cocc. Coffea. 

Croc. Ferr. Graph. Hell. Hep. Ign. 

Ipec. Kali c. Lycopod. Merc. Natr. 

mur. N. vom. Petr. Phosph. Ph. ac. 

Puis. Rhus. Euta. Sabad. Sabin. 



26 



MOUTH. 



Sep. Seneg. Sil. Spig. Staph. 

Stram. Sulph. Zinc. 
DBYNESS: Agaric. Alumina. Ambr. 

Anac. Ant. crud. Ars. Asa f. Bar. 

Bell. Bry. Calacl. Calc. Canth. 

Caust. Cham. Cocc. Colch. Cupr. 

Hyosc. Ign. Ipec. Kali c. Lye. Merc. 

Mur. ac. Natr. mur. Nitr. ac. JSf. 

vom. Op. Petr. Phosph. Ph. ac. 

Plat. Plumb. Puis. Khus. Sabad. 

Sabina. Sec. corn. Sepiae. Sil. 

Spongia. Stann. Staph. Stram. 

Thuj. Sulph. 
INFLAMMATION: Aeon. Agar. 

Apis. Alum. Arg. Ars. Bar. Bell. 

Bry. Canth. Caps. Cham. Con. 

Euphorb. lod. Lach. Lye. Mercur. 

Petr. Phosph. Ph. ac. Puis. Buta. 

Seneg. Sep. 
LUMP IN THROAT: Ambr. Ant. 

crud. Arn. Ars. Bell. Calc. Caust. 

Croc. Hep. Mercur. Natr. m. Plumb. 

Sabad. Sab. Sep. 
PABALYSIS : Aco. Bell. Cocc. Ipec. 

Plumb. Sep. 
AS IF A PLUG IN THBOAT: 

Amm. Bar. Chamom. Crocc. Ferr. 

Hep. Ign. Merc. Mur. ac. Natr. mur. 

Nux vom. Sep. Sulph. 
BEDNESS : Aco. Alum. Apis. Bell. 

Canth. Merc. Nitr. ac. Spong. 

ROLLING OF DBINKS, audible: 

Cuprum. Laur. 
ROUGH : Aeon. Ambr. Antim. crud. 

Arg. Ars. Bar. Bryon. Carbo veget. 

Caustic. China. Coccul. Dros. 

Euphr. Graph. Hep. Hell. Hyosc. 

Ign. Ipec. Mur. acid. Natr. c. N. 

vom. Phosph. Ph. ac. Plat. Plumb. 

Bhod. Rhus. Sabad. Sassap. Sen- 
ega. Spong. Stann. Staph. Sulph. 

Thuj. Veratr. 
SCRAPING: Alum. Anac. Arg. Ars. 

Bry. Carbo an. Cocc. Croc. Dros. 

Dulcam. Kali c. Hyosc. JV. vom. 

Puis. Bhus. Sabad. Stann. Thuj. 

Veratr. 



SMABTING: Ambr. Carbo veget. 

Dros. Hyosc. N. vom. Ph. ac. Sep. 
SOBE THROAT, chronic : Ammon. 

Arg. Bar. Bov. Dulc. Lach. Lye. 

Nitr. Pulsatilla. Rhus. Zinc 
— in measles : Carbo veg. 
HEAT: Bellad. Cham. Duicam. 

Euphr. Ferr. Hyosc. Iodine, Mer- 

cur. Natrumc. Nitric ac. Phosphor. 

Bhododend. Sepise. Stram. 
SPASM: Alumina. Carbo veget. 

Caps. Con. Dig. Graph. Ipec. 

Phosphor. Sassap. Sepias. Stram. 

Sulph. Veratr. 
SWELLING: Aco. Arg. Bellad. 

Bry. Carbo animalis. Cham. Chin. 

Hep. Hyosc. Iodine. Ign. Lye. 

Merc. Petr. Spig. Stann. Sulph. 
AS IF SWOLLEN: Veratr. 
ULCEBS : Arg. Calc. Iod. Ign. Merc. 

Nitr. ac. 
UVULA INFLAMED : Apis. Bell. 

Brom. Millefol. Mercur. Buta. Zinc. 
— elongated: Caps. Chel. Croc. Plat. 

Sabad. Sulph. 
— swollen: Bell. Calc. China. Coff. 

Dulc. Kali bichr. Lycop. Merc. 8. 

vom. Pulsatilla. Sabad. Seneg. Sil. 

Sulphur. Zinc. 

Saliva. 
FBONT OF MOUTH: Bell. Calc. 

Camph. Canth. Chamom. Cic. Cocc. 

Cupr. Hyosc. Ign. Laur. Op. Plumb. 

Sec. corn. Stram. Yeratr. 
— bloody: Cantharis. Hyosc. Pyro- 

carb. Sec. cornut. Stram. 
MUCUS, bitter: Arn. 
—-bloody: Alum. Amm. Bism. Iod. 

Lye. Mercur. Phosphor. Sec. corn. 

Selen. Sulphur. Strain. Thuj. Zinc. 
— foul : Bellad. Bov. Calcarea. Carbo 

veg. Cham. China. Sep. Zinc. 
— yellow: Bry. Spig. 
—gray: Arg. 
— green : Carbo vegetab. Colch. Natr. 

mur. Plumb. Zinc. 



MOUTH. 



27 



— salt: Alum. Amm. Bovista. Graph. 

N. Tom. Phos. Rhus. Sulpk. 
— som- : Plumb. 
— sweetish: Asar. 
— tasting badly : Merc. 
— smelling badly : Chin. Ignat. Puis. 

Rheum. 
— viscid: Alum. Ambr. Anac. Ant. 

crud. Arg. Asar. Bell. Bnj. Camph. 

Caps. Chamom. Coff. Dulc. Euphr. 

Iod. Ign. Merc. Nux vom. Phosph. 

Ph. ac. Plumb. Pulsat. Rhus. 

Samb. 
SALIVATION : Ant. cruel. Agar. 

Alum. Apis. Bellad. Broni. Bry. 

Camph. Canth. Cham, Chin. Cocc. 

Colchic. Con. Cyc. Dros. Dulc. 

Euplir. Ferr. Hell. Hyosc. Ign. Iod. 

Kali c. Ipec. Merc Nitrum ac. 

Nux vom. Op. Phosph. Plumb. 

Puis. Rhus. Stram. Yeratr. 
SALIYA, bitter: Arm Ars. Merc. 

Thuj. 
— frothy : Ant. crud. Bell. Bry. Cam- 

phora. Canth. Cic. Cocc. Ign. Ipec. 

Phosph. Plumbum. Sil. Sabin. Sec. 

corn. Spigelia. Stram. 
— watery : Asarum. Camphora. Colch. 

Dig. Dros. Hell. Iod. Ipec. Lach. 

Nux vom. Phosph. Plumb. Staph. 
— increased flow : Aeon. Alum. Arg. 

Asar. Bar. Bell. Bov. Brom. Bry. 

Calc. Camph. Canth. Carb. veget. 

Caustic/Cham. Chin. Cocc. Colchic. 

Dros. Dnlc. Graph. Hell. Hep. 

Hyosc. Ign. Ipec. Merc. Natr. mur. 

X. vom. Phosph. Pulsat. Rhus. Sep. 

Spig. Spong. Staph. Stram. Sulph. 

Yeratr. 

Tongue. 
BLACK: Ars. Chin. Op. Sec. corn. 
BLOTCHES: Apis. Dros. Lycop. 

Phosph. 
BLISTERS : Amm. Arg. Ars. Apis. 

Bar. Bell. Brom. Bry. Calc. Canth. 



C. an. Caust. Cham. Chin. Croc. 

Graph. Hell. Kali carb. Mur. ac. 

Natr. mur. Nitr. ac. N. vom. 

Phosph. Puis. Sabad. Sep. Spig. 

Spong. Staph. 
BLUE: Ars. Dig. Lach. Mur. acid. 

Sabad. 
BURNING: Aeon. Alum. Argent. 

Ars. Asar. Bar. Bell. Bry. Calc. 

Canth. Carb. an. Caust. Chin. 

Coff. Coloc. Croc. Graph. Hyosc. 

Ign. Kali carb. Merc. Natr. mur. 

Op. Phosph. Ph. ac. Plat. Plumb. 

Bhodod. Sabad. Spig. Spong. 

Sulph. Yeratr. 
CANCER: Apis. Ars. 
COATED, brown: Arsen. Bell. Bry. 

Carb. veg. Crotal. Mancin. Plumb. 

Sabin. Sec. cor. Sulph. 
— yellow: Aeon. Alum. Arn. Ars. 

Bellad. Bry. Cann. Chamom. Chin. 

Cocc. Kali bichr. Lach. Merc Nitr. 

acid. Sabad. Sabina. Senec. Stann. 

Zinc. 
— like a crust : Chin. 
— like fur : Merc. Puis. 
— frothy: Plumb. 
— slimy: Aeon. Agar. Bell. Canth. 

Chamom. Chin. Cina. Ignat. Merc. 

Nitr. Nux vom. Phosph. Plumb. 

Puis. Sec. corn. Sep. Sil. Stann. 
—dirty: Aeon. Ant. crud. Arn. Chin. 
— blackish: Ars. Bry. Merc. Sec 

corn. 
— white: Aeon. Agar. Alum. Anac. 

Ant. crud. Ars. Asar. Arn. Bell. 

Bryon. Calcar. Canth. Cann. Carb. 

veg. Cham. Chin. Cina. Croc. Dig. 

Euplir. Ign. Ipec. Merc. Mur. ac. 

Nat. mur. Petr. Phosph. Plumb. 

Puis. Rheum. Rut. Sabad. Sabin. 

Sassap. Selen. Seneg. Spigel. 

Staph. Sulphur. Yeratr. Zinc. 
CRACKS: Bar. Calc. Ign. Merc. 
CRACKED : Bar. Bell. Bryon. Calc. 

Cham. Chin. Plum 1 - Ph. ac. Sec. 

corn. Spig. 



28 



MOUTH. 



DRY : Aeon. Ambr. Arn. Ars. Bell. 

Bry. Calc. Canth. Carb. veg. Caust. 

Cham. Cocc. Coff. Con. Dulc. 

Kali carb. Lye. Hell. Hyosc. Ipec. 

Lach. Merc. N. vom. Op. Phosph. 

Ph. ac. Plumb. Puis. Kims. Sep. 

Staph. Stram. Sulph. Yeratr. Zinc. 
HEAT : Aeon. Bellad. Canth. Carbo 

veget. Plumb. Pulsat. Stram. 

Sulph. 
HEAVY: Anac. Bell. Calc. Carb. 

veget. Merc. Mur. ac. Natr. mur. 

Plumb. N. vom. Kuta. 
INDENTED: Merc. 
INFLAMMATION: Aconit. Arn. 

Canthar. Cham. Nux vom. Plumb. 
PAPILLA, erect: Croc. Oleand. 
— inflamed: Bell. 
PARALYSIS: Aeon. Bar. Cocc. 

Crotal. Dulcam. Ipec. Hyosc. 

Laur. Mur. ac. N. voin. Op. Rhus. 

Kut. Sec. cor. Stram. 
PEELING OFF: Spig. 
KANULA: Ambr. Calc. Natr. mur. 

Nitr. ac. Staph. 
KED : Cham. Veratr. 
KOUGHNESS: Aeon. Alum. Bar. 

Calc. Carb. veg. Cocc. Dulc. Graph. 

Hyosc. Merc. Phosph. Sep. Stram. 

Sulph. 
SMARTING: Aeon. Arn. Arsen. 

Asar. Bell. Cham. Chin. Coloc. 

Croc. Dros. Ign. Ipec. Natr. mur. 

Op. Sep. Sulph. Zinc. 
SOKE : Agar. Ars. Canth. Cic. Dig. 

Kali c. Lye. Merc. Mur. acid. Natr. 

mur. Nitr. ac. Op. Sen. Sil. . 
SUPPURATION: Canth. Mancin. 
SWELLING : Anac. Apis. Ars. Bell. 

Bryon. Calad. Chin. Cic. Dig. Dros. 

Glonoin. Hell. Merc. Natr. mur. 

Plumb. Pyrocarb. Kuta. Sabad. 

Sec. Sil. Stram. Veratr. 
TONGUE PKOTKUDED : Aco. 

Plumb. 
TREMBLING: Bell. Phos. ac. 

Stram. 



TWITCHES : Sec. corn. 
ULCERS : Amm. Apis. Arsen. 

Canth. Chin. Cic. Dros. Kali hichr. 

Lye. Mur. ac. Merc Natr. mur. 

Nitr. ac. Op. 
— at the edge of tongue : Caust. 

Merc. Nitr. ac. Thuj. 
— under the tongue : Lye. 
WHITE : Arsen. Canth. Coloc. Hell. 

Kali carb. Nitr. ac. Nnx vom. Op. 

Petr. Phosphor. Puis. Sep. Sulph. 

Veratr. 
WITHERING: Veratr. 



Speech. 
DUMB: Cicuta. Pyrocarb. Stram. 
SPEECH, impeded: Aeon. Anac. 

Arg. Arn. Ars. Bell. Bry. Calc. 

Cann. Canth. Carb. veg. Caust. 

Cocc. Conium. Dulc. Hyosc. Ign. 

Lye. Merc. Mur. ac. Natr. mur. 

N. vom. Op. Plumb. Petr. Phos- 
phor. Sec. cor. Spong. Stann. Strain. 

Sulph. Veratr. Zinc. 
— hurried : Aeon. Bry. Hep. Merc. 
— stuttering: Cocc. Stram. 
— slow: Thuj. 
— low tone: Bell. Canth. Chamom. 

Chin. Hep. N. vom. Op. Sec. corn. 

Staph. 
— nasal: Bry. 
SPEECHLESS: Arn. Ars. Bar. 

Bell. Bryon. China. Con. Crotal. 

Cupr. Hyosc. Lye. Merc. Mur. ac. 

N. vom. Op. Phosph. Plumb. Puis. 

Ruta. Sec. corn. Stram. Veratr. 
STUTTERING: Aco. Arn. Bell. 

Cham. JEuphr. Hell. Opium. Sec. 

corn. Strain. Verat. 
STAMMERING: Euphr. 
VOICE, clear: Chin. Secale corn. 

Spong. Stram. Yeratr. 
— low : Ant. crud. Canth. Ign. Nux 

vom. Op. Puis. Secale corn. Spong. 

Veratr. 



APPETITE. 



29 



— indistinct : Bry. Cann. Cocc. Hyosc. 

Sec. corn. Stram. Yeratr. 
— loss of: Antimon. cruel. Cann. 



Dros. Hyosc. Lack. Plumb. Kuta. 
Spong. Yeratr. 



II APPETITE. 



LOSS OF APPETITE: Aco. Agar. 

Alumina. Ant. crud. Arg. Am. Ars. 

Bar. Bell. Bry. Calc. Canth. Carbo 

vegetabil. Caustic. Cham. China. 

Cic. Cocc. Coff. Colch. Con. Croc. 

Cupr. Cyel. Dig. Dros. Dulc. Ferr. 

Graphites. Hell. Hep. Hyosc. Ign. 

Ipec. Lack. Lye. Merc. Natr. mur. 

Nux vom. Op. Phosphor. Plat. Puis. 

Bhodod. Rhus. Buta. Sabad. Sec. 

corn. Sep. Sil. Spigel. Spong. 

Stann. Staph. Sulph. Thuj. Veratr. 

Zinc. 
AVERSION TO BEEK: BeU. 

Cham. China. Cocc. X. vomica. 

Phosph. Spig. Spong. Stann. 

Sulph. 
— to brandy : Ign. Merc. 
— to bread: Con. Ign. Lycopod. 

Natr. mur. Nitr. ac. Nux vom. 

Phosph. Ph. ac. Puis. Khus. Sep. 

Sulph. 
— to brown bread: Kali c. Lye. N. 

vom. Puis. Sulph. 
— to solid food : Ferr. Mercur. Staph. 
— to fat food : Ars. Bell. Bry. Calc. 

Carbo veg. Drosera. Hell. Hep. 

Merc. Natrum mnr. Petr. Pulsatilla. 

Psorin. Bhus. Sep. Sulph. 
— fish: Graph. Zinc. 
— meat : Alum. Am. Ars. Aur. Bry. 

Calc. Carbo veget. Causticum. Ferr. 

Graph. Ign. Kali bicher. Lye. 

Mercur. Mur. ac. Xatr. mur.Nitr. 

ac. N. vom. Op. Petr. Plat. Puis. 

Rhus. Sabad. Sepiae. Sil. Sulph. 

Zinc. 
— broth : Am. Ars. Belladonna. 

Graph. Bhus. 



— vegetables: Hell. 

— coffee: Bellad. Bry. Calc. Carbo 

veget. Cham. China. Coff. Dulc. 

Lijc. Merc. Natr. mur. N. vom. 

Phosphor. Bhus. Sabad. Spig. 
— to milk: Am. Bell. Bryon. Calc. 

Carbo veg. Cina. Ign. Natr. c. 

Nux vom. Phosphor. Pulsat. Sep. 

Sil. Stann. Sulph. 
— sour things: Bellad. Cocc. Ferr. 

Ign. Nux vom. Ph. ac. Sabad. 

Sulph. 
— salt things: Carbo veg. Graph. 

Selen. 
— sweet things: Ars. Caust. Graph. 

Merc. Nitr. ac. Phos. Sulph. Zinc. 
— to water: Bellad. Brom. Bryon. 

Canth. Caust. China. Lye. Natrum 

mur. N. vom. Stram. 
— to wine: Ign. Lach. Merc Bhus. 

Sabad. Sulphur. 
DESIRE FOR BEEB: Aeon. Bry. 

Calc. Causticum. China. Cocc. 

Graph. Lach. Merc. Natr. c. N. 

vom. Op. Petr, Ih. ac. Pulsat. 

Rhus. Sabad. Spig. Spong. Sulph. 

Zinc. 
— bitter things : Dig. Natrum mur. 
— brandy : Aco. Arg. Ars. Bov. Bry. 

Calc. China. Cic. Hep. Mur. ac. N. 

vom. Op. Puis. Selen. Sep. Spigel. 

Staph. Sulph. Sulph. ac. 
— bread : Ars. Bell. Bov. Ferr. Hell. 

Ign. Natr. m. Plumb. Puis. Staph. 
— bread and butter : Ferr. Ign. Merc. 
— something refreshing: Carbo an. 

Caust. Cocc. Phosph. Ph. ac. Pulsat. 

Rheum. Yaler. 



30 



TASTE. 



— for fat food : Nitr. ac. Nux yoni. 

— for meat : Hell. Sulph. 

— liquids : Ferr. Merc. Staph. Sulph. 

— pastry: Plumb. 

— smoked tilings : Caust. 

— vegetables: Alum. Magnes. carK). 

— cucumbers : Ant. crud. Veratr. 

— herrings : Nitric ac. Yeratr. 

— cheese: Ign. 

— coffee : Ars. Aur. Bryon. Capsicum. 

China. Colch. Con. Mosch. Selen. 
— chalk : Nitr. ac. N. vom. 
— sweet things : Amm. Calcar. Carbo 

veg. Chin. Ipec. Kali c. Lye. Natr. c. 

Nux vom. Petr. Pheum. Rims. 

Sabad. Sulph. 
— farinaceous : Sabad. 
— milk: Anac. A7S. Aur. Bov. Bry. 

Calc. Chel. Mercur. Natr. mur. Nux 

vom. Ph. ac. Ehus. Sabad. Sabina. 

Sil. Staph, 
—fruit: Alum. China. Ignat. Puis. 

Sulph. ac. Yeratr. 
— juicy: Ph. ac. 
— salt: Calc. Carbo veg. Caust. 

Conium. Nitric acid. Phosph. Ye- 
ratr. 
— sour: Antim. crud. Arn. Ars. Bry. 

C. an. Cham. China. Con. Dig. Hep. 

Ign. Kali c. Lach. Phosph. Puis. 

Sabin. Sec. corn. Sep. Strain. 

Sulph. Yeratr. 
— wheat bread : Aur. 
— warm food : Cycl. Ferrum. Lye. 
— wine : Aco. Arg. Bov. Bryon. Calc. 

Chin. Cic. Hep. Lach. Pulsat. Sep. 

Spigelia. Staph. Sulph. 
BAD EFFECTS OF FOOD OB 

DBINK: see Index. 



HUN GEE : Agar. Alum. Antim. crud. 

Arg. Ars. Aur. Bellad. Bryon. 

Calc. Canth. Carbo veg. Cham. 

China. Cina. Cocc. Coff. Graph. 

Hell. Hyosc. Ign. Lye. Merc, Mur. 

ac. Natr. mur. Nux vom. Op. Petr. 

Phosphor. Plat. Plumb. Puis. Ehus. 

Sabad. Secale corn. Sep. Sil. 

Spong. Staph. Yeratr. 
— without appetite : Ars. Bellad. Bry. 

Calc. Chin. Dulc. Hell. Ign. Lye. 

Natr. mur. Nux vom. Op. Puis. 

Rhus. SU. Sulph. Yeratr. 
— canine: Ars. Bryon. Calc Cham. 

Chin. Cina. Cocc. Graph. Hell. Hy- 
osc. Iodine. Lye. Natr. mur. N. 

vom. Op. Phosph. Puis. Phus. 

Sep. Sil. Spig. Sulph. Yeratr. 
THIEST: Aeon. Ant. crud. Arn. 

Ars. Bell. Bryon. Calc. Canth. 

Carb. veg. Caust. Cham. Chin. 

Cina. Coffea. Crocus. Crotal. Cupr. 

Dros. Dulc. Ferr. Hep. Hyosc. Ign. 

Kali bichr. Merc. Natr. mur. Nux 

vom. Plumb. Phus. Sec. cornut. 

Silic. Stram. Sulph. Veratr. 
— loss of : Ambr. Apis. Arsen. Bellad. 

Camph. Canth. Chin. Con. Hell. 

Hep. Lycop. N. mosch. Oleand. Op. 

Ph. ac. Puis. Ehus. Sep. Spig. 

Spong. Staph. 
— with aversion to drinks : Arn. Bell. 

Canth. Caust. Hyos. Lach. Lye. 

Natr. mur. Nux vom. Ehus. Samb. 

Strain. 
— none, but desire to drink : Ars. 

Camph. Cocc. Coloc. Graph. Man- 

cin. Phosph. 



I TASTE. 



TASTE, bitter: Aconit. Alum. Ant. 
crud. Arg. Arn. Ars. Aur. Bar. 
Bell. Bov. Bry. Calcar. Canth. 



Carb. veg. Cham. Chin. Cocc. Coff. 
Croc. Cupr. Dig. Glonoin. Hyosc. 
Ign. Ipec. Kali c. Lye. Merc. Mur. 



ERUCTATIONS. 



31 



ac. Natr. mur. Nitr. ac. Nux vom. 

Op. Pete. Phosph. Pulsat. Rhod- 

odend. Rhus. Sabad. Sabin. Sec. 

corn. Sep Ice. Slllc. Spong. Staph. 

Strain. Sulph. Veratr. 
— of food : Ars. Bnjon. Camph. Chin. 

Ferr. HeU. Hep. Ign. Ph. ac. Puis. 

Sabin. Staph. Stram. 
— of blood : Alum. Ars. Canth. Ferr. 

Ipec. Kali carb. Bhus. Sabin. Zinc. 
— burnt : Bnjon. Cyclam. Laur. Puis. 

Still Sulph. 
— of pus: Bros. Merc. Natr. carb. 

Puis. 
— nauseous : Bry. Chel. N. vom. Puis. 

Valer. 
— earth : Caps. Ferr. Hep. Merc. 

Puis. 
— flat : Agar. Alum. Ant. crud. Ars. 

Asaf. Aur. Bell. Bry. Caps. Chin. 

Coloc. Dig. Dulc. Euphorb. Ign. 

Ipec. Natr. mur. Op. Ph. ac. Puis. 

Khus. Sec. corn. Stann. Staph. 
— foul : Aeon. Arn. A?~s. Aur. Bellad. 

Bry. Cham. Con. Cupr. Ign. Kali 

carb. Lycop. Merc. Mur. ac. N. 

vom. Ph. ac. Puis. Khus. Spig. 

Staph. Veratr. 
— of foul eggs: Aeon. Arn. 
— bilious: Aeon. Bry. Cham. Puis. 

Veratr. 
— of cheese : Chin. 
— chalky : Ign. Nux mosch. 



— insipi' . Aeon. Alum. Ars. Bell. 

Bry. Caps. Chin. Euphras. Ign. 

Kali c. Op. Petr. Phosph. Sabin. 

Spig. Stann. Staph. Valer. 
— salt: Alum. Ars. Bar. Bell. Calc. 

Carb. veg. Chin. Coff. Croc. Iod. 

Merc. Puis. Rhodocl. Sulph. 
— sour: Aeon. Alum. Ars. Aur. Bar. 

Bell. Calc. Canth. Caps. C. an. 

Con. Chamom. Chin. Cocc. Crotal. 

Graph. Ignat. Kali c. Kali bichr. 

Lye. Merc. Nitr. ac. Nux vom. 

Pyroearb. Phosph. Puis. Bhus. 

Sep. Sil. Sulph. 
— slimy: Alum. Arn. Arsen. Bell. 

Cham. Chin. Cocc. Dig. Hell. Hep. 

Lye. Merc. Nux vom. Petr. 

Phosph. Ph. ac. Bhus. Sep. Sulph. 
— sweetish: Alum. Aur. Bell. Bry. 

Canth. Chin. Coff. Croc. Cupr. 

Ferr. Kali c. Lye. Merc. N. vom. 

Phosph. Plat. Plumb. Puis. Sabad. 

Spong. Sulph. Zinc. 
— offensive: Ars. Brom. Bry. Calc. 

Canth. Chin. Cocc. Dros. Ign. 

Merc. Natr. mur. Nux vom. Phosph. 

Pulsat. Sep. Spig. Stann. Sulph. 

Zinc. 
— lost: Alum. Anac. Ant. cr. Bell. 

Bry. Calc. Hyosc. Ipec. Kali c Lye- 
Merc. Natr. mur. Bhoclcd. Sec. 

corn. Sep. Silic. Stram. Sulph. Ve- 
ratr. 



XL ERUCTATIONS. 



ERUCTATIONS, bitter: Alum. Ar- 
nica. Ars. Bar. Bell. Bry. Cham. 
Chin. Calc. Carb. veg. Cocc. 
Droser. Hyosc. Ign. Kali carb. 
Lye. Merc. Mur. ac. N. vom. 
Phosph. Pulsat. Sil. Spong. 
Stann. Sulph. Yeratr. 

— foul: Aeon. Arn. Bellad. Brom. 



C. an. Cocc. Merc. Mur. ac. N. vom. 

Phosph. Puis. Sep. Sulph. 
— after eating: Antim. crud. Bellad. 

Bry. Camph. Canth. Chin. Cina. 

Cocc. Coff. Crotal. Euphr. Ferr. 

Graph. Ign. Natr. mur. Phosph. 

Pulsat. Rhus. Sil. Sulph. Thu.j. 
— bilious: Am. Bryon. Cocc. Dros. 



32 



HEARTBURN AND REGURGITATION. 



N. vom. Puis. Spong. Veratr 
— hot : Mancin. 
— spasmodic : Ferr. Nux vom. Phosph. 

Buta. 
— loud : Ant. crud. Caust. Con. Kali c. 

Petr. Phosph. Plat. Puis. 
— empty: Aeon. Agar. Alum. 

Ambr. Ant. crud. Am. Ars. Bar. 

Bell. Bryon. Calc. Cann. Canthar. 

Carb. veg. Caust. Coloc. Con. 

Chamom. China. Cocc. Coff. 

Colchic. Croc. Dulc. Euphorb. 

Graphit. Hell. Iod. Ign. Ipec. Kali c 

Lye. Merc. Millefol. Natr. mur. 

N. vom. Phosphor. Plumb. Plat. 

Rhus. Buta. Sabad. Sabin. Sep. 

Sil. Spig. Spong. Staphis. Yeratr. 
— sour : Ambr. Arsen. Bar. Bell. Bry. 



Calcar. Carb. veg. Cham. Chin. 
Con. Dros. Dig. Graph. Ignat. 
Kali c. Kali bichr. Lye. Mercur. 
Natr. mur. N. Yom. Op. Posph. Puis. 
Sabin. Sil. Stann. Sulph. Sulph. 
ac. Zinc. 

-fetid : Bism. Cocc. Merc. N. vom. 
Sulph. Thuj. 

-incomplete: Arn. Bell. Canth. 
Cina. Cocc. Con. Hyosc. Millefol. 
Natr. mur. Ph. ac. Rhus. Sabad. 
-suppressed: Aconit. Alum. Ambr. 
Bar. Bell. Calc. Canthar. Caustic. 
C. an. Cocc. Con. Hyosc. Ign. Kali 
carb. N. vom. Phosph. Plat. Plumb. 
Puis. Sulph. 

-repulsive : Asa f . Cina. Nat. mur. 
Ph. ac. Plumb. 



ffl. HEARTBURN, REGURGITATION. 



HEABTBUBN : Agaricus. Alumina. 

Ambr. Ant. crud. Arg. Arn. Bar. 

Bell. Calc. Capsic. Carbo veg. 

Caust. Cham. Chin. Croc. Crotal. 

Con. Dig. Dulc. Ferr. Graph. Iod. 

Ign. Lye. Merc. Natrum mur. N. 

Tom. Petr. 
BEGUBGITATION, bitter : Arnica. 

Bar. Bry. Dros. Ign. Nux vom. 

Phosph. Puis. Bhod. 
—of blood : Canth. Chin. Merc. N. 

vom. 
— salt : Arn. Lye. Veratr. 
— sour : Alum. Calc. Con. Dros. Nux 

vom. Petr. Plumb. Puis. Bhus. 

Sabin. Spong. Zinc. 
— of food : Antim. crud. Arnica. Bell. 

Bry. Camph. Canth. Carbo veget. 

Cham. Dulc. Ferr. Ign. Lye. Merc. 

Nux vom. Phosph. Plumb. Puis. 

Sep. Sulph. 
. — of water: Aco. Arg. Arn. Bar. 

Bryon. Cann. Caust. Cina. Hep. 



Kali c. Merc. Nux vom. Petr. 

Phosph. Plumb. Puis. Sulph. ac. 
BISING: Alumina. BeUad. Calc. 

Chin. Phosph. Pulsat. Bhus. 

Sabad. Stann. 
— hot : Asa f . Canth. Carbo veg. Cic. 

Coffea. Croc. Dulc. Hell. Merc, 

Nux vom. Plat. 
— cold: Veratr. 
— sweet: Aco. Chin. Plat. Merc. 

Stann. 
— burning: Arsenic. Bov. Calc. 

Carbo veget. Croc. Hep. Hell. Lye. 

Nux vom. Phosph. Sabina. Secale 

corn. Sep. Sil. Staph. Sulph. Thuj. 

Yerat. Zinc. 
WATEB-BBASH, bitter: Chelidon. 

Graph. Nux mosch. Sulph. 
— sour: Bell. Calc. C. an. Con. 

Natrum c. Sulph. 
— general: Ant. crud. Arsenic. Bry. 

Carbo yeg. Chin. Cina. Cocc. 



NAUSEA AND VOMITING. 



33 



(*-raph. Hell. Ign. Kali c. Lye. 

Merc. Nux vom. Staph. Sulph. 
-more fully : Aco. Alum. Ars. Bar. 

Bryo. Calc. Canth. Carbo veg. 

Caustic. Cic Cina. Cocc Bros. 

Ferr. Hep. Ign. Kali c. Lye. Natr. 

mur. Nitr. ac. Nux vom. Petr. 

Phos. Puis. Sabad. Sep. Sil. Spig. 

Staph. Sulphur. Veratr. 
-with shuddering : Sil. 



-with hiccup : Aconit. Agar. Alum. 
Ant. crud. Arg. Am. Asar. Bar. 
Bell. Bov. Bry. Calc. Cann. Canth. 
Carbo veg. Causticum. Cham. Cic. 
Cina. Cocc. Coff. Colchicum. Con. 
Cupr. Dig. Dros. Dulcam. Euphr. 
Euphorb. Graph. Iod. Kali c. 
Merc. Natr. mur. N. vom. Op. 
Phosph. Pulsat. Samb. Sep. Spong. 
Staph. Stram. Sulph. Veratr. 



M. NAUSEA, Y01TING. 



LOATHING: Aco. Ant. crud. Arg. 

Arn. Asar. Bar. Bell. Bry. Canth. 

Cham. Chin. Cocc. Colch. Cupr. 

Digit. Dulc. Ferr. Hep. Ign. Ipec. 

Kali c. Merc. Nux vom. Op. 

Phosph. Plumb. Puis. Ehod. Se- 
cale corn. Sep. Sil. Spigel. Stram. 

Sulph. ac. 
TAUSLA, generally: Aco. Alum. 

Ant. crud. Arg. Arn. Ars, Bell. 

Bry. Calc. Cann. Carbo veg. Caus- 
tic. Cham. China. Cocc. Coff. Con. 

Croc. Cupr. Dig. Dros. Dulc. 

Glonoin. Hep. Ign. Ipec. Kali c. 

Lye. Mosch. Mercur. Mancin. Natr. 

mur. Nux vom. Petr. Phosph. Ph. 

ac. Puis. Bhus. Kuta. Sabad. Sep. 

Sil. Staph. Sulph. Veratr. 
— in the chest: Aco. Bry. C .Jc. 

Merc. Nux vom. Rhus. Sec. corn. 

Staph. 
— in the throat: Aco. Ars. Bell. 

China. r Cocc. Coffea. Cupr. Cycl. 

Ferr. Merc. Ph. ac. Puis. Rhus. 

Spig. Stann. Staph. Sulph. Valer. 
—in the stomach : Aconit. Arn. Asar. 

Calc/Cann. Cantharis. Cham. Chin. 

Cic. Cocc. Croc. Cupr. Hell. Ipec. 

Kali carb. Lye. Merc. Natr. mur. 



Nux vom, Phosphor. Puis. Ehus- 
Sil. Sulph. Veratr. 

— in the abdomen: Bell. Bry. Cocc. 

Cupr. Hell. Hep. Puis. Rheum. 

Samb. Sil. Staph. 
QUALMISHNESS: Aco. Arnica. 

Ars. Bar. Bellad. Bry. Calc. Caps. 

Carbo veg. Caustic. Cham. China. 

Cina. Coffea. Croc. Digit. Euphr. 

Hep. Ign. Ipec. Kali c. Lye. Natr. c. 

Nitr. ac. Nux vom. Petrol. Phos- 
phor. Plat. Pulsat. Rhus. Sabad. 

Sil. Staph. Sulph. Thuj. Veratr. 

Zinc. 
EETCHING : Aco. Ant. crud. Arg. 

Arn. Ars. Asar. Bell. Bryon. Canth. 

Chin. Cocc. Cupr. Dig. Dulc. 

Glonoin. Hyosc. Ipec. Lyc.Natrum. 

mur. Plumb. Pulsat. Sabin. Secale 

corn. Sulph. Veratr. 
YOMIT, inclination to: Aeon. Ant. 

crud. Arg. Arn. Ars. Aur. Asar. 

Bell. Bryon. Cann. Canth. C. veg. 

Cham. China. Cocc. Coffea. Croc. 

Cupr. Dig. Ferr. Graph. Hep. 

Hyosc. Hell. Ign. Iod. Ipec. Kali 

bichr. Lye. Merc. Mur. ac. N. vom. 

Op. Plat. Plumb. Puis. Pyro carb. 

Rhus. Sabina. Secale corn. Sep. 



34 



NAUSEA AND VOMITING. 



Sil. Spig. Spong. Staph. Stram. 
Sulph. Thuj. Veratrum. 

— anxious : Aco. Calc. Caustic. Kali c. 
Lach. Lye. Nitrum ac. Plumb. 
Sabad. 

VOMITING, generally : Antim. crud. 

Arg. Arn. Arsen. Asar. Bar. Bell. 

Bryon. Calc. Campli. Cann. Can- 

thar. Caps. Cham. Chin. Cina. 

Cocc. Colfea. Colch. Con. Cupr. 

Dig. Bros. Bulc. JEuphorb. Ferr. 

Graph. Hell. Hep. Hyosc. Ipec. 

Iodine. Kali c. Lach. Lye. Mer- 

cur. N. Yom. Phosph. Ph. ac. Op. 

Plumb. Puis. Euta. Sabin. Sec. 

corn. Sep. Sil. Sulph. Veratr. Zinc. 
— bitter: Bryo. Cann. Canth. Cham. 

Chin. Cocc. Cupr. Ipec. Sec. corn. 

Sep. Sil. Sulph. Thuj. Yeratr. 
— bloody: Aco. Arn. Arsenic. Bry. 

Camph. Cann. Canth. Chin. Cupr. 

Bros. Ferr. Hyosc. Ipec. Lye. Nux 

vom. Op. Plumb. Pulsat. Khus. 

Sepiae. Stann. Yeratr. Zinc. 
— of brown substance: Arsenic. 

Bism. 
— bilious: Aeon. Ant. crudum. Ars. 

Bell. Bism. Bryo. Camph. Cann. 

Canth. Cham. Colch. Con. Cupr. 

Dig. Dros. Bulc. Hyosc. Ipec. 

Iodine. Kali bichr. Lye. Merc. 

Natr. mur. N. vom. Phosph. Puis. 

Sab. Sec. corn. Sep. Sil. Stann. 

Stram. Veratr. Zinc. 
— yellow: Arsen. Bryon. Cann. 

Colchic. Iod. Ipec. Plumbum. 

Veratr. 
— yellow-green : Arsen. Bryon. Bulc. 

Ipec. Yeratr. 

— of drinks: Ant. crud. Bulc. Ipec. 

— green : Aco. Ars. Asar. Bry. Cann. 
Chamom. Crotal. Cupr. Digitalis. 
Hell. Hep. Hyosc. Ign. Ipec. N. 



vom. Op. Plumb. Pulsat. Stram 
Yeratr. 

— violent : Cupr. Ipec. Yeratr. 

— green-blackish : Plumb. Petr. 

Phosph. 
— of urine: Op. 

— of faeces : Bry. N. vom. Op. Plumb. 
— sour: Ars. Asar. Bellad. Calc 

Caust. Cham. Chin. Cocc. Ferr. 

Graphites. Hep. Ipec. Lye. Nux 

vom. Op. Phosph. Psorin. Pulsat. 

Sabin. Secale cornut. Stann. 

Stram. Sulph. Yeratr. 
— frothy: Yeratr. 
— of mucus: Aeon. Ant. crud. Ars. 

Bar. Bell. Bry. Cann. Cham. Chin. 

Cocc. Cupr. Big. Bulc. Fen*. 

Graphit. Hep. Hyosc. Ign. Ipec. 

Lye. Merc. N. vom. Pulsat. Phosph. 

Sec. cornut. Sil. Stram. Sulph. 

Yeratr. 
— of food: Antim. cruel. Arn. Ars. 

Bell. Bryon. Calc. Canth. Chamom. 

Chin. Cina. Cocc. Coffea. Coloc 

Dig. Bros. Ferr. Graphites. Hyosc. 

Ign. Ipec. Kali bichr. Kali c. Lach. 

Lycop. Merc. N. vom. Op. Phos. 

ac. Plumb. Puis. Pyro carb. Sabin. 

Sep. Sil. Stan. Sulph. Yeratr. 
— fetid: Cupr. Ipec. Plumb. Sec. 

corn. Yeratr. 
— watery : Asar. Bry. Cannab. China. 

Cupr. Dros. Ferr. Hyosc. Ipec. 

Pulsat. Stram. Yeratr. 
— black : Ars. Calc. Camphora. Chin. 

Hep. Ipec. Lye. Mancin. Nux vom. 

Op. Petr. Phosph. Plumb. Secale 

corn. Stram. Sulph. Sulph. ac. 

Yeratr. 
— of worms: Aco. Anac. Ars. Cina. 

Coff. Ferr. Hyoscyam. Merc. Na- 

trum mur. Sabad. Secale corn. Sil. 

Spigelia. Veratr. 



35 



XIY. STOMACH AND PIT OF STOMACH. 



1. Stomach.. 
ACIDITY : Con. Graph. Sil. Sulph. 

acid. Zinc. 
AS IF BLOATED : Alum. Bellad. 

Bov. Chin. Con. Croc. Dulc. Ferr. 

Hell. Iod. Kali bich. Lye. Nitr. ac. 

Nux mosch. Op. Petr. Phosph. 

Sab. Stann. Zinc. 
BURNING: Aeon. Ambr. Arg. Ars. 

Asa f. Bar. Bell. Bry. Calad. Cal- 

car. Camph. Canth. Caps. Carl). 

veg. Chin. Cic. Colch. Con. Croc. 

Digit. Euphorl). Graphit. Ignat. 

Iod. Nux vom. Petr. Phosph. 

Phosph. ac. Sabad. Sec. cornut. 

Sep. Sil. Sulph. 
— at the pylorus : N. Tom. 
CANCER : Ars. Lye. N. vom. 
— as if something alive in it: Croc. 
COLD : Ars. N. vom. Puis. Veratr. 
COLDNESS: Alum. Arsen. Bar. 

Caps. Con. Graph. Ign. Natr. mur. 

Phosph. Sabad. Sulph. Sulph. ac. 
CONSTRICTION : Aco. Alum. Bry. 

Bellad. Calc. Carb. veg. Chin. Con. 

Cocc. Euphorb. Lycop. Nux vom. 

Phosph. Plumb. Sil. Sulph. 
CONTRACTION OF PYLORUS: 

Ars. Euphorb. Ign. Nitr. ac. Nux 

vom. Phosph. Zinc. 
CRAMP: Ars. Ambr. Ant. crud. 

Am. Asa feet. Bar. Bellad. Brom. 

Bry. Calc. Carb. veg. Caust. Cha- 

mom. Chin. Cocc. Con. Cupr. Dig. 

Euphorb. Ferr. Hyosc. Iod. Ign. 

Ipec. Kali carb. Lye. Merc. Natr. c. 

Natr. mur. N. vom. Petr. Phosphor. 

Plumb. Puis. Psoriu. Sabad. Sec. 

corn. Seneg. Sep. Sil. Stann. Staph. 

Sulph. Sulphur, acid. Thuj. Valer. 

Veratr. 
CRAMP Y PAINS : Arn. Caust. Eu- 
phorb. Ign. Kali carb. Nux vora. 

Puis. 



CUTTING: Alum. Antim. cr. Ars. 

Asa f. Calc. Cann. Canth. Chel. 

Digit. Kali carb. Petr. Phosph. 

Stann. Sulph. 
EMPTY FEELING: Alum. Bar. 

Bry. Carbo veg. Caust. Chin. Dig. 

Graph. Ign. Ipec. Iod. Kali c. 

Kali bichr. Lye. Mur. ac. Natr. 

mur. N. vom. Petr. Phosph. Platin. 

Plumb. Rhus. Sep. Veratr. 
FLATULENCE, feeling of : Arnica. 

Ars. Croc. N. mosch. 
FULLNESS, feeling of: Aco. Alum. 

Arn. Asa f. Asar. Bar. Bov. Calc. 

Canth. Carb. veg. Cham. Chin. 

Cocc. Ferr. Hell. Iod. Kali c. Ign. 

Lach. Lye. Merc. N. vom. Opium. 

Petr. Phosphor. Puis. Rhus. Sa- 

bina. Sepiae. Silicea. Stann. Sulph. 

Sulph. ac. Valer. 
GRIPING : Caustic. Euphorb. 

Graph. Natr. carb. Phosph. Sil. 

Stann. 
HEAT: Aco. Ars. Camph. Canth. 

Cocc. Con. Digit. Euphorb. Mur. 

ac. Plumb. Phos. Sulph. 
INFLAMMATION: Aco. Ant. cr. 

Arsen. Bell. Bry. Canth. Chin. Cic. 

Colchic. Hyosc. Ipec. Nux vom. 

Phosph. Plumb. Puis. Sabad. Sec. 

cor. Stram. Veratr. 
MOVEMENTS : Cocc. Cupr. Iod. 
PINCHING: Argent. Arn. Asar. 

Bry. Canthar. Con. Croc. Dulcam. 

Hell. Nitr. ac. Rhus. Sep. Stann. 

Sulph. 
PRESSURE: Aeon. Agar. Ambr. 

Ant. crud. Arn. Anac. Asa foel. 

Asar. Ars. Bar. Bell. Bov. Bryon. 

Calc. Canth. Carb. v. Caust. Cham. 

Chin. Cic. Cocc. Coloc. Con. Crotal. 

Cupr. Dig. Ferr. Hell. Hep. Ign. 

Ipec. Iod. Kali c. Lye. Mercur. 



36 



STOMACH AND PIT OF STOMACH. 



Mur. ac. Natr. mur. Nux Yom. Op. 

Petr. Phosph. Ph. ac. Plat. Plumb. 

Puis. Rhus. Sabin. Sec. corn. Sep. 

Spigel. Spong. Staph. Stram. Sil. 

Stann. Sulph. Veratr. 
PEESSUEE AS EBOM A STONE : 

Aco. Alum. Am. Ars. Bar. Bmj. 

Calc. Carbo veget. Cham. Dig. 

Ferr. Kali c. Merc. N. vom. Op. 

Puis. Sepise. Sil. Staph. Sulph. 
BUMBLING: Arn. Arsen. Croc. 

Graph. Kali c. Natr. c. Phos. Ph. 

ac. Sep. Stann. Zinc. 
TEABING: Arn. Ars. Puis. 
WEAK DIGESTION: Bar. Bryon. 

Calc. Canth. Carbo an. Caust. Con. 

Chin. Cuprum. Dig. Graph. Hyosc. 

Ign. Lye. Merc. Natr. c. N. vom. 

Op. Petr. Phosph. Pulsat. Euta. 

Valer. Veratr. Zinc. 
WEENCHING: Arn. Calc. Carbo 

veg. Caust. Chin. Cocc. Lye. N. 

vom. Petr. Phosph. Puis. Sulph. 

Sulph. ac. 

2. Pit of Stomach. 

ANXIETY: Ars. Bry. Calcarea. 

Cann. Canth. Cham. Chin. Cic. 

Con. Ferr. Ign. Mercur. N. vom. 

Pulsat. Sab ad. Sabina. Sec. corn. 

Stram. Stann. Sulph. 
BUENING: Ambr. Ant. crudum. 

Arg. Ars. Bry. Caps. Cham. Kali 

bichro. Mancin. Merc. Natr. mur. 

Nux vom. Phosphor. Pyro carb. 

Sec. corn. Sep. Sil. Veratrum. 

Zinc. 
CONSTEICTION: Agar. Alumina. 

Asar. Calc. Carbo veg. Digit. Dros. 

Kali c. Merc. Natrum mur. Plat. 

Ehus. Sulph. Zinc. 
CEAMP: Hyosc. Kali c. Nitric ac. 

Phosph. 
CUTTING: Anac. Bellad. Bryon. 

Cann. Digit. Kali c. Mercur. Nitr. 

Phosphor. Sulphur. Yaler. 



DIGGING : Am. Chin. Cina. Kalic. 

Natr. mur. Phos. Sabad. Sulph. 
GNAWING: Glonoin. 
OPPEESSION: Ars. Ant. crudum. 

Bell. Bry. China. Cocc, Hyosc. 

Platina. Plumb. Ehus. Sec. corn. 

Staph. 
PEESSUEE: Aeon. Anac. Arn. Ars. 

Asar. Aur. Bar. Bellad. Bry. Caps. 

Carbo veget. Caust. Cham. China. 

Cocc. Cupr. Dig. Graphites. Hell. 

Hyosc. Ign. Ipec. Kali c. Lye. 

Merc. N. vom. Natrum mur. Petr. 

Phosph. Plat. Puis. Rhocl. Rhus. 

Sec. corn. Sep. Spig .[Stann. Staph. 

Sulphur. Yaler. Veratr. 
PULSATIONS : Asa f. Cann. Cic. 

Iod. Merc. Puis. Ehus. Thuj. 
SENSITIVENESS: Alumina. Arn. 

Bry. Camph. Canth. Carbo vege- 

tabilis. Cupr. Eerr. Hell. Hyosc 

Kali c. Natrum, c. Nux vom. Sec. 

cornut. Spong. Stann. Veratr. 
STITCHES: Aconit. Anac. Arn. 

Bar. Bell. Bryon. Calad. Canth. 

Caps. Chel. China. Cocc. Coff. 

Cupr. Dig. Dulc. Euphr. Graphit. 

Ign. Iodine. Ipec. Kali c. Natrum 

mur. Phosph. Plat. Plumb. Puis. 

Rhus. Sabin. Sep. Sil. Spig. Staph. 

Stann. Sulph. Zinc. 
SWEAT: BelL Nux vom. Secale 

corn. 
SWELLING-. Ars. Aur. Bellad. 

Bryon. Calc. Cham. Cic. Coff. Eerr. 

Hell. Kali c. Lye. N. vom. Natr. 

mur. Op. Sabina. 
THEOBBING : Arn. Ars. Asa f. 

Bell. Cann. Carbo veg. Cham. Cic 

Dros. Ferr. Ipec. Phos. Puis. 

Rhus. Sep. Sulph. 
TENSION : Aeon. Anac. Arsenic. 

Bry. Cham. Cocc. Dros. Dulc. Hep. 

Kali c Lycop. Mercur. Pulsat. 

Phosphor. Rheum. Sabin. Staphy- 

sag. Stann. Sulph. Veratr. 



XV. HYPOCHONDRIA. 



37 



(L. Signifies region of the liver; S. region 
of spleen; B. both sides .) 

BURNING : Aco. Alum. Bryon. 

Crotal. Ign. Mur. ac. Phosph. 

Phosph. ac. Plat. Secale corn. 

Sulph. 
— S.: Cann. Cliel. Graph. Ign. Seneg. 

Spig. 
— B.: Laur. Kali carb. Mercur. 

Sulph. 
CONSTRICTION, L: Aco. Asa f. 

Asar. Dros. Ign. 
DISTENTION, L: Am. Bryon. Lye. 

Merc. Sep. 
— S.: Merc. Natr. c. Nitr. ac. 
— B.: Calc. Cham. Ign. 
FLATULENCE : Cham. Chin. 

Colch. Ign. Xuxvom. Puis. Veratr. 
HARDNESS, L.: Arn. Bryon. Calc. 

Cann. Graph. Merc. Mur. magn. 
—5.: Iod. 
INFLAMMATION, L.: Aco. Bell. 

Bry. Canth. Cham. Cocc. Ignat. 

Merc. Hex vom. Puis. Sec. corn. 
— S.: Aeon. Ars. Dros. Ferr. IS. vom. 

Plumb. 
— B.: Aco. Canth. Nux vom. 
PRESSURE, L.: Aco. Ambr. Arn. 

Ars. Asa f. Bar. Calc. Carbo veg. 

Camphor. Chamom. Chin. Cocc. 

Con. Graph. Ign. Iodine. Kali c. 

Lycop. Merc. Mur. magn. Natr. 

mur. >*. vom. Petr. Phosph. Ruta. 

Sabad. Sabina. Sepise. Stann. 

Staph. Sulph. Veratr. Zinc. 
— S.: Alum. Arn. Asa f. Bell. Camph. 

Cann. Chin. Con. Ign. Lycop. 



Mur. ac. Natrum mur. Petr. Plat. 

Rheum. Rhodod. Rhus. Sassap. 

Sepise. Stann. Zinc. 
— B.: Aco. Alum. Am. Asaf. Camph. 

Caps. Cham. Chin. Cocc. Con. Ign % 

N. vom. Ph. ac. Rhodod. Sec. corn. 

Spong. Staph. Veratr. Zinc. 
STITCHES, L.: Aco. Agar. Alum. 

Arn. Asa f. Bell. Bov. Bry. Calc. 

Camph. Canth. Carbo veget. Caust. 

Chin. Cocc. Con. Dulc. Graphites. 

Hyosc. Ipec. Iod. Kali c. Laur. 

Lye. Merc. Mosch. Mur. ac. Natr. c. 

N. vom. Phosphor. Platina. 

Plumb. Psorin. Ehus. Sep. Sil. 

Sabad. Spig. Spong. Sulph. Zinc. 
— S.: Aco. Agar. Arn. Arsen. Aur. 

Bar. Bry. Caust. Chin. Glonoin. 

Hep. Ignat. Ipec. Mur. ac. Na- 
trum mur. Ph. ac. Plumb. Rhodod. 

Selen. Spig. Sil. Sulph. 
SWELLING, L.: Cann. China. N. 

mosch. 
— S.: Ign. N. mosch. Ruta. 
— B.: Aco. Alum. Arn. Arsenic. Bry. 

Canth. Chin. Ferr. Ipec. Phosph. 

Plumb. Pulsat. Sil. Spig. 
TENSION, L.: Ars. Brom. Bry. Calc. 

Carbo veg. Causticum. Ferr. Lye. 

N. vom. Sulph. Teratr. 
— S.: Camph. Con. Merc. Rhus. Zinc. 
— B.: Aco. Ant. crud. Asa f. Calc. 

Cham. Chin. Conium. Ferr. Hell. 

Lye. > T . Tom. Op. Puis. Staph. 

Teratr. 
WARMTH, f eeling of : Sabad. 



XVI. ABDOMEN. 



Sensations. 

ALIVE, as of something: Cann. 

Croc. Hyosc. Ign. 3Ierc. Plumb. 

Spong. Thuj. 
BALL, ascending: Aeon. Ignatia. 

Plumb. 



BLOATING: Aeon. Alum. Am- 
bra. Antim. crud. Arg. Arn. Ars. 
Asa f. Aur. Bar. Bell. Bry. Calc. 
Canth. Capsicum. Carbo an. Carbo 
vegetal). Caust. Cham. Chin. Cic. 
Cina. Cocc. Coloc. Con. Croc. Cupr. 



ABDOMEN. 



Dulc. Euphorbium. Euphr. Ferr. 

Graphit. Hell. Hep. Hijosc. Iod. 

Ign. Ipec. Kali c. Lachesis. Lye. 

Merc. Mur. ac. Natr. niur. N. vom. 

Op. Petr. Phosph. Phos. ac. Plati- 

na. Plumb. Pulsat. Rheum. Rhod. 

Rhus. Ruta. Sabina. Sec. cornut. 

Sep. Sil. Spigel. Spong. Stannum. 

Staph. Strain. Sulphur. Thuj. 

Yaler. Veratrum. Zinc. 
BOUNDING, as of something: 

Croc. 
BRUISING PAIN: Asa fast. Aur. 

Camph. Cann. Cina. Coccul. 

Coloc. Con. (Ferr.) Hell. Hep. s. c. 

Ign. Nux vom. Op. Phos. Pulsa- 
tilla. Samb. Sep. Staph. Stram. 

Snlph. Valet. Yerat. 
BURNING: Aco. Alum. (Ambr.) 

Arg. Am. Ars. Asa f. Bell. Bry. 

Camph. Canth. Caps. Carbo 

vegetab. Canst. CI tarn. Coccul. 

Coloc. Cuprum. Euphorb. Euphr. 

Graphites. Ipec. Kali c. Laches. 

Merc. N. vom. Phosph. acid. Plat. 

Plumb. (Puis.) Rhus. Sabad. 

Sabin. Sec. cornut. Sep. Sil. 

Spigelia. Spong. Stann. (Thuj.) 

Veratr. 
COLDNESS: Alum. Ambr. Ars. 

Kali c. Merc. Phos. Plumb. Ruta. 

Secale cornut. Sulphur. Zinc. 
CLOTHES TOO TIGHT, as if the: 

Nux vom. 
CRAMPY FEELING : Ambr. Arsen. 

Carbo veget. Coccul. Coloc. Con. 

Graph. Phosph. Ph. ac. 
COLIC: Aco. Alum. Am. Arson. 

Asa f. Aur. Bar. Bry. Camphora. 

Cann. Canth. Cham. Chin. Cocc. 

Coff. Coloc. Con. Cupr. Digit. 

Euphorb. Ferr. Hell. Hep. sulph. 

Hijosc. Ign. Iod. Kali c. Mur. ac. 

N. vom. Op. Plumbum. Puis. Ruta. 

Secale corn. Staph. Stram. Veratr. 
CONTRACTION: Arg. Aur. Bell. 



Calc. Carbo an. Carbo veget 

China. Coccul. Coloc. Con. Dig. 

Euphorbium. Ferr. Graph. Hep. 

sulph. Ignatia. Ipec. Kali c. Lach. 

Lycop. Nitric acid. N. vom. Petr. 

Phosphor. Ph. ac. Platina. Plumb. 

Rheum. Rhus. Sabad. Sabin. Sec. 

corn. Sep. Spig. Sulph. Thuj. 
CRAMPS: Alum. Ambr. Arsen. 

Aur. Bell. Bryon. Caustic. Chamom. 

Chin. Coccul. Coff. Con. Cupr. 

Digitalis. Euphorb. Ferr. Hep. 

sulph. Hyosc. Ign. Ipec. Iodine. 

Kali c. Mosch. Mur. ac. N. vom. 

Plumb. Pulsat. Rhus. Sec. corn. 

Spong. Stann. Staph. Stramon. 

Thuj. Valer. Veratr. 
CREEPING: Asa f. Carbo veget, 

Caust. Chin. Plat. Stann. Zinc. 
CUTTING: Alum. Ambr a. Ant. 

crud. Arg. Am. Ars. Asa f. Bar. 

(Bell.) Bryon. Calc. Camph. Canth. 

Carbo an. Carbo veg. Caust. Cham. 

Chin. Cina. Coccul. Coff. Coloc. 

Con. Croc. Cupr. Dig. Bros. Dulc. 

Graph. Hep. sulph. Hyosc. Ignat. 

Ipec. Iod. Lach. Lye. Merc. Mur. 

ac. Natr. mur. Nitr. ac. N. vom. 

Op. Petr. Phosph. Ph. ac. Plat. 

Plumb. Puis. Rheum. Rhus. Sabad. 

Sabin. Selen. Sepia?. Sil. Spig. 

Spong. Staph. Sulphur. Valer. 

Yerat. Zinc. 
DIGGING: Alum. Am. Ars. Asaf. 

Bell. Calc. Cina. Coloc. Con. Dig. 

Dulc. Graph. Kali c. Phosph. 

Phosph. ac. Rheum. Rhod. Rhus. 

Sabadilla. Sep. Spig. Spong. 

Stann. Valer. 
DRAWING: Aco. Ars. Asa feet. 

Bar. Bry. Calc. Camph. Cann. 

Caps. Carbo veget. Chamom. 

Chin. Cic. Coccul. Conium. Cupr. 

Dros. Graph. Hep. s. c. Hyosc. Ign. 

Iod. Lye. Nitrum ac. N. vom. Op. 

Plat. Plumb. Puis. Rheum. Rho- 

dod. Rhus. Ruta. Sabin. Sep. 



ABDOMEN. 



39 



Spig. Stann. Staph. Stramon. 

Thuj. Valer. Veratr. 
DROPSY: Aeon. Ambr. Arn. Ars. 

Bry. Camph. Canth. China. Dulc. 

Ferr. Hell. Kali c. Lye. Merc. 

Nux vom. Spong. 
DYSENTERIC PAIN : Am. Bry on. 

Rhus. 
EMPTY FEELING: Ant. cntdum. 

Arn. Carbo veg. Caust. Cham. 

Cina. Cocc. Coloc. Croc. Dulc. 

Euphorb. Kali c. Lach. Mere. Mur. 

ac. N. vom. Phosphor. Pulsat. 

Rhus. Sabad. Sep. Stann. Zinc. 
FLATULENCE, moving about : 

Ant. cruel. Bell. Bry. Cann. Canth. 

Caps. Carbo an. Caust. Chin. Cina. 

Coff. Croc. Dig. Euphorb. Hell. 

Hep. sulph. N. vom. Plat. Plumb. 

Pulsat. Sabad. Stann. Staph. 

Sulph. 
FULLNESS: Alum. Ant. crudum. 

Arn. Ars. Asa f. Aur. Bar. Calc. 

Camph. Cann. Canth. Cham. 

China. Cic. Cojfea. Coloc. Con. 

Croc. Dig. Ferr. Graph. Hell. 

Hyosc. Ignatia. Kali c. Lye. Mur. 

ac. Natrum mur. N. vom. Phosph. 

Phos. ac. Plat. Plumbum. Pulsat. 

Rheum. Rhod. Rhus. Sil. Spig. 

Spong. Stann. Sulphur. Thuj. 

Yaler. Zinc. 
GURGLING: Alum. Ambr. Asa f 

Carbo veg. Cham. Croc. Dig. 

Graph. Hell. Lye. Merc. Nux 

vom. Ph. ac. Plat. Plumbum. Sep. 

Stann. Yaler. Zinc. 
GRIPING: Aconit. Bell. Cham. 

Coloc. Con. Hep. s. Ipec. N. vom. 

Phosph. Pulsat. Sil. Stann. 
— colicky: Bry. Canth. Euphorb. 

Plumb. Ruta. Sil. 
HARDNESS: Alum. Ars. Belad. 

Calc. Caps. Caustic. Cham. China. 

Coloc. Con. Cupr. Ferr. Grapliit. 

Hep. sulph. Hyosc. Kali c. Merc. 



Phosph. flumb. Pals. Sec. corn. 

Sep. Sil. Sulphur. Yaler. Veratr. 
HEAT: Bellad. Bry on. Calcarea. 

Camph. Canth. Carb. an. Carbo 

veg. Cic. Cina. Digit. Euphorb. 

Graph. Ipec. Lye. Phosphor. 

Plumb. Ruta. Sil. Spong. Stann. 

Sulph. Zinc. 
HEAVINESS: Ambr. Asa f. Aur. 

Bell. Camph. Ferr. Graph. Hell. 

(Ipec.) Merc. N. vom. Op. Puis. 

Rhod. Rhus. Sec. corn. Sep. 

Staph. 
INACTIVITY: Champhor. Cham- 

om. Kali c. Nux vom. Op. Staph. 
INDURATIONS: China. Lycop. 

Plumb. 
INFLAMMATION: Aeon. Arsen. 

Bellad. Bryon. Canth. Cham. Chin. 

Cic. Ipec. N. vom. Phosph. Plumb. 

Puis. Rhus. Sabina. Spongia. 

Stram. Yeratr. 
LABORLIKE-PAIN: Aco. Asa. feet. 

Aur. Camph. Carbo vegetab. Cham. 

Cina. Coff. Cupr. Ferr. Hyoscyam. 

Ign. Ipec. Kali c. Nux voin. Op. 

Puis. Rhus. Sabina. Sec. corn. 
LARGE : Antim. crud. Calc. Caust. 

Coloc. Hep. sulph. Kali c. Sep. 

Staph. Thuj. 
LEAD-COLIC: Hyoscyamus. Op. 

Stram. 
MOVEMENTS, internal: Coloc. 

Croc. Cupr. Dig. Iod. Nux vom. 

Thuj. Valer. Veratr. 
NAUSEA : Bryon. Cic. Coccul. Croc. 

Cupr. Hell. Ipec. Rheum. Ruta. 

Samb. Silic. Stannum. Staph. 
PAIN, diarrhoeic: Ambr. Antim. 

crud. Arg. Asaf. Bar. Bellad. Bry. 

Calc. Canth. Carbo an. Carbo veg. 

Cham. Chin. Coff. Dig. Graph. 

Hell. Ign. Kali c. Merc. N. vom. 

Nitr. ac. Op. Petr. Phosph. Plat. 

Pulsat. Rhod. Rhus. Sabin. Sec. 

corn. Sep. Spigel. Staph. Vera- 

trum. Zinc. 



40 



ABDOMEN. 



—simple : Aco. Ant. crua. Arg. Ars. 

Bar. Bell. Bryon. Calc. Canth. 

Carbo veg. Causticum. Cham. 

China. Cic. Coloc. Con. Cupr. 

Dros. Euphorb. Euphr. Graphit. 

Hell. Htjosc. Ign. Ipec. Iod. Kalic. 

Lye. Merc. Nitr. ac. Nux yom. Op. 

Petr. Phosph. Plat. Plumb. Puis. 

Rheum. Rhus. Ruta. Samb. Sec. 

corn. Sep. Sil. Spig. Stann. Sul- 
phur. Yeratr. Zinc. 
PINCHING: Alum. Ant. cr. Ars. 

Asa f. Aur. Bar. Bell. Bry. Calc. 

Cann. Canth. Carb. v. Caust. 

Chamom. Chin. Cic. Cina. Cocc. 

Coloc. (Coff.) Croc. Cupr. Big. 

Bros. Bute. Euphr. Graph. Hell. 

Hep. Hyos. Ign. Ipec. Kali c. 

Lye. Merc. Mur. ac. Natr. mur. 

Nitr. ac. JV. vom. Petr. Phosph. 

Ph. ac. Plat. Plumb. Puis. Rheum. 

Rhus. Rut. Sabad. Samb. Sep. 

Silic. Spigel. Spong. Stann. Staph. 

Sulph. Valer. Yeratr. Zinc. 
PRESSUBE: Aeon. Alum. Ambr. 

Antim. crud. Arg. Am. Ars. Asa f . 

Aur. Bell. Bry. Calc. Camph. 

Caps. Carb. v. Chin. Cina. Cocc. 

Coff. Coloc. Con. Croc. Cupr. Dig. 

Ferr. Hep. Ign. Iod. Kali c. Lye. 

Merc. Mosch. Mur. ac. Nitr. ac. N. 

yom. Opium. Petr. Phosph. Plumb. 

Pulsatilla. Rheum. Rhus. Ruta. 

Sabad. Sabin. Samb. Sep. Sil. 

Spig. Staph. Yaler. Yeratr. Zinc. 
— outwards: Aeon. Asaf. Bell. Cann. 

Dulc. Kali carb. Lye. Mercur. Nitr. 

acid. Nux vom. Rheum. Thuj. 
— inwards: Bry. Bell. Rheum. Zinc. 
— as from a stone : Cupr. Hyosc. N. 

yom. Op. Puis. Sabad. 
PRESSING: Alum. Argent. Chin. 

Coff. Coloc. Euphr. Ign. Iod. Plat. 

Pulsat. Ruta. Sulph. Thuj. Valer. 

Zinc. 
PULSATION: Alum. Calc. Lycop. 

Merc. Zinc. 



QUALMISHNESS : Bar. Calc. Carb. 

veg. Ipec. Phosph. Plat. Rho- 

dodend. Spong. Yeratr. 
RING AROUND NAYEL, as if: 

Puis. 
SENSITIVENESS: Aconit. Am. 

Bry. Canth. Cham. Cic. Coff. Dulc. 

Mosch. Pulsat. Secale cornut. 

Stram. Yaler. Yeratr. 
SHOCKS: Am. Cannab. Platina, 

Stann. 
SORE PAIN: Aeon. Alum. Ars. 

Bar. Bellad. Calc. Carb. veg. China. 

Cic. Coloc. Con. Croc. Euphorb. 

Kali c. Natr. mur. Nux vom. 

Phosph. Sep. Stann. Sulph. Zinc. 
STITCHES : Alum. Ars. Asa f. Bell. 

Bryon. Calc. Cann. Canthar. Caps. 

Caust. Cham. China. Cina. Coccul. 

Con. Croc. Cupr. Dig. Ferr. Graph. 

Hell. Ign. (Ipec.) Kali carb. Merc. 

Nitr. ac. Nux vom. Phosph. Phosph. 

ac. Plumb. Puis. Rhodod. Ruta. 

Sabad. Sep. Spig. Stann. Staph. 

Sulphur. Thuj. Yeratr. Zinc. 
SWELLING: Aeon. Ant. crud. 

Ars. Bryon. Cann. Canth. Cham. 

Chin. Coloc. Con. Kali carb. Op. 

Plumb. Sec. corn. Sulph. 
TEARING: Alum. Am. Ars. Aur. 

Bry. Calc. Canth. Carb. an. Carb. 

veg. Caustic. Cham. Chin. Coccul. 

Coloc. Con. Big. Hell. (Ign.) Ipec 

Iod. Kali carb. Lye. Merc. N. vom. 

Phosph. Plumb. Pulsat. Rhus. 

Ruta. Samb. Sil. Spig. Stram. 

Thuj. Yeratr. Zinc. 
TENSION : Aeon. Alum. Ambr. Ant. 

crud. Am. Ars. Asa f. Bar. Bell. 

Calc. Caps. Carb. an. Car b. veg. 

Chin. Coloc. Graph. Hyosc. Ign. 

Iod. Lye. Nitr. ac. N. vom. Opium. 

Petr. Plat. Plumb. Pulsat. Rheum. 

Rhododend. Sec. com. Sep. Sil. 

Spong. Stann. Staph. Stram 

Sulph. Thuj. 



ABDOMEN. 



41 



TWITCHING: Aur. Canth. Caust. 

Chin. Coff. Con. Dig. Graph. Ign. 

Kali c. Phosph. Rhus. 
THROBBING: Am. Cann. Canth. 

Chin. Dulc. Ign. Kali c. Op. Plat. 

Selen. 
ULCERS: Cupr. Plumb. 
ULCERATIVE PAINS : Cann. 

Chin. Cocenl. Cupr. Dig. Hell. 

Merc. Nitr. ac. Rhus. Sabad. Sep. 

Stann. 
UNEASINESS: Calcar. Dulc. Eu- 

phorb. Ipec. Kali c. Nitr. ac. 

Phosph. Plat. Sabin. Sep. 
URGING : Asa f. Bell. Calc. Carb. 

veg. Coloc. Dig. Dulc. Graph. Ign. 

Iod. Kali carb. Phosph. Puis. Sep. 

Thuj. 
WARMTH: Canth. Caps. Cina. 

Coff. Iod. Ipec. N. vom. Phos. 

Sabin. Sec. corn. 
WEAK FEELING: Aeon. Carb. 

an. (Ferr.) Ign. Phosph. Platina. 

Rhodod. Sen. Stann. Zinc. 
WRITHING : Alum. Ars. Asa f. 

Bryon. Calc. Caps. Cina. Con. 

Dros. Dulc. Merc. Plat. Plumb. 

Rhus. Ruta. Sabad. Sabin. Silic. 

Staphys. Valer. Veratr. 

Region of the Abdomen. 

ABDOMEN, lower: Alum. Ambra. 
Ant. crud. Arg. Arn. Arsen. Asa f. 
Aur. Bar. Bell. Bry. Calc. Camph. 

Cann. Canth. Caps. Carbo an. 
Carb. veg. Caust. Cham. Chin. Cic. 
Cina. Coccul. Coff. Coloc. Con. 
Croc. Cupr. Dig. Dulc. Ferr. Hell. 
Hepar. Hyosc. Ign. Iod. Kali c. 
Lye. Merc. Natr. mur. Nitr. ac. 
>". vom. Phosph. Pit. ac. Plat. 
Plumb. Puis. Rheum. Rhod. Rhus. 
Ruta. Sabad. Sabin. Sambuc. Sep. 
Silic. Spigel. Spong. Stann. Staph. 
Sulph. Thuj. Valer. Veratr. Zinc. 
—sides of: Aconitum. Alum. Ambr. 

51 



Antim. crud. Arg. Arn. Ars. Asaf. 
Aur. Bar. Bell. Bry. Calc. Cam- 
phor. Cann. Canth. Caps. Carb. 
an. Carb. v. Caust. Cham. Chin. 
Cina. Coccul. Coff. Croc. Dig. Dros. 
Dulc. Euphorb. Ferr. Graphit. 
Hell. Hep. s. c. Hyosc. Ign. Ipec. 
Iod. Kali c. Lye. Mercur. Moschus. 
Natr. mur. Nitr. ac. N. vom. 
Opium. Petr. Phosph. Plat. Plumb. 
Puis. Rheum. Rhodod. Rhus. Ruta. 
Sabad. Samb. Sep. Sil. Spig. 
Spong. Stann. Staph. Sulph. Thuj. 
Valer. Zinc. 
EPIGASTRIUM: Aco. Ambr. Ant. 
crud. Arn. Ars. Asa f. Aur. Bar. 
Bell. Bry. Calc. Camph. Cann. 
Canth. Caps. Carbo veg. Caust. 
Chamom. China. Cina. Coccul. 
Coloc. Con. Croc. Cuprum. Dig. 
Dros. Dulc. Euphr. Hell. Hep. 
sulph. Hyosc. Ignat. Ipec. Iod. 
Kali c. Lycop. Mercur. Mosch. 
Mur. acid. Natr. mur. N. vom. Op. 
Petr. Phosph. Ph. ac. Plat. Plumb. 
Puis. Rhodod. Rhus. Sabad. Samb. 
Sep. Sil. Spig. Spong. Stannum. 
Staph. Sulph. Thuj. Valer. Yeratr. 
Zinc. 

LUMBAR REGION: Aeon. Ambr. 
Ant. crud. Arg. Arn. Aurum. 
Asa f. Calc. Cann. Canth. Carbo 
an. Carbo veg. Cham. China. Cina. 
Coccul. Coloc. Dig. Euphorb. Ign. 
Iod. Kali^c. Lye. Merc. Nitr. ac. 
Nux vom. Plumb. Pulsatilla. 
Rheum. Rhus. Ruta. Sab. Sec. 
corn. Sep. Spig. Spongia. Staph. 
Sulph. Thuj. Valer. Zinc. 

UMBILICAL REGION : Aco. Alum. 
Ambr. Ant. crud. Arn. Asa f. Bar. 
Bell. Bry. Calc. Cann. Canth. 
Caps. Carbo an. Carbo veg. 
Causticum. Cham. Chin. Cina. 
Coccul. Coloc. Con. Dig. Dulcam. 
Graph. Hep. sulph. Hyosc. Ignat. 



42 



CATARRH. 



Ipec. Tod. Kali carb. Merc. Moscli. 
Mur. acid. Nux vom. Op. Phosph. 
Ph. ac. Platina. Plumb. Pulsat. 
Rheum. Rhod. Rhus. Buta. 



Sabina. Sep. Sil. Spigel. Spongia 
Stann. Staph. Sulph. Tliuj. Valer 
Veratr. Zinc. 



XVII. CATARRH. 



Sensations. 

CATARRH: Alum. Ambr. Antim. 

crud. Arg. Asa f. Ars. Bar. Bell. 

Bry. Calc. Camphor. Canth. Caps. 

Carbo vegetab. Caust. Chin. Cina. 

Coccul. Coloc. Cupr. Bros. 

Euphorb. Euphr. Graphit. Hell. 

Ign. Iod. Kali c. Lack. Lye. Merc. 

N. vom. Natrum mur. Nitric acid. 

Petr. Phosphor. Ph. ac. Plat. 

Plumb. Puis. Rhod. Rhus. Selen. 

Sep. Sil. Spig. Spong. Stannum. 

Staph. Sulph. Thuj. Veratrum. 

Zinc. 
— on one side : N. vom. Puis. 
— alternately fluent and stopped : Nux 

vom. Puis. 
— in the day time : N. vom. 
CATARRH, generally : Aeon. Am. 

Camph. Coccul. N. vom. Puis- 

Sabad. 
CATARRHAL FEVER: Aeon. 

Bellad. Bryon. Camph. Cham. Coff. 

Graph. Hep. s. Mercur. Nitric ac. 

N. vom. Rhus. Sabad. Sep. Spig. 
CATARRHAL DISCHARGE DE- 
LAYED : Calc. 
CATARRHAL PEELING: Ambr. 

Ant. crud. Arg. Bry. Cann. Carbo 

an. Carbo veg. Cic. Coff. Ign. Ipec. 

Merc. Mur. ac. Nitr. ac. Phosph. 

Sabin. Thuj. 
CORYZA : Aeon. Alum. Ambr. Ars. 

Bar. Bellad. Bry. Calc. Camphor. 

Cann. Capsicum. Carb. an. Carb. 

veg. Caust. Cham. China. Coff. 

Con. Cupr. Dig. Dulc. Graphites. 



Hep. sulph. Ign. Ipec. Kali c. Lye. 

Mosch. Mur. ac. Natr. mur. Nitr. 

ac. N. vom. Op. Petr. Phosph. 

Plat. Pulsat. Rhod. Sabin. Samb. 

Sep. Sil. Spig. Spong. Stannum. 

Sulph. Thuj. Zinc. 
— on side : Nux vom. 
— of infants : Samb. 
— evening and morning : Nux vom. 
DRY NOSE: Ambr. Bar. Bellad. 

Bry. Calc. Canth. Cic. Con. Dulc. 

Graph. Hyosc. Ignat. Ipec. Lye. 

Merc. Mur. acid. Natr. mur. Nitr. 

ac. (Nux vom.) Petr. Phosph. Rhod. 

Sep. Sil. Spig. Sulphur. Veratr 

Zinc. 
DRY NOSE, without being stopped: 

Sep. 
— upper nostrils : Sabad. 
— front nostrils : Spig. 
MUCUS FROM THE NOSE, dis- 
charge of: Cham. Euphorb. Phos. 

Rhod. 
— arrest of discharge : Euphorb. Ph. 

ac. Bhod. 
NASAL MUCUS FROM THE 

POSTER. NARES, corrosive. 

Ars. Nux vom. Nitr. ac. Sil. 
— smarting: Ars. Sulph. 

without catarrh : iihus. Sabad 

Selen. Spig. 

involuntary : Bhus. 

— bloody: Ambra. Bar. Canth. Caps. 

Caust. (Coccul.) Cupr. Graph. 

Kali c. Lach. Lycop. Merc. Natr. 

mur. Nitrum ac. N. vom. Petr. 

Phosph. Ph. ac. Puis. Sabad. Sep. 

Sil. Spig. Sulph. Thuj. 



CATARRH. 



43 



.—burning: Arsen. Pnlsat. Snlph. 
— thick : Alum. Ant. crud. Bar. Calc. 

Graph. Mur. ac. Natr. miir. Nitr. 

ac. Puis. Sabad. Selen. Staph. 

Sulph. 
— thiu : Campli. Capsic. Elms. Staph. 
— transparent: Sabad. 
— purulent: Calc. Cina. Con. Graph. 
Lack. Merc. Puis. 

and yellow : Calc. Cicuta. Con. 

Sulph. 
— gelatinous: Selen. 
— yellow: Cic. Puis. Selen. 
— yellow-green : Natr. Pkosph. Puis. 
Sabad. 

and bloody : Sep. 

— yellowish: Alum. Ant. crud. Bar. 

Bell. Graph. Nitr. ac. Puis. Spig. 

and watery : Sep. 

— greenish : Puis. Spig. 
— clear: Sabad. 
— in little lumps : Selen. 
— acrid : N. vom. Spig. 

pus : Merc. 

— —water : Ars. Lach. Lycop. Mur. 

ac. N. vom. Sil. 
— odor of catarrh : Puis. 
— suppressed: Spong. 
— fetid : Bellad. Calc. Caustic. Graphit. 

Hep. s. Lye. Mercur. Nitr. ac. 

Puis. Sep. 
— indurated: Bryon. Lach. Sep. 

Staph. 
— increased: Arg. Bar. Calcar. 

Canth. Carbo veg. Cic. Cina. Coff. 

Con. Euphr. Graph. loci. Lach. 

Mur. ac. Nux vom. Petr. Phospli. 

Plat, niiocl. Rhus. Sabad. Scill. 

Selen. Sil. Zinc. 
— watery: Alum. Bellad. Carbo an. 

China. Coff. Con. Graphit. Ign. 

Iod. Lach. Mercur. Mur. ac. N. 

vom. Phosphor. Plumb. Ehus. 

Staph. Sulph. 
— white : Spig. 
— tenacious: Alumina. Canthar. 

Graph. Sabad. Sep. Spig. 



SNEEZING: Alum. Ambr. Ant. 

crud. Arg. Arn. Ars. Asa f. Bar. 

Bellad. Bov. Bry. Calc. Cann. 

Canth. Carbo animahs. Carbo veg. 

Caust. Chin. Cina. Coccul. Con. 

Croc. Dros. Dulc. Euphorb. 

Euphr. Graph. Hell. Hep. sulph. 

Iod. Ipec. Kali c. Lach. Lye. Merc. 

Mosch. Mur. ac. Natr. mur. Nitric 

acid. N. vom. Petr. Phosph. Rhod. 

Rhus. Euta. Sabad. Sepise. Sil. 

Spig el. Spong. Slannum. Staph. 

Sulph. Thuj. Veratr. Zinc. 
— troublesome: Phosph. Sulph. 
— racking: Sabad. 
— violent : Aconit. Bar. Capsic. Chin. 

Merc. Rhus. Sabad. 
— vehement: Cina. Puis. Rhus. 

Sabad. Yaler. Veratr. 
— spasmodic: Rhus. 
— after tingling in nose : Ambr. Car- 
bo veget. Dros. Mur. acid. Nitr. ac. 

Puis. Spig. Zinc. 
— painful : Aeon. Dros. 
— without catarrh : Alum. Ars. Calc. 

Carbo veg. Caust. Cic. Con. Dros. 

Euphorb. Hyosc. Iod. Lijc. Mer- 
cur. Nitric acid. Phosph. Stann. 

Staph. Zinc. 
— dry: Chin. 

— excessive : Bry. Merc. Sil. 
— suppressed : Aconitum. Alum. 

Carbo veg. Caust. Cocc. Natr. mur. 

Plumb. Sil. Zinc. 
— desire for : Ambr a. Carbo veg. Mur. 

ac. Phos. Sil. Sulph. Zinc. 

ineffectual : Canth. Carbo veg. 

Caust. Euphorb. Hell. Lye. 
Phosph. Plat. Plumb. Sil 
SNIFFLING: Sep. 
STOPPAGE OF NOSE: Alum. 

Ambra. Ant. crud. Arg. Aur. Bar. 

Bell. Br ij. Calcarea. Carbo veg. 

Caustic. Cham. Chin. Cic. Cina. 

Con. Digit. Graph. (Ign.) Iod. 

Kali c. Lach. Lye. Merc. Mosch. 

Natr. mur. Nitr. ac. N. vom. Op. 



u 



CATARRH. 



Petr. Phosph. Plumbum. Puis. 

Ehocl. (Khus.) Sanib. Sep. Sil. Spig. 

Stann. (Staph.) Strain. Sulph. 

Thuj. Zinc. 
— behind: Staph. 
— in front : Arg. Spig. 
— in one nostril: Ignat. Sabad. 

Staph. 
— as from a leaf high up: Ignat. 

Mur. ac. 
— f eeling of : Plumb. Stram. 
— by ulceration every night: Lycop. 

Accompanying Ailments. 

ABDOMEN, burning on: Carb. v. 
— rumbling in : Phosph. 
— stitches in : Carb. veg. 
BACK-ACHE : Kali carb. 
CHEEKS, redness of one half: 

Cham. N. vom. 
STUPEFACTION: Hell. 
CHEST, simple jDain in: Aconit. 

Bry. Caust. 
— roughness : Carb. veg. Sulph. 
— stitches: Merc. 
— pain, as if flying to pieces: Cina. 

Sil. 
— constriction of : Phosph. 
CHILLINESS : Caust. Graph. 

Sulph. 
— and heat altern. : Graph. 
COLIC: Calc. 
— aching: Aeon. Canth. 
COUGH: Bell. Cupr. Nitr. ac. N. 

vom. Sulph. 
— desire to, in throat: Petr. Sep. 

Sulph. 
DIABEHCEA: Sep. 
DBA WING IN THE AEMS: Sep. 
DBY LABYNX: N. vom. 
DKY MOUTH: N. vom. 
DBOWSINESS: Cham. N. vom. 

Petr. 
DULL FEELING IN HEAD: 

Cham: Hell 
DYSPNCEA: Sep. 
EABS, buzzing in the : Bhodod. Sep. 



— pains in the : Arn. Lach. Puis. 

EYES, pain in the: Sep. 

— red: Yeratr. 

— weeping: Alum. Carlo veget. Chin. 

Euphr. N. vom. Staphys. Veratr. 
— lids, red: Sabad. 
— closed by gmn : Caust. 
— smarting in the corners of : Carb. 

veg. 
FACE, bloated: N. vom. Staph. 
— hot : N. vom. Bhodod. 
FEVEB CHILL: Bry. Caps. Cha- 

mom. N. vom. Puis. Spong. 
— heat: Spig. 
HEAD, burning in : Calc. Hell. Lye. 

N. vom. Phosph. 
— simple pain in: Aeon. Byron. 

Calc. Caust. Chin. Cic. Cina. 

Euphr. Graph. Hell. Kalic. Lach. 

Lye. Nitr. ac. N. vom. Phosph. 

Puis. Bhodod. Sep. Spig. Thuj. 
— stitches: Sabad. 
— cloudiness: Staph. 
— contraction: Sabad. 
—dull: Chin. Dulc. Euphr. Hell. 

Lye. Phosph. Bhodod. 
HOABSENESS: Ars. Caust. Kali 

carb. Nitr. ac. N. vom. Puis. Spig. 
HOT HANDS AND FEET : N. vom. 
— at night : Lye. 
LANGUOB: Graph. Sep. 
LIMBS, pains in the: Calc. Caust. 

Ipec. 
— distortion of : Phosph. 
LIPS, corrosive: Cairn. 
— chapped: Chamom. Hell. Staph. 
— itching: Hell. 
LOSS, of appetite: Phosph. 
— of smell: Arn. Cina. Coccul. Hell. 

N. vom. Puis. Bhod. Sabad. Spig. 

Staph. 
— of taste: Puis. Sabad. 
NAUSEA: Graph. 
NOSE, sensitive: Calcar. China. 

N. vom. 
— burning: (Arn.) Puis. 
— inflammation : Lycop. Merc. Stann, 



BREATHING, RESPIRATION. 



45 



— biting in the : Carb. veg. Eupkorb. 

— ulceration : Cham. 

— swelling: Brij. Cham. Puis. Ehus. 

Spig. 
— heat : N. vom. 
— itching : Nux vom. Sabad. Spig. 

under the nose : Hell. 

— titillation : Capsic. Carb. veg. Nux 

vom. Puis. Sabad. Sep. Staph. 
— scraping : N. vom. 
— soreness: Lack. Nux voin. Puis. 

Spig. 
— sore pain: China. Nitr. acid. N. 

vom. Staph. 
NOSTRILS, ulcerated: Biy. Calc. 

Coccul. Ign. Lye. Merc. Petr. Puis. 
PHOTOPHOBIA: Puis. 
SICK FEELING ALL OVER: 

Phosph. 



SLEEPLESSNESS: Ars. 
SUBMAXILLARY GLAND, pains 

in the : Graph. 
THIGHS, drawing in the: Sep. 
THIRST : Cham. Graph. Lye. 
THROAT, inflamed : Phosph. 
— creeping in : Kali c. 
— simple pain in : Nux vom. 
— feeling of roughness : N. vom. Nitr. 

ac. Phosph. Rhodod. 
THROAT, stitches in : Nitr. ac. 
— scraping in : N. vom. 
— mucus in : N. vom. 
TOOTH-ACHE : Chin. Lach. 
UPPER' LLP, inflamed : Lye. 
URINE, flow of : Veratr. 
VERTIGO : Chin. N. vom. 
WHINING MOOD : Puis. Spig. 
YAWNING: Bry. Cupr. Hell. 



XVIII. BREATHING, RESPIRATION. 



Sensations. 
ASTHMA: Aco. Ant. cruel. Am. 

Ars. Asa f. Aur. Bell. Bry. Calc. 

Capsic Carb. anim. Carb. veg. 

Cham. Chin. Cic. Cina. Coccul. 

Coloc. Con. Cupr. Dig. Dros. 

Euphorb. Euphras. Ferr. Graphit. 

Hyosc. Ignat. Ipec. Iod. Kali c. 

Lye. Merc. Mur. ac. Natr. mur. 

Nitr. ac. Nux vom. Op. Petr. 

Phosph. Plat. Plumb. Puis. 

Rheum. Rhod. Buta. Sabin. Sec. 

cor. Sep. Sil.Spic.|( Spong.) Stann. 

Staph. Sulph. Thuj. Veratr. Zinc. 
— spasmodic : Aconitum. Ambr. 

Caust. Cham. Chin. Coffea. Cupr. 

Ferr. Ipec. Kali c. Mosch. N. vom. 

Op. Puis. Samb. Veratr. 
BREATHING, moaning: Ipecac. 

(See also : groaning.) 
— Anxious: Aeon. Am. Ars. Belliid. 

Bryo. Camph. Cham. CofF. Ferr. 



Hep. s. Ign. Ipec. N. vom. Op. 

Phosph. Plat. Plumb. Puis. Rhus. 

Samb. Secale corn. Spig. Spong. 

Staph. Strain. Thuj. 
—intermittent: Camph. Op. 
— wheezing: Cham. China. Nitr. ac. 
— noisy: Aeon. Chin. 
— hurried: Ipec. Samb. 
— labored: Aco. Ign. Spong. 
—hot: Aco. Ant. crud. Bry. Brom. 

Cham. Coffea. Ferr. Natrum mur. 

Platina. Rhus. Sabad. Sulph. 
— cold : (Carbo vegetab.) Chin. Rhus. 
— cooling in trachea: Arn. 
— panting : Arn. Camph. Cupr. Ipec. 

Nitr. ac. Op. Phosph. Sil. Spong. 

Stann. 
— small: Bell. 
— spasmodic: Puis. 
— slow: Aconit. Camph. China. Cic. 

Hyosc. Ign. Nux vom. Op. 

Spong. Staph. 



46 



BBEATHING, BESPIBATION. 



— loud: Aco. Cina. Op. Veratr 
— low: Ign. 

— deficient : Bell. Camph. Can- 
tharis. Caustic. Cic. Coccul. Dig. 
Ferr. Hell. Ign. Ipec. Iod. Merc. 
Nux vom. Platina. Puis. Bhus. 
Spig. Spong. Stann. Staph. Yeratr. 
— faint: Chin. Nitr. ac. Opium. 

Phosph. Veratr. 
— wheezing: Calc. 

— piping: Alum. Ambra. Cann. 
Cham. China. Cina. Cocc. Coloc. 
Hep. sulph. Iod. Kalic. Lye. Natr. 
mur. Nux vom. Phosph. Plumbum. 
t Sabad. Samb. Sep. Spong. Sulph. 
— having an odor: Ars. Aur. Natrum 
mur. Nitr. acid. Petr. 

pungent : Dros. 

foul: Aru. Arsen. Aur. Bry. 

Cham. Chin. Graph. Iod. Nitr. 
ac. Puis. Buta. Sabin. Sep. Spig. 

like milk : Spong. 

sour : (Cham.) Nux vom. 

like sulphur : Nux vom. 

fetid: Aco. Anibr. Arn. Aur. 

Bar. Bellad. Bryo. Camph. 
Canth. Caps. Carbo animal. 
Carbo vegetab. Cham. Chin. Croc. 
Ferr. Graph. Hyosc. Ign. Ipec. 
Kali c. Merc. N. vom. Petr. 
Plumb. Puis. Bheum. Sep. Spig. 
Stann. Stram. Sulph. Zinc. 
BBEATHING, short : Aeon. Alum. 
Arn. Ars. Asa f. Aur. Bar. Bell. 
Bry. Calc. Camph. Cann. Canth. 
Carbo veg. Caust. Cham. Chin. 
Cic. Cina. Coccul. Coffea. Coloc. 
Con. Cupr. Digit. Euphorb. Eu- 
phrasia. Ferr. Hepar. sulph. 
Hyosc. Ign. Ipec. Kali carb. 
Lycop. Merc. Natr. mur. Nitr. ac. 
N. vom. Op. Petr. Phosph. Plat. 
Plumbum. Puis. Bhod. Rhus. 
Ruta. Sabad. Sabina. Samb. Sec. 
corn. Sep. Sil. Spig. Spong. Stann. 
Stram. Sulph. Yeratr. Zinc; 



— heavy: Aco. Alumina. Arg. Arn. 

Ars. Asa f. Aur. Bar. Bell. Bry. 

Calc. Camph. Cann. Canth. Caps. 

Carb. veg. Caust. Chin. Cic. Cina. 

Coccul. Con. Croc. Cupr. Dig. 

Dros. Euphr. Ferr. Graph. 

Hell. Hep. s. Hyosc. Iodine. Kali c. 

Lye. Merc. Nux vom. Op. Phosph. 

Ph. ac. Plat. Plumb. Pulsat. 

Bhod. Rhus. Sabad. Sec. corn. 

Selen. Sep. Sil. Spig. Spong. 

Stann. Staphysag. Stram. Sulph. 

Thuj. Yaler. Veratr. 
— deep: Ant. crud. Arn. Aurum. 

Bell. Bry. Camph. Ca,nn. Caps. 

Cham. Chin. Cic. Dig. Dros. Hell. 

Hep. sulph. Ign. Ipec. Kali c. Merc. 

Mosch. Mur. ac. N. vom. Op. Phos. 

Plat. Plumbum. Bhus. Selen. (Sil.) 

Spong. Stann. 
— disposed to draw along: Croc. 

Cupr. Hell. Lach. Mosch. Bhus. 

Sabin. Selen. Stram. 
BKEATH, stoppage of: Asa foet. 

Bell. China. Cic. Coff. Dros. 

Mosch. Opium. Pulsat. Buta. Zinc. 
— incarceration of: Aco. Arn. Bar. 

Bellad. Bryon. Calc. Camph. Cann. 

Canth. Capsic. Carbo an. Cina. 

Cocc. Croc. Cupr. Dros. Euphr. 

Ipec. Kali carb. Mosch. Natr. mur. 

Nitric ac. Op. Phosph. Plat. 

Plumb. Puis. Bhus. Ruta. Sabin. 

Sep. Sil. Spig. Spong. Staphys. 

Stram. Sulphur. Veratr. 
BBEATHING, oppressed: Aconit. 

Alum. Ambr. Ant. crudum. Arg. 

Arn. Ars. Asa f. Aur. Bar. Bellad. 

Bryon. Calc. Camph. Cann. Canth. 

Caps. Carbo an. Carb. veg. Caust. 

Cham. Chin. Cina. Coccul. Coff. 

Coloc. Con. Croc. Cupr. Digitalis. 

Dros. Dulc. Ferr. Graph. Hell. 

Hep. sulph. Hyosc. Ignatia. Ipec. 

Iod. Kali c. Lycop. Merc. Mosch. 

Mur. ac. Natr. mur. Nitric ac. N. 

vom. Op. Petr. Phosph. Phos. ac. 



BREATHING, RESPIRATION. 



47 



Plat. Plumo. Puis. (Rheum.) 

Ehod. Ehus. Euia. Sabad. Sabina. 

Samb. Sec. com. Sepia) Sil. Spig". 

Stann. Staph. Stram. Sulph. Thuj. 

Yaler. Veratr. Zinc. 
EXPIRATION, blowing: Chin. 
— slow: (Arnica.) Camphora. Cham. 

Chin. Hell. Ign. 
— quick: Chin. Ign. Stram. 
— sniffling: Rhus. 
— difficult: Ipcc. 
— strong: Caps. Chin. 
INSPIRATION, slow: Ferr. Ignat. 

Op. Staph. Stram. 
— stertorous : Nux vomica. Op. Puis. 

Bhenm. 
— quick: (Arnica.) (Camphora.) 

Cham. Ign. 
— difficult : Chin. Cina. Coccul. Ferr. 

Ign. Staph. Veratr. 
— like urine : Graph. 
— rattling: Aeon. Am. Bell. Bry. 

Calc Cann. Carbo an. Caust. 

Cham. Chin. Cina. Croc. Cupr. 

Ferr. Hyosc. Ipec. Lye. Op. Petr. 

Samb. Sepias. Spong. Stannuin. 

Stram. 
— hiccuping: Asa f. Op. Sec. corn. 
— stertorous : Bellad. Cham. Chin. 

Coccul. Cupr. Hep. sulph. Ign. 

Kali c. Natr. mur. Nitric acid. Nux 

vom. Op. Petr. Sep. Stannum. 

Stram. Sulph. 
— painful: Aeon. Am. Arsenic. Bry. 

Chin. 
— quick: Aeon. Asa f. Bell. Bry on. 

Cupr. Dig. Hell. Hep. s. Ign. Ipee. 

N. vom. Op. Samb. Secale cornut. 

Spon£. Stram. Veratr. 
— sniffling: Arn. China. Nux vom. 

Rhus. Sabin. 
— sigliing: Ant. crud. Capsicum. 

Chin. Coccul. Op. Secale corn. 

Selen. Stram. 
EXPIRATION, groaning: Bell. Bry. 

Cham. Cina. Coccul. Cupr. Ign. 



Kali c. Mur. ac. Nux vom. Op. Sec. 

corn. Strain. 
— inequal: Coccul. Ignat. Ipec. Op. 

Sec. corn. 
— imperceptible : Yeratr. 
— irregular : Bell. 
— interrupted: Aeon. Cham. Cic. 

Cina. Cupr. Ignat. Op. Puis. 

Phosph. 
— suppressed : Cupr. 
SUFFOCATING FITS: Aeon. Ant. 

crud. Ars. Bell. Bryon. Camph. 

Cann. Causticum. Cham. Chin. 

Coccul. CofT. Con. Cupr. Digit. 

Hep. sulph. Hyosc. Ignat. Ipec. 

Lach. Mosch. Nux vom. Op. Plat. 

Plumb. Puis. Rhus. Sabad. Samb. 

Sec. corn. Spong. Staph. Sulph. 

Yeratr. 

Causes of the Impeded 
Respiration. 

ABDOMEN, flatulence: Capsic. 

Cham. Ign. 
— unpleasant feel : Ars. 
— simple pain : Arn. Bry. Ign. Ruta- 
— swelling : Dry. 
— pinching: Rhus. Spig. 
— cutting: Puis. 
— weight like a stone: N. vom. 
— stitches: Croc. Dros. Mosch. Nux 

vom. Puis. Ruta. 
— fullness: Cann. Caps. Cham. Chin. 

Phosph. 
— compression : Staph. 
— crying: Cupr. Rhus. Samb. 
— simple pain in : Stannum. 
— jerks in : Calc. 
ANXIETY: Aco. Arnica. Croc. N. 

voin. Puis. Rhus. Euta. Yaler. 

Yeratr. 
— fits of: Ars. Lye. Stann. 
ARMS ABOVE THE HEAD, rais- 
ing the: Cupr. 
BACK-ACHE: Arg. Cann. Lsch. 

Ruta. Sop. (Staph.) 
— dislocation-pain in : Petr. 



48 



BREATHING, RESPIRATION. 



— simple pain in : Puis. Selen. 
— stitches in : Nux vom. Puis 
BLADDER, stitches in : Aur. 
BREATHING, nasal: Puis. 
CHAGRIN: Ars. Cham. 
CHEST, oppression in : Aconit. Am. 

Cann. Cic. Cin. Coccul. Coff. Dros. 

Ign. Merc. N. vom. Puis. Rhus. 

Sabad. Spigel. Veratr. 
-pressure in the : Argent. Arn. Asaf. 

Bellad. Camph. Cann. Caust. Cham. 

Chin. Cic. Ign. N. vom. Rheum. 

Ruta. Sabad. Samb. Spig. Staph. 

Stram. Valer. 
— spasm in the : Petr. 
— empty feeling : Stann. 
— faintness in the : Stann. 
— heaviness in the: Plat. 
— tension in the : Merc. Mur. ac. 
— stitches in the: Aur. Carbo veg. 

Merc. Stann. 
— fullness in the : Sep. 
— contraction in the: Sep. 
— as if oppressed by a load : Rheum. 

Sabad. Spig. 
— ulcerative pain : Staph. 
— throbbing in : Asa f. 
— spasms in : Asa f oet. Cupr. Plumb. 
— pressing in : Ign. Veratr. 
— mucus in : Cina. 
— pain generally : Selen. 
— weight in : Cann. Ign. Rhus. 
— tension in : Cann. Cic. Coccul. Puis. 

Rhus. Staph. 
— stitches in: Aeon. Arg. Asaf. Bry- 

on. Canth. Caps. Chin. Dros. Plumb. 

Ruta. Spig. Staph. Veratr. 
— shocks in : Cann. 
— fullness in : Aeon. Ant. cr. Cans. 

Puis. Ruta. Veratr. 
— as if bruised : N. vom. 
—drawing in : N. vom. 
— contraction in : Arn. Asa f. Can- 

thar. Capsic. Chin. Coccul. Cupr. 

Hell. Ipec. Moschus. N. vom. Op. 

Spig. Staph. Veratr. 
COUGH; Ars. Bry. Coccul. Cuprum. 



Dros. N. vom. Petr. Rhus. Sil. 

Spig. Veratr. 
— dry: Cupr. Ipec. N. vom. Rhus. 

Sep.. 
CRAMP, in left side: Merc. 
DREAMS, anxious; Graph. 
— as from dust : Ipec. 
EPIGASTRIUM, pain in: Arsenic. 

Coccul. Hell. Pulsat. Sep. Staph. 
FLATULENCE: Cham. Nux vom. 

Puis. 
HEAD, dull: Sep. 
— ache: Arn. 
HEART, stitches in the : Cham. Petr. 

(Puis.) 
— region of, pain in the: N. vom. 

(Puis.) 
HYPOCHONDRIA, swelling in: 

Cham. Ign. 
— pain in: Chin. Puis. Staph. 
LARYNX, mucus in : Clan. Cupr. 
— contraction: Sabad. Spong". 
LIVER, pain in : Sep. 
LUNGS, weak: Stann. 
MORTIFICATION: Ign. Staph. 
NAPE OF NECK, drawing and 

stinging in : Sep. 
NAUSEA: Rhus. Samb. 
NOSE, dry: Canth. 
ODORS, strong: Phosph. 
PALPITATION OF HEART : Spig 
RECTUM, stitches in : Sulph. 
RIBS, pains under the : Sep. 
RISING, from abdomen : Valer. 
SCAPULiE, pressure in: Rhus. 
— pressure when leaning against: Sep. 
— stitches: Puis. Sep. 
— dislocation-pain : Petr. 
— drawing : Rhus. Ruta. 
STITCHES IN RIGHT SIDE: 

Graph. 
SPLEEN, pain in : Ruta. 
— stitches in: Arn. 
STOMACH, anxiety in pit of : Can- 
nab. Ferr. Sabad. Stram. 
— pressure in pit of: Arn. Bry. 

Camph. Chamom. Chin. Cic. Coc- 



COUGH. 



49 



oil. Helleb. Hyosc. Ignat. Mosch. 

Nux voni. Rhus. Samb. 
— crauip iu pit of: Sulpli. 
— simple pain in pit of : Arnic. Cina. 

Helleb. N. vom. Pulsat. Euta. 

Sabad. 
— feeling as if swollen in pit of : Rhus. 
— stitches in pit of: Chin. Phosph. 

Splg. 
— warmth in ditto : Biy. 
— digging in ditto: Chin. 
— griping: Phosph. 
— pain in : Caps. Cham. Rhus. 
— fullness in : Chin. Coccul. 
LIKE VAPORS OF SULPHUR: 

Croc. Mosch. 



TRACHEA, obstacle in: Cannab. 

Spong. 
— tickling: Rhus. 

— mucus in : Cupr. Ruta. Veratrum. 
— contraction of : Canth. Ipec. Puis. 
THROAT, as if larger: Veratr. 
— scraping in : Sabad. 
— like a plug : Spong. 
— constriction: Canth. N. vom. Puis* 

Veratr. 
— rising in: Cann. Stann. 
— like a foreign body in : Cic. 
— mucus in : Aur. 
— dryness: Petr. 
— constriction : Cham. Coccul. 
THROAT-PIT, constriction in : 

Rhus. 



XIX. COUGH. 



Character of the Cough. 

COUGH, in general: Aco. Ambr. 

Bell. Calc. Cann. Cantharis. Caps. 

Carbo an. Carbo veget. Causticum. 

Cham. Chin. Cina. Coccul. Coloc. 

Con. Digital. Dros. Ferr. Euphorb. 

Graphites. Hep. s. Ignat. Iod. Ipec. 

Kali c. Lye. Mercur. Mur. ac. Natr. 

mur. Nitric ac. Op. Petr. Phosph. 

Phos. ac. Plumb. Puis. Rhus. Ruta. 

Sabin. Sep. Sil. Spig. Spong. 

Staph. Sulph. 
— with expectoration: Ambr. Ant. 

crud. Arg. (Arn.) Ars. Asa f. Bell. 

Bry. Calc. Carbo veg. Caust. Cham. 

China. Cic. Cina. Con. (Croc.) Dros. 

Euphorbium. Euphr. Ferr. Graph. 

Hepar s. Ipec. Kali c. Lye. Merc. 

N. vom. Xatrum mur. Petr. Phosph. 

Ph. ae. Plumbum. Puis. Rheum. 

Rhus. Ruta. Sabad. Sabin. Secale 

cornut Selen. Sep. Sil. Spigelia. 

Spong. Staph. Stront. Sulph. Ye- 

ratr. 
— with easy expectoration: Argent. 

Euphr. Plumb. Puis. Staph. 



— with difficult expectoration : Ambr. 

Ars. Aur. Bry. Camph. Cann. 

Canth. Caust. Cham. Cina. Dros. 

Euphr. Hyosc. Ign. Iod. Kali c. 

Nux vom. Phosph. Plumb. Puis. 

Sep. Stann. Staph. Sulph. Zinc. 
— without expectoration : Aconit. 

Alum. Ambr. Antim. crud. Arn. 

Ars. Asa fast. Bar. Bellad. Bry. 

Calc. Cann. Canth. Caps. Carbo an. 

Carbo veg. Caust. Cham. China. 

Coff. Coloc. Con. Croc. Cupr. Digit. 

Dros. Euphorb. Ferr. Graphit. 

Hell. Hep. s. Hyosc. Ignat. Iod. 

Ipec. Kali c. Lycop. Mur. ac. Merc. 

N. vom. Op. Petr. Phosph. Phos. 

ac. Plat. Plumb. Pulsat Rheum. 

Bhocl. Rhus. Sabad. Sep. Sil. Spi- 

gel. Spong. Stann. Sulphur. Veratr. 

Zinc. 
— anxious : Aeon. Cina. Coff. Rhus. 
— fatiguing: Cocculus. Crocus. Ipec 

N. vom. Rhus, 
—barking: Dros. Spong. 
—dull : Arsen. Bar. Bell. Carbo veg. 



50 



COUGH. 



Euphorb. Hep. s. Kali c. Lyc.Petr. 

Phosph. Sep. 
— close: Asa f. Bry. Chamom. Coc- 

cul. Sab ad. 
— rocking: Antim. crud. Ipec. Puis. 

Ehus. 
— suffocative : Aco. Bry. Cham. Cupr. 

Ipec. Op. Spigilia. Spong. 
— violent : Ambra. Cina. Con. Hep. s. 

Ign. Ipec. Merc. N. vom. Phosph. 

Euta. Sabad. Spig. Spong. Stann. 
— hoarse: Aco. Ainfor. Asa f. Brom. 

Chin. Cina. Drosera. Samb. Spong. 

Veratr. 
—hollow: Aco. (Bell.) Caust. Cina. 

Euphorb. Hepar sulph. Ign. Ipec. 

Opium. Phosph. Sambucus. Spig. 

Spong. Verair. 
— hacking: Aeon. Alum. Ars. Cann. 

Canth. China. Coffea. Coloc. Cupr. 

Dros. Euphorb. Hell. Hyosc. 

Kali c. Natrum mur. Op. Phosph. 

Plumb. Ehus. Stann. Sulph. Thuj. 

and dry : Alum. Arg. Am. Ars. 

Bell. Canth. Capsic. Carbo an. 
Caust. Cina. Con. Graph. Ign. 
Phosph. Sabad. Sabin. Sulph. 
Veratr. Zinc. 
— irritating : Coff. Ign. 
— spasmodic: Aconit. Ambr. Bell. 

Bry. Carbo veg. Chin. Cina. Con. 

Ferr. Hyosc. Ignatia. Ipee. N. vom. 

Phosph. Plumbum. Puis. Sep. Sil. 

Staph. 
— short: Aco. Alumina. Arg. Am. 

Ars. Aur. Bell. Canth. Carbo vege- 

tabilis. Caust. Coff. Euphorb. Ign. 

Ipec. Merc. Mur. acid. Nux vom. 

Natr. mur. Phosph. Platina. Puis. 

Ehus. Sabad. Spigel. Spong. 
— scraping: Nux vomica. Puis. 

Sabad. 
— deep : Ambra. Ars. Drosera. Hep. s. 

Petr. Phos. Samb. Spong. Stann. 

Yeratr. 
— unceasing: Cupr. Droser. Hyosc. 

Ipec. 
— titillating: Alum. Arn. Asa f. Calc. 



Canth. Caust. Chamom. Chin. 

Con. Hyosc. Iod. Kali. Merc. Nux 

vom. Natrum mur. Nitric ac. 

Phosph. Ehus. Stann. Staph. 
— with vomiting: Alumin. Arg. Ar- 

sen. Asa f. Aur. Bry. Calc. Carbo 

an. Carbo veget. Cina. Coccul. Coff. 

Dig. Dulc. Iod. Nitric ac. Phosph. 

Plat. Puis. Ehus. Spong. Stann. 

StajDhys. Zinc. 
— whooping : Aeon. Ambra. Am. Ars. 

Bell. Byron. Cham. China. Cina. 

Con. Cupr. Dros. Euphr. Hep. s. 

Hyosc. Ign. Ipecac. Kali c. Mosch. 

Mur. ac. N. vom. Opium. Phosph. 

Puis. Ehus. Euta. Sep. Spong. 

Sulph. Yeratr. 

Expectoration. 

ACEID : Puis. 

BITTEE: Ars. Cham. Drosera. Ni* 
trie ac. Puis. 

BLOODY: Aeon. Alum. Arn. Ars. 
Bell. Bry. Calc. Canth. China. Cina. 
Con. Croc. Cupr. Daph. Dig. Dros- 
era. Dulc. Ferr. Hepar sulph. Hy- 
osc. Iod. Ipec. (Kali c.) Lye Merc. 
Mur. ac. Nitric ac. Op. Phos. 
Plumb. Puis. Rhus. Sabad. Sabina. 
Sec. corn. Selen. Sep. Sil. Staphys. 
Stram. Sulphur. Zinc. 

BLOOD, brown: Bry. Ehus. 

— thick: Cupr. 

— thin : Ferr. Sabin. 

— coagulated: Arn. Bryonia. Canth. 
Nux vom. Nitric acid. Puis. Sep. 

— bright-red: Arn. Cantharis. Chin. 
Dros. Hyoscyam. Rhus. Sabad. Sa- 
bina. Sep. Sil. 

— frothy: Arn. Dros. Ferr. 

— black: Arn. Canthar. China. Croc 
Nux vom. Nitric acid. Puis. 

BILIOUS: Puis. 

TASTING OF OLD CATAEEH: 
Ignat. Puis. Sulph. Zinc, 

COOL : Cann. Phosph. (Sulph.) 

COPIOUS: Alum. Bry. Caust. Cic 



COUGH. 



51 



Cina. Dros. Euphr. Ferr. Graph. 

Kali c. Lye. Puis. Sep. Sil. Stan- 

nuiii. Sulph. 
HAVING A FOUL TASTE: Cal- 

carea. Carbo veg;. Cham. Cupr.Ferr. 

Pliospli. Pulsat. Sepite. Stann. 

Zinc. 
FROTHY: Op. Phosphor. Plumb. 

Sil. 
GRANULAR: Chin. Phosphor. Sep. 
GLOBULAR: Thuj. 
GRAY : Ambra. Lycop. Sepiae. Thuj. 
GREEN : Ars. Cairn. Carb. veg. Ferr. 

Hyosc. Lycop. Puis. Sep. Stann. 

Thuj. 
INDURATED: Iod. 
INODOROUS : Arg. 
LITER-COLORED: Puis. 
HAYING A METALLIC TASTE : 

Ipec. 
MUCUS, bloody: Alum. Am. Ars. 

Bry. Chin. Con. Dros. Ferr. Iod. 

Ipecac. Opium. Phosph. Sab hi. 

Sec. corn. Selen. Sil. Spong. Zinc. 
— transparent: Ars. China. Sil. 
— yellow : Bry. Dros. Puis. 
— gray: Ambr. 
— blackish: Lye. 
— dry: Bry. Plumb. 
— white : Ambr.Argent. Cina. Phosph. 

Rhus. Sep. Spong. 
— tenacious: Antim. cruel. Ars* Bell. 

Bryon. Cann. Canth. Carbo veget. 

Caust. Cham. Coccul. Euphr. Iod. 

N. vom. Phosph. Puis. Ruta. Sauib. 

Sep. Staph. Yeratr. Zinc. 
HAWKING UP OF MUCUS : CSee 

Larynx.) 
NAUSEOUS: Dros. (Puis.) 
PURULENT: Bell. Calc. Chin. Con. 

Dros. Ferr. Lycop. Kali c. Natr. 

mur. Phos. Ph. ac. (Puis.) Ruta. 

Sep. Sil Staph. Zinc. 
SALT : Alum. Ambr. Ars. Bar. Cann. 

Carbo veg. (Drosera.) Graph. Lye. 

Phos. Puis. Sep. Stann. Sulph. 
SOUR: Calc. Phosph. Ph. ac. 



SLIMY : Alumina. Ambr. Arg. Ars. 

Aur. Bar. Bell. Brijo. Calc. Caps. 

Caust. Chamom. Chin. Cina. (Croc.) 

Digit. Euphr. Ferr. Hep. s. Hyosc. 

Iod. Ipec. Merc. Mur. acid. A ' :tr. 

mur. Op. Phosphor. Plumb. Fi*Is. 

Rheum. Rhod. Rhus. Sab In. Sec. 

corn. Selen. Sep. Sil. Spigelia, 

Spongia. Stann. Staph. Sulph. Z..:c 
HAYING A BAD SMELL: Arsen. 

Calc. Stann. 
— — taste: Ars. Stann. 
LIKE STARCH: Arg. Bar. 
SWEETISH: Calc. Ferr. Nux vokl 

Phosph. Stann. 
TASTELESS: Arg. 
TENACIOUS: Alum. Ars. Carbo 

veg.Caust.Dulc. Iod. Kali c. Phospli. 

Sep. Stann. Zinc. 
THICK: Arg. Ipec. Lye. Phos. Staniio 

Sulph. Zinc. 
TITILLATING: Caust. 
LIKE TOBACCO: Puis. 
TUBERCLES, brownish: Phos. 
YISCED: (Rhus.) 
WATERY: Arg. 
WHITISH-YELLOW : Lyc.Phosph. 

ac. 
YELLOW: Ars. Bryo. Calc. Dros 

Ign. Lye. Phosphor. Puis. Sep 

Spong. Stann. Staph. Thuj. 

Exciting Causes. 
AS FROM THE ABDOMEN : Ye^ 

ratr. 
BY OPEN AIR: Ars. Lye. Phosph. 
IN — — : Bry. Coccul. Ipecac 

N. vom. (Rhus.) Spig. 
BY GETTING ANGRY: (Cham.) 
FROM ASCENDING : Arg. N. vom. 
BY BARING ONE SELF : N. v-m. 
BY DRAWING A LONG BREATH : 

Dulc. Hep. s. 
BREATHING: Bellacl. Coloc. Dulc. 

Graphit. Hepar sulph. >*atr. mar. 

Sulph. 



52 



COUGH. 



BY BENDING IN THE CHEST: 

Phos. acid. 
AFTER CHAGEIN: Aco. Bry. 
IN COLD AIR: Aco. Bry. Carbo 

veg. Hepar sulph. Phosphor. Spong. 
BY TAKING COLD: Bryo. Cupr. 

Dros. Ipec. Op. N. vom. Rhus. 
PROM TAKING COLD: Carbo veg. 

Dulc. Hep. s. Petr. Phosphor. 
BY CONTRACTION OP ABDO- 
MEN: Dros. 
BY GETTING COOL : Arn. Rhus. 
AFTER CRYING: Arn. 
AFTER DRINKING: Aeon. Ar- 
senic. Bry. Coccul. Ferr. Hep. sulph. 

Lye. N. vom. Op. (Phosph.) 
FROM DRINKING COFFEE: 

Capsic. Cham. Coccul. Ign. N. 

vom. 
FROM DRYNESS: Puis. 
BY FEELING OF DRYNESS: 

Merc. 
AFTER EATING: Bell. Bryon. 

Chin. (Dig.) Ferr. N. vom. Opium. 

(Puis.) Ruta. Staph. Zinc. 
WHEN EATING: Carbo vegetabil. 

Coccul. (Puis.) Sep. 
BY EMOTIONS : Aeon. Arn. Bry. 

Cham. Nux vom. Op. Rhus. Staph. 
AFTER ERUCTATION: Staph. 
BY EXPIRATION : Cann. N. vom. 
AS FROM FEATHER-DUST : 

Bellad. Calc. Cina. Ign. 
BY HEAT OF BODY: (Aco.) 
BY GETTING HEATED : Aco. Bry. 

Ipec. N. vom. Thuj. 
AS FROM A HAIR ON THE 

TONGUE : Sil. 
HYPOCHONDRIA, irritation in: 

Thuj. 
— inspiration : Cina. Croc. Ipec. Puis. 

deep : Bry. Cina. Ipec. 

IRRITATION, generally: Aconit. 

Alum. Arg. Arn. Ars. Asa f. Bar. 

Bellad. Bryon. Calc. Cann. Carbo 

an. Carbo veget. Caust. Cham. 



China. Cina. Coccul. Coloc. Con. 

Croc. Dig. Euphorb. Ferr. Graphit. 

Hepar s. Hyosc. Ignat. Iod. Ipec. 

Lye. N. vom. Nitric ac. Petr. 

Phosph. Pulsat. Rhodod. Sabin. 

Sep. Sil. Spig. Stann. Staph. Sul- 
phur. Thuj. Zinc. Veratr. 
BY AN IRRITATION IN THE 

LARYNX: Aco. Alum. Arn. Ar- 

sen. Bar. Bry. Canth. Caps. Carbo 

an. Carbo veget. Cham. Cina. 

Coccul. Coif. Dros. Hep. s. Ign. 

Iod. Ipec. Merc. Mur. ac. N. vom. 

Pulsat. Sabad. Sabin. Sep. Sil. 

Spongia. Staph. Sulph. 
FROM IRRITATION IN THE 

REGION OF THEJYOIDIBODY : 

(Iodine.) Spong. 
FROM IRRITATION IN THE 

STOMACH: Bell. Bry. Merc. 
BY LAUGHING: Arg. Chin. Stann. 
BY LOSS OF BREATH: Aur. 

Coccul. Dros. Euphr. Hep. sulph. 

Ign. Ipec. Nux vom. Spig. 
AFTER LYING DOWN: N. vom. 

Puis. Rhus. Ruta. Sabad. Staph. 
WHEN LYING DOWN : Ambr. Ars. 

Bellad. Cham. Coccul. Con. Dros. 

Ferr. Hyosc. Ignat. Ipec. Merc. 

Phosph. Puis. Rhus. Sabad. 

in bed: Cham. Ferr. Nux vom. 

Puis. Rhus. 

on the back : "8. vom. 

on left side : Aeon. Bryon. Ipec 

Phosph. Puis. 
on right side: Aco. Carbo an. 

Ipec. 
FROM MENTAL LABOR: Ignat. 

N. vom. 
BY MOTION : Arn. Ars. Bryon. Ferr. 

N. vom. 
BY MUCUS : Cham. Cina. Puis. 
BY MUCUS ON CHEST: Caustic. 

Stann. 
BY MUCUS IN TRACHEA: N. 

vom. 
FROM NAUSEA: (Bry.) N. vom. 



COUGH. 



53 



WHILE NURSING: Chin. Ferr. 
DURING PREGNANCY: Ipecac. 
Puis. 

BY PRESSURE : Iod. 

BY READING: N. vom. 

BY READING ALOUD: Nitric acid. 

Phospli. 
IN REST: Caps. Dros. Euphorb. 

Ferr. Hyosc. N. vom. PIiosxdIi. 

Puis. Rhus. Samb. 
BEFORE RISING: N. vom. 
IN THE ROOM: Arg. Bry. Croc. 

Puis. Spig. 
IN SCREAMING: Am. 
BY SHOCKS : N. vom. 
WHEN SITTING: Hell. Phosph. 
IN SLEEP: Am. Bell. Calcarea. 

Cham. Lach. Nitr. ac. Sep. 
WHEN SMOKING: Aeon. Bryon. 

Coloc. Ferr. Hell. Ign. Nux vom. 

P etr. Spong. Staph. 
WHEN STEPPING INTO WA- 
TER: Spig. 
BY STITCHES : Aconit. Bryon. N. 

vom. 
WHEN STOOPING: Arg. Caust. 

Hep. s. Spig. 
BY SUFFOCATIVE FITS: Cham- 

om. Ipec. Puis. 
AS FROM YAPOR OF SULPH. 

Carbo veg. Chin. Ign. Lye. Puis. 
FROM SWALLOWING : Op. 
FROM TALKING: Bar. Cham. 

China. Hep. s. Ign. Ipec. Merc. 

Phosphor. Stann. Rhus. 
WHEN TEETHING: Chamom. 

Ciua. Hyosc. Ipec. Rhus. 
THROAT, as if swollen : Ars. 
— scraping in : Ambr. Croc. 
— roughness in: Bry. Nux vom. 

Plumb. Rhus. Sabad. 
— irritation: Coff. 
— scraping in: Puis. Sab. 
— mucus in : Caustic. Chamom. Coc- 

cul. Euphr. 
— stitches in : Cham. Stann. 



— dryness in : Bry. Dros. Puis. Rhus. 

Stann. 
— constriction in : Coccul. Ign. 
— rising in: Cham. 
THROAT-PIT, tickling in: Bella. 

Cann. Cham. Coccul. Ign. Phos. ac. 

Puis. 
— pain generally : N. vom. 
STOMACH, tickling in pit of: Bar. 

Bell. Bry. Hep. s. Natr. mur. 

Phosph. ac. 
BY TICKLING IN THROAT : Dig. 

N. vom. 
BY TITILLATION IN THROAT: 

Ambra. Bryon. Calc. Caustic. Chin. 

Euphorb. Hepar sulph. Iod. Zinc. 
HIP, twitching in : Ars. 
ON WAKING : Ign. Nux vom. Puis. 

Rhus. 
WHEN WALKING: Alumina. Ars. 

Carbo veget. Ferr. JVatrum mur. 
AFTER WALKING IN THE OPEN 

AIR : Ferr. Ipec. 
WHEN GETTING WARM IN 

BED : Cham. N. vom. Puis. 
BY WEAKNESS: Stann. 
WORSE BY COUGH: Ign. 
BY YAWNING: Am. N. vom. 

Accompanying Ailments. 

ABDOMEN, pain in: Dros. Lye. 

N. vom. Phosph. Ph. ac. Sil. Ve- 

ratr. 
— cutting in: Yeratr. 
— stitches in: Ars. Sep. Veratr. 
—shocks in : Natr. mur. 
— bruised in: Arsen. N. vom. Puis. 
— contraction: Dros. 
— pain in muscles of : Hyosc. 
— stitches in sides of : Arn. 
ABDOMINAL RING, stitches in: 

Veratr. 
ANXIETY: Aeon. Cina. Coffea. 

Rhus. 
ASTHMA: Am. Carb. v. Caust 

Coccul. Dig. Euphorb. Ferr. Ipec. 



54 



COUGH. 



Natr. mur. Phosphor. Khodod. 

Rhus. Sep. Yeratr. 
BACK, stitches in : Aco. Chin. Merc. 

Puis. Sep. 
BLADDER, pain in : Caps. 
BREATHING, breath, hot : Ant. cr. 
— tnorting: Chin. 
— *etid: Caps, 
—want of : Ferr. Ipec. 
— incarceration of : Aeon. Arn. Bar. 

Bryon. Cale. Cina. Cupr. Ipec. 

Merc. Nat. mur. Sil. Spig. 
CATARRH: Bell. 
CERVICAL GLANDS, pain in: 

Natr. muriat. 
CHCKING: Carbo veget. Droser. 

Hep. snlph. Ipec. N. vom. Puis. 

Sep. Sulph. 
CHEEKS, drawing in : Carb. veg. 
CHILLINESS: Calcar. Carbo veg. 

Con. Phosph. Sulph. 
COLIC : Ambr. Arsen. Canth. Coloc. 

Con. Droser. (Ferr.) Ipec. Lycop. 

N. vom. Phosph. Sep. Stann. Ye- 

ratr. 
CONCUSSING THE BODY: Ant. 

cr. Ipec. Puis. Rhus. 
CONSCIOUSNESS, loss of: Cina. 
CONSUMPTION: China. Ferr. N. 

vom. Puis. 
CRYING : Arnic. Bellad. Cina. 

Hep. s. 
CHEST, oppression in : Rhus. Yeratr. 
-burning in : Ant. crud. Carb. veg. 

Caust. Cina. Ferr. Phos. Ph. ac. 

Spong. 
— pressure in: Carb.veg. Chin. Iod. 

Ph. ac. Sil. 
—as if shaken: Rhns. 
—ulcerative pain : Staph. 
— as if hollow: Sep. Zinc. 

- itching: Ambr. 

=- coldness in : Zinc. 

- cramp in : Cina. 

■ scraping in: Ruta. Staph. 

- roughness : (Arn.) Carb. veg. Kali 
carb. Lye. Sep. 



— rattling: Bell Caust. Cham. 
COUGH, 

— pains generally: Ambr. Ars. Bel- 
lad. Carb. veg. Caustic. Cham. 

Cina. Com Dig. Dros. Kali carb. 

Lye. Merc. Mur. ac. N. vom. Nat. 

mur. Nitr. ac. Phosph. Ph. ac 

Puis. Sep. Spong. Sulph. Yeratr. 
— relieved by pressure: Phosph. 
— cutting: Natr. mur. Sulph. 
— excoriated, as if : Carbo. veg. Lye. 

Phosph. Sep. Spong. 
— heaviness: Zinc. 
— tension in : Phosph. Rhus. 
— stitches in: Aco. Arn. Ars. Bell. 

Bry. Cann. Chin. Com Con. Dros. 

Merc. Nux vom. Natr. mur. Pulsat. 

Rhus. Sabad. Sep. Zinc. 
— fullness: Sabin. 
— qualmishness: Rhus. 
—as if sore : Alum. (Arn.) Bar. Carb. 

veg. Caust. Cina. Hepar sulph. 

Ipec. Lye. Mur. ac. Nux vom. Nitr. 

acid. Phosph. Sep. ' Sillc. Spig. 

Spong. Staun. Sulph. 
— pain as if bruised : Arn. 
— as if flying to pieces : Arsen. Bry. 

Caps. Merc. Zinc. 
— drawing: Caps. 
— contraction: Dros. 
EAR-ACHE: Caps. (N. vom.) 
EPYGASTRIUM, pain in: Ambra. 

Dros. N. vom. 
— stitches in: Sep. 
ERECTIONS : Cann. Canth. 
ERETHISM, vascular : Am. Chin. 
ERUCTATIONS : Ambr. Yeratr. 
EYES, obscured: Com 
— sparks before : Kali, 
—tears in: Cina. : Puls. Sabad. 
FACE, blue : Ipec/ Op. Yeratr. 
— pale: Cina. 
— hot: Bell. IpecrSulph. 
— sweat in : Ipec. 
—distorted: Spong. 
FAUCES, burning in: Caust. Ph. 

acid. 



COUGH. 



55 



— sore feeling in : Canst. 

FALLING DOWN : Ipec 

FOREHEAD, cold sweat on : Yeratr. 

HANDS, swelling of: Aeon. 

— coldness of : Sulph. 

HEAD, pressure in : Alum. Bry. Con. 

Nitr. ac. Phospli. Ruta. 
— as if shaken: Rhus.. 
— heat in: Ars. Ipec. Sulph. 
— tearing in: Alum. Calc. Sep. 
— pain generally: Aco. Bell. Bry. 

Chin. Con. Lye. Sabad. 
— stitches in: Alum. Arn. Bry. Calc. 

Carb. veg. Con. Ruta. Sabad. 
— shocks in: Arseu. Ipecac. Lye. Natr. 

nmr. Rhus. 
— as if bruised: Sulph. 
— as if flying to pieces : Bryon. Caps. 

Merc. Nuxvoni. Natr. mur. Phosph. 

Ph. acid. Sep. Sulph. 
— contractive pain in : Petr. 
HEAT : Arn. BeU. Nux vom. Sabad. 
HOARSENESS: Aco. Ambr. Asa 

feet. Chin. Clna. Droser. Sarah. 

Spong 1 . Stann. Verat. 
ILL-HUMOR: (Bell.) (Spong.) 
LARYNX, ulcerative pain in: Car- 
bo veg. 
— crawling: Sabin. 
— irritation in: Coccul. 
— pain generally : Spong*. 
— stitches : Kali c. Phosph. 
— as if sore : Arg. Bry. Carbo veg. 

Hep. sulph. Ign. Kali c. Natr. mur. 

Sep. 
LARYNX, as if torn: Staph. 
LIMBS, pain in : Caps. 
MOUTH, dry: Coccul. 
NAPE OF NECK, pain in: Bell. 
NAUSEA: Bryo. Caps. Drosera. 

Ipec. Merc. N. vom. Puis. Ruta. 
NOSEBLEED: Aco. Bros. Merc. 

Puis. 
PAIN IN ARM: Dig. Puis. 
PALPITATION OF HEART: Ar- 

nic. Calc. 



PAIN AS FROM HERNIA : Petr. 

— as from fatigue : Puis. 

— generally : Ambra. Droser. N. x m. 

— tension: Hell. 

— stitches: Aco. Ars. Bryon. Phosph. 

Sabad. Sulph. 
— as if bruised: Bry. 
— contraction in : Dros. 
— hip : Ars. Bellad. Caustic. Rhus. 
PRESSURE IN HYPOCHON 

DRIA : Coccul. Spong. Valer. 
PENIS, pain in the : (Ign.) 
PTYALISM: Veratr. 
RECTUM, stitches in: Nitric ac. 
RESTLESSNESS: Aconit. Coff. 

Samb. 
RIBS AS IF BRUISED : Arn. 
SALIVA, bloody: Dros. 
SCREAMING: Op. Samb. 
SHORTNESS OF BREATH: Bry. 
SHOULDER, stitches in : Puis. 
— blade, stitches in : Mercur. Sep. 
SIDE, stitches in: Aco. Bry. Puis. 

Zinc. 
SLEEPLESSNESS : Hyosc. Lycop. 

N. vom. Puis. Rhus. Sabad. 
SNEEZING: Bell. Bryo. Hepar 

sulph. 
SMALL OF BACK, pain in: Merc. 
— stitches in : Aco. Arn. Nitric acid. 
SPERMATIC CORD, stitches in: 

Yeratr. 
START, tendency to: Aco. 
STERNUM, pain of : Bell. Chin. Sep. 

Sil. 
STOMACH, pressure in: Lye. 
— pain in: Bry. Hell. Ipecac. Lye. 

Phosph. Puis. Rhus. Ruta. Sabad. 

Sep. 
— pressure in pit of: Phosph. 
— simple pain : Sepioe. Stannum. Thuj. 
— pain generally : Ambr. Bryo. Ipec. 
—stitches: Ars. Bry. Phospli. Sulph. 
— qualmishness: Ign. 
— sore pain : Bry. 
— as if bruised : Stann. 
— contraction: Ars. 



56 



LARYNX AND TRACHEA. 



SUFFOCATIVE FITS : Aco. Bryon. 
Cham. Cupr. Hep. s. Ipec. Op. 
Spig. Spong. 
SWEAT : Ars. Dig. Hep. sulph. Ipec. 

Ehus. Sabad. Spong. 
TASTE IN MOUTH, as of blood: 

Bell. Elms. 
— bad: Caps. 

TEETH, gritting of: Bell. 
TOOTH-ACHE: Lye. 
TBEMBLING OF WHOLEBODY : 

Phosph. 
TESTICLES, pain in: Zinc. 
THEOAT, bitter taste in : Ehus. 
— burning in : Mur. ac. Phosph. 
— pressure in : Caps. 
— inflammation: Aco. Cham. Ipec. 

Nux vom. Puis. 
— ulcerative pain : Caps. 
— as if swollen : Caps. Puis. 
— itching: Ambr. 
— titillation : Bry. Kali c. 
— scraping: Ambr. Bell. Bry. Croc. 

Hep. s. 
— roughness : Carbo an. Caust. Hep. s. 
Kali c. Phosphor. Bhod. Sep. 
Spong. 
—pain generally: Caps. Hepar s. 

Natr. mur. Phosph. Sil. Sulph. 
— stitches in: Bryo. Nitric acid. 

Phosph. 
— dryness: Puis. Ehus. 
— sore pain: Ambra. Phosphor. Sep. 
THEO AT-PIT, pain in : N. vom. 
THEOBBING IN AETEEIES : 
Calc. 



THYEOID GLAND, itching in: 

Ambra. 
— CAETILAGE, titillation in : Puis. 
TOSSING ABOUT: Aeon. Arn. 
TEA CHE A, itching in: Ambr. N. 

vom. 
— tickling in: Cham. Sabin. 
— pain generally : Camph. Chin. Ign. 

N. vom. Spong. 
— shocks: Bry. Cina. 
— as if sore : Ant. crud. Bryon. Cann. 

Caust. Chin. Nux vom. Natr. mur. 

Plumb. Stann. 
— as if torn : Staph. 
ULCEES, pain in: Con. 
UMBILICUS, pain in : Ambr. 
UEINATE, urging to : Ipec. 
URINATION, involuntary: Antim. 

crud. Bry. Puis. Spong. Staph. 

Veratr. 
UBINE, retention of : Ipec. 
YEETIGO : Aco. Coff. 
VOMITING, in general: Arnica. 

(Bell.) Bry. Calc. Capsic. Carbo veg- 

Con. Cuprum. Dros. Hep. s. Iod. 

Ipec. Kali c. Nux vom. Phosph. ac. 

(Puis.) Sabad. Sep. 
— bitter: Cham. Sep. 
—of food: Bryo. (Dig.) Dros. Ferr. 

Natr. mur. (Ehus.) 
— of mucus: Dros. Hyosc. 
— sweet: Calc. 
— of water: Dros. 
WATEBBBASH: Amb. Ars. Bry. 

Spig. Staph. 
WEAKNESS: Chin. Fen-. Veratr. 
YAWNING: Op. 



XI LARYNX AND TRACHEA. 



Sensations. 

1. Larynx. 
AIE, rising of : Lye. 
APHONIA: Bell. Carb. veg. Caust. 



Hep. sulph. Merc. Natr. mur. Phos. 

Plat. 
BUENING : Canth. Chamom. Spong. 
CHOKING : Cupr. Dros. 
CONSTEICTION: Camphor. Cham. 



LARYNX AND TRACHEA. 



57 



Coccul. Coff. Ipec. Mosch. N. vom. 

Plumb. Puis. Spong. Yeratr. 
CONTRACTION: Spong. 
CONTUSIYE PAIN: Ruta. 
COUGH, desire to: Aeon. Arnica. 

Bry. Canth. Caps. Cham. Cina. 

Coccul. Coff. Droser. Ign. Ipec. N. 

vom. Puis. Sabad. Sab in. Spong. 

Staph. 
CRAMP Y FEELING: Cham. Nux 

vom. 
CRAWLING: Sabin. 
CROUP, gangrenous : Chin. 
— membranous: Aco. Cham. Dros. 

Lack. Samb. Spong. 
DRYNESS: Alum. Carb. an. Con. 

Hyosc. Nux vom. Natr. mm. Petr. 

Phosph. Spong. Sulphur. Zinc. 
FOOD GETS INTO THE LAR- 
YNX: Aco. Cann. Rhus. Veratr. 
HAWKING UP MUCUS : Alumina. 

Ambr. Ant. crud. Arg. Aur. Bry on. 

Calc. Camph. Cann. Canth. Carb. 

an. Caust. Cham. Chin. Cina. Coc- 
cul. Croc. Dig. Dulc. Hyosc. Iod. 

Kali c. Lach. Lye. N. vom. Natr. 

mur. Phosph. Plumb. Rhod. Rims. 

Sabad. Sabin. Samb. Selen. Spig. 

Stann. Staph. Sulph. Yaler. 
HEAT : Ant. crud. Canth. Iod. 
HOARSENESS: Aeon. Alumina. 

Ambr. Arn. Ars. Asa f. Bell. Bry- 

on. Calc. Camph. Canth. Caps. 

Carb. an. Carb. veg. Caust. Cham. 

Chin. Cic. Coff. Con. Croc. Cnpr. 

Dig. Dros. Ferr. Graph. Hep. Ign. 

Iod. Kali c. Lach. Lycop. Merc. 

Mur. ac. Nux vom. Natr. mur. Nitr. 

ac. Op. Petr. Phosph. Ph. ac. Plat. 

Plumb. Puis. Rhus. Sabad. Samb. 

Sec. corn. Selen. Sep. Sil. Spig. 

Spong. Stann. Staph. Stramon. 

Sulph. Thuj. Yeratr. Zinc. 
INFLAMMATION: Aeon. Dros. 

Ipec. N. vom. Puis. Spong. 
ITCHING: Ambra. Con. Nux vom. 
52 



MUCUS, accumulation of: Alum. 

Arg. Ars. Calc. Carb. an. Caust. 

Cham. Chut. Cina. Coccul. Coff. 

Dig. Hyosc. Iod. Kali c. Lye. Nux 

vom. Natr. mur. Phosph. Samb. 

Sep. Stann. 
PHTHISIS OF LARYNX: Ambra. 

Carb. veg. Caust. Cupr. Dros. Ign. 

Iod. Lach. Merc. Nux vom. Pulsat. 

Spong. Stann. Sulph. 
AS OF A PLUG: Bar. Kali c. 
PRESSURE: Bar. Bellad. Capsic. 

Carb. veg. Cic. Graph. 
AS IF RAW: Arg. Puis. 
ROUGHNESS: Alum. Ambr. Ars. 

Bell. Canth. Caps. Carb. veg. Caust. 

Chin. Coff. Kali c. Mur. ac. N. vom. 

Natr. mur. Phosph. Phos. ac Plumb. 

Puis. Rhod. Rhus. Sabad. Sil. 

Spong. Stann. Sulph. Zinc. 
AS IF SCRAPED: N. vom. Pulsat. 

Sabad. Yeratr. 
SCRAPING: Alumin. Carbo veg. 

Ign. Kali c. Natr. mur. Nitr. acid. 

Rhus. Sabad. Spong. Staph. 
SENSITIVENESS: Bell. Laches. 

Phosph. Sulph. Hepar. sulph. Iod. 

Phosph. Sep. Spong. Zinc. 
SIMPLE PAIN: Aeon. Canthar. 

Hep. s. Iod. Lach. N. vom. Spong. 
AS OF A SOFT BODY: Dros. 
SORE FEELING: Arg. Bry. Carb. 

veg. Caust. China. Graph. Ign. Iod. 

Kali c. Natr. mur. Puis. Sep. 
SPASM: Mosch. Yeratr. 
STITCHES: Capsic. China. Dros. 

Hyosc. Iod. Kali c. Nitr. ac. Phosph. 

Spig. Zinc. 
AS IF STOPPED UP : Spong. 
LIKE YAPOR OF SULPH. : Mosch. 
SWELLING: Iod. Sil. 
AS IF SWOLLEN: Cans. Iod. 
TEARING: Ign. 
TENSION: Spong. 
TICKLING : Calcar. Carb. veg. Con. 

Hep. s. Ipec. Merc. Sabin. Zinc. 



58 



EXTERNAL NECK AND NAPE OF THE NECK. 



TINGLING: Con. Dros. Graphit. 

lod. Kali c. JSfatr. mur. Sep. Zinc, 
VOICE, raised : Stann. 
--impure: Baryta. Carbo vcg. Caust. 

Graphit. Merc. Natr. mur. Sulph. 
2. Trachea. 

BUBNING: Euphorb. Phosphor. 

Bhus. Sulph. JZinc. 
COLDNESS: Camph. Sulph. 
ASIFCONSTBICTED: Ars.Ignat. 

Ipec. Mosch. N. yom. Puis. Rhus. 
AS IE CONTBACTED: Coccul. 

Lach. Staph. 
COUGH, desire to: Aeon. Arg. Arn. 

Asa feet. Bry on. Cann. Cham. 

China. Cina. Cocc. Croc. Ferr. Hy- 

osc. Ignatia. Ipec. Nux vom. Puis. 

Sabina. Spig. Staph. Veratr. 
GROUP :~ Hep. Phosph.. 
DBYNESS: Alum. Carbo veget. 

Caust. Cina. Phosph. Puis. Bhod. 

Sep. Sulph. Zinc. 
FEELING OF : Camph. Causticum. 

Phosph. Puis. Stann. 
HEAT: lod. 
INFLAMMATION: Aeon. Capsic. 

Con. Brosera. lod. Ipecac. Spong. 
ITCHING: Ambr. N. yom. Puis. 
MUCUS, accumulated : Alumina. 

Arg. "Aur. Bar. Bell. Calc. Camph. 

Cann. Capsicum. Caust. Coccul. 

Cuprum. Hepar s. Hyosc. Ignatia. 

lod. Lye. N. yom. Natrum mur. 

Nitric ac. Op. Phosphor. Plumb. 

Puis. Samb. Stann. Sulph. Zinc. 

(See larynx.) 
NUMB FEELING: Aco. 
SIMPLE PAIN: Camph. Capsic. 

Carbo an. Chin. Ign. N. vom. 

Phosph. Puis. Spoitg. 



PHTHISIS OF TEACHEA: Aco. 

Arg. Am. Calc. Caust. Chamom. 

Cuprum. Dros. Ferr. Hep. Lye. N. 

yom. Nitric ac. Phosph. Ptds. Bhus. 

Spong. Stann. Sulph. Veratr. 
PBESSUBE: Bar. Graph. Phosph. 

Thuj. 
KOUGHNESS: Alum. Carbo veg. 

Caust. Dig. Graph. lod. Kali c. 

Mur. ac. N. vom. Natrum mur. Ni- 
tric ac. Phosphor. Plumb. Puis. 

Bhodod. Bhus. Stann. Sulph. Zinc. 

(See larynx.) 
AS OF A FOBEIGN BODY : Cann. 

Cic. Hyosc. 
SCBAPING: Alum. Antim. crud. 

Canth. Carbo veget. Caustic. Graph. 

Hep. s. Kali c. Lye. Mur. ac. Nitr. 

ac. Pulsatilla. Stann. Sulph. 
AS IF SCBAPED : N. Tom. Puis. 

Bhus. Veratr. 
SENSITIVENESS: Phosph. 
SHOCKS : Bry. Cina. 
AS IF GONE TO SLEEP : Aco. 
AS IF SOBE: Ant. crud. Bry on. 

Cann. Caust. Cham. China. lod. N. 

vom. Natrum muriat. Phosph. 

Plumbum. Bhus. Sil. Stann. 
STITCHES: Ant. crud. Arg. Bar. 

Bell. Caps. Ipec. Thuj. 
AS IF STOPPED UP : Bhus. 

AS OF VAPOBS OF SULPH.: 

Puis. 
TICKLING: Aconit. Arn. Capsic. 

Cina. Ferr. Ipec. N, yom. Puis. 

Bhus. Sabin. Veratr. 
TINGLING: Arn. Calc. Carbo veg. 

Dros. Euphorb. Iodine. Kali c. 

Lye. Petr. Phosphor. Platina. Sep- 

ise. Sil. Staim. Thuj. 
AS IF TOBN: Staph. 



XXI. EXTERNAL NECK AND NAPE OF THE NECK. 



Sensations. 
1. Neck. 
BLOTCHES : Sec. com. 
BOILS : Arn. Caust. Sep. 



BUBNING: Ferr. Ign. 

AS IF BBUISED : Arn. Cic. Hep 

s. Sabin. 
COLD FEELING: Phosph. 



EXTERNAL NECK AND NAPE OF THE NECK. 



59 



CKAMP: Cic. 

CUTTING: Graph. Ruta. Samv,. 

DRAWING: Aco. Ant. crud. Arn. 

Asa f. Bell. Bry. Camphor. Cantha- 

ris. Chin. Cic. Coccul. Croc. Dulc. 

Graph. Kali. Nux vom. Natr. mur. 

Nitr. ac. Ph. ac. Puis. Rhod. Sabin. 

Spig. Spong. Staph. Yeratr. 
ERUPTION: Ant. crud. Ars. Aur. 

Bry. Canth. Dig. Hep. sulph. 

Merc. Ph. ac. Puis. Spig. Spong. 

Staph. Thuj. Yeratr. 
AS IF THE FLESH WERE DE- 
TACHED: N. vom. 
GLANDS, boring in: Bell. Pulsat. 

Sabad. 
— pressure in : Aur. Bell. Chin. Cina. 

Coccul. Ign. Mercur. Rhus. Stram. 
— simple pain in: Alum. Ambra. 

Arn. Bry. Calcar. Carbo veget. 

Canst. China. Cic. Con. Graph. 

Hell. Ignat. Kali c. Lye. Merc. N. 

vom. Natr. mur. Nitr. ae. Phos. 

Ph. ac. Pulsatilla.i Rhus. Selen. 

Sep. Sil. Spig. Spong. Stann. 

Staph. Thuj. 
— suppuration : Bell. Hyosc. Sil. 
— sensitiveness : Arnic. Aurum. 

Spong. 
— inflammation : Bar. Bell. Canth. 

Kali c. Nitric ac. Plumb. Yeratr. 
— swelling: Alum. Ambra. Arg. Am. 

Asa f. Aur. Bar. Bell. Bry. Calc. 

Camph. Canth. Carbo veg. Cham. 

China. Cic. ^Coccul. Con. Dulcam. 

Ferr. Graph. Hepar s. Ign. Iod. 

Lye. Merc. Mur. ac. Natr. mur. 

Nitr. ac. Petr. Phospli. Ph. ac. 

Plumb. Puis. Rhus. Sabad. Sep. 

Sil. Spigel. Spong. Stann. Staph. 

Sulphur. Thuj. Veratr. Zinc. 

feeling of: Spong. Staph. 

— hard swelling: Coccul. Plumb. 

Rhus. Spig. Staph. 
— itching : Con. Ant. crud. 
— tickling : Kali c. 
— pinching: Bry. Yeratr. 



— creeping: Con. 

— as if air passed through : Spongia. 

— as if excoriated : Con. 

— as if pressed together : Ign. 

GOITRE: Ambr. Spong. 

— as if swollen : Spong. 

— large: Calc. Carbo an. Caust. Iod. 

Kali c. Lycop. Natr. mur. 
— pressing: Spong. 
— hard: Iod. Spong. 
— movements in : Spong. 
— pressing out: Spong. 
— as if alive : Spong. 
— painful: Iod. Plat. 
— stitching: Iodine. Spongia. Sulph. 
— larger: Iod. 
— constriction in : Iod. 
HEAD DRAWN TO ONE SIDE: 

Chin. Cupr. Hyosc. 
HEAT: Calc. Caust. Cham. Ign. 

Sep. Sulph. 
ITCHING: Alum. Bry. Carbo veg. 

Ign. Natrum mur. Nitric ac. Op. 

Puis. Rhus. Stann. Thuj. 
LAMENESS: Dig. Lye. Sulph. 
PAIN: laming: Cocc. 
— rheumatic : Aco. Iod. Rhod. Staph. 
— as of sore : Bry. Cic. Yeratr. 
— in lower vertebrae : Con. 
—simple : Bell. Bry. Calc. Caps. 

Caust. Ferr. Graphit. Kali c. Lach. 

Nux vom. Phosph. Ph. ac. Sabin. 

Sil. Zinc. 
AS IF PRESSED OUT: Spong. 
PRESSING: Sil. 
PRESSURE: Aco. Ant. crud. Arg. 

Arn. Aur. Bell. Calc. Cann. Carbo 

veg. Caust. Ign. Kali c. Lach. Lye. 

Nitr. ac. Fh. ac. Sabin. Spong. 

Staph. Yeratrum. Zinc. 
RESTLESSNESS: Thuj. 
SCRAPING: Ars. 
SLEEP, gone to: Carbo an. 
SPASM : Ant. crud. Spong. 
SPOTS, yellow: Iod. 
— red: Bell. Carbo veg. Coccul N. 

vom. Sep. Stann. 



60 



EXTEENAL NECK AND NAPE OF THE NECK. 



STIFFNESS: Alum. Ang. Argent. 

Ars. Bell. Bryon. Calcar. Camph. 

Carbo an. Causticum. China. Cic. 

Coccul. Croc. Cupr. Dig. Ferr. 

Graph. Hell. Lye. Merc. Natr. mur. 

Nitric ac. Petr. Phospli. Phospli. 

ac. Rhus. Sil. Spong. Staphys. 

Tliuj. Veratr. Zinc. 
STITCHES: Aco. Ant. crud. Anr. 

Bell. Bry. Cantli. Chin. Cina. Coc- 
cul. Cupr. Dig. Graphites. Hep. s. 

Kali c. Phos. Samb. Spig. Spong". 

Staphys. Thuj. Veratr. Zinc. 
SWEAT: Cann. Cham. Com Ipec. 

N. vom. Rhus. 
SWELLING, of bones: Calc. 
SWELLING: Alum. Ars. Bell. Calc. 

Caustic. Cic. Iod. Lye. Merc. Nitr. 

ac. Phos. Rhus. Sil. Zinc. 
— external: Alum. Arn. Ars. Bar. 

Caustic. Croc. Hyosc. Iod. Lye. 

Puis. Rhod. 
— hard : Caust. Lye. N. Yom. 
TEAKING: Arn. Aur. Carbo veg. 

Cham. Cupr. Iod. Kali c. Lye. 

Merc. Phos. Plumb. Sabin. Selen. 

Spong. Staph. Sulphur. Zinc. 
TENSION : Arg. Arn. Bar. Bell. Bry. 

Cale. Camph. Caustic. Cic. Dig. 

Graph. Iod. Plumb. Puis. Bhod. 

Rhus. Spigelia. Spong. Staph. 

Sulph. Zinc. 
THROBBING O F CAROTIDS : 

Opium. Spong. 
— of arteries: Bell. Hepar s. Op. 

Spong. 
AS IF TIED TOO FAST: Arn. 
TINGLING: Spong. 
TWITCHINGS: Canthar Qpongia. 

Zinc. 
— convulsive: Phosph. 
ULCERS : Ars. Hyosc. Lycop. Sec. 

corn. 
ULCERATIVE PAIN : Graph. Puis. 
VEINS, swelling of : Op. Thuj. 
WEAKNESS : Arnica. Coccul. Staph. 

Veratr. 



AS FROM A WRONG POSITION: 

Dulc. Thuj. Zinc. 

2. Nape of the Neck. 
BEATING: Con. 
BLOTCHES: Hep. 
BOILS: Arn. Sil. 
BORING: Bar. 
BURNING: Arn. Bar. Calcarea. 

Carbo veget. Ignatia. Mercur. Ph. 

ac. 
COLDNESS, feeling of: Sulph. 
CONTRACTION: Puis. 
CRACKING: Spong. 
CRAMP : Ant. crud. 
CRAMPY FEELING: Thuj. Sil. 
CRAMPY STIFFNESS : Zinc. 
CRAWLING: Dulc. 
CUTTING : Dig. 
DRAWING: Alum. Ambra. Ant. 

crud. Asa feet. Bell. Camphor. 

Cann. Caps. Chin. Coloc. Con. Dig. 

Hyosc. Kali c. Lycop. Merc. Mosch. 

Nux vom. Ph. ac. Plumb. Pulsa- 
tilla. Rhod od. Rhus. Ruta. Sep. 

Staph. Sulph. Thuj. Zinc. 
ERUPTION: Bar. Bellad. Bryon. 

Caust. Cham. Hep. Lycop. Sep. Sil. 

Staph. 
GLANDS: see Neck. 
GRASPING: Lye. 
HEAT : Ign. Lach. Phosph. 
HERPES : Hyosc. 
ITCHING: Carb. veg. Nitr. acid. 

Rhodod. Rhus. Sep. Sil. Staph. 
LAMING PAIN: Cina. Nux vom. 

Spig. Staph. Veratr. 
AS OF A LOAD : N. vom. Rhus. 
AS IF THE FLESH WERE 

LOOSE: Aco. 
NAPE OF NECK, stiff: Aconit. Arg. 

Ars. Bar. Bell. Bry. Calc. Camph. 

Canth. Caps. Carb. an. Caust. 

Chin. Coloc. Big. Dros. Dulc. 

Graph. Hell. Hyosc. Ign. Kali c. 

Lach. Lye. Merc. N. yom. Natr. 

mur. Nitr. ac. Petr. Phos. Ph. ac- 

Plat. Puis. Rhod. Rhus. Sec. corn. 



CHEST. 



61 



Sep. SiL Spigel. Spong. Stann. 

Staph. Sulph. Thuj. Veratr. Zinc. 
PAIN, crainpy : Am. 
— rheumatic: Aeon. Asa f. Graphit. 

Iod. Merc. Nux vom. Puis. Rhod. 

Rhus. Staph. Yeratr. 
— simple: Aeon. Bry. Cann. Chin. 

Dulc. Graph. Hyosc. Ipec. KaU. 

Merc. Nux^voin. Natr. mur. Petros. 

Phosphor. Rhodod. Sabad. Sep. 

Spigel. Stann. 
— as if tired : Rhus. 
— ulcerative : Puis. 
PRESSURE: Ambr. Asa f. Bar. 

Bell. Bry. Carb. veg. Coecul. 

Coloc. Dig. Euphorb. Grajjh. 

Laches. Lycop. Merc. Mosch. 

Natr. mur. Phosph. Ph. ac. Rheum. 

Rhus. Samb. Spong. Staph. Thuj. 
PULLING IN MUSCLES: Coloc. 
PUSTULES: Staph. 
RASH: Caust. 
SARCOMA : Bar. Calc. 
SENSITIVENESS: N. vom. 
AS IE GONE TO SLEEP : Rhus. 

Spig. 
SPOTS, yellow: Iod. 
— red : Carb. veg. Sep. Stann. 
STEATOMA: Bar. Puis. 



STITCHES : Aeon. Alum. Arn. Bar. 

Bellad. Calc. Cainph. Cann. Chin. 

Coecul. Graph. Ign. Merc. Phosph. 

ac. Puis. Rhus. Sepias. Stann. 

Staphys. Sulpk. 
AS IP STRAINED: Dulc. Nux 

vom. Puis. Zinc. 
SWEAT: Chin. N. vom. Sulph. 
AS IE SWOLLEN: Sep. 
TEARING: Asa f. Camph. Canth. 

Carb. veg. Graph. Ign. Kali c. 

Nux vom. Natr. Phosph. Plumb. 

SiL Spig. Sulph. 
TENSION: Alumin. Arnic. Aur. 

Bar. Bryon. Calcar. Camph. Canth. 

Carb. an. Caust. Con. Dig. Euphorb. 

Graph. Hyosc. Iod. Ipec. Kali c. 

Mosch. Nitr. acid. Plat. Plumb. 

Pulsat. Rhus. Sep. Sil. Staph. 

Sulph. Thuj. Zinc. 
TETANUS: Op. 
TWITCHING: Asa f. Caps. Chest. 

Natur. mur. Ph. ac. Sulph. 
MUSCLES, twitching of: Arg. 
ULCERS: Sil. 
UNSTEADINESS: Aeon. 
WEIGHT: N. vom. Petr. Phos. 

Rhus. Sabin. Samb. 



XXII. CHEST. 



Sensations. 
1. Internal Chest. 

ANXIETY : Aeon. Arn. Asa f. Bry. 
Camph. Cann. Caps. Chin. CoeeuJ. 
Ignat. Lach. Mosch> N. Yom. Pul- 
sat. Rhus. Samb. Sec. c. Spig. 
Spong. Staph. Yaler. Yeratr. 

AS IF A BAND AROUND: Sabad. 
Sabin. 

BLOOD, of erethism: Alum. Carb. 
veg. Bf. vom. Plumb. Rhod- Sep. 
Spong. Thuj. 



AS IE THE BLOOD DID NOT 

CIRCULATE: Sabad. 
AS IE BOUNDING: Croe. 
BORING: Aconit. Alum. Asa f. 

Cina. Kalic. Mur. ac. Ph. ac. Rlius. 

Spig. Staph. Thuj. 

BURNING: Aeon. Alum. Ambr. 
Ant. crud. Arg. Arn. Ars. Asa f. 
Bar. Bell. Bry. Calc. Canth. Carbo 
veget. Caust. Cliamom. Chin. Cic. 
Cina. CoecnL CofT. Con. Dros. 
Ferr. Graph. Hyosc. Ign. Iod. Lach. 



62 



CHEST. 



Lyc. Merc. Mosch. Mur. acid Nux 

vom. Phosph. Ph. ac. Plat. Buta. 

Sabad. Sabin. Sec. corn. Sep. 

Spong. Stann. Sulph. Zinc. 
CATABBH: Arn. Cann. Ign. Nux 

vom. 
CHILLINESS: Bry. Natr. 
AS IF CONCUSSED : Ehus. 
COOLING, pleasant: Euta, 
CONSTEICTION : Aconit Alumi- 
na. Arn. Ars. Asa f. Bell. Cann. 

Caps. Carb. an. Cham. Coccul. 

Coloc. Cupr. Digit. Droser. Ferr. 

Hell. Xgnat. Mosch. Nux vom. Natr. 

mur. Op. Phosph. Ph. ac. Puis. 

Plat. Ehodod. Rhus. Euta. Spig. 

Stann. Stram. Sulph. Veratr. 
CEAMPY PAIN : Puis. Veratr. 
CEAMPY FEELING: Aco. Bell. 

Bry. Canth. Carbo. an. Cham. 

Cina. Dulc. Hyosc. Kali c. Mur. 

ac. Nux vom. Plat. Ehod. Stann. 

Thuj. Yeratr. 
CUTTING: Alum. Arg. Arn. Aur. 

BeU. Calc. Caust. Chin. Con. Dig. 

Dulc. Kali c. Lyc. Merc. Mur. ac. 

Ph. ac. Plat. Pulsat. Euta. Sabin. 

Samb. Spigelia. Spong. Stann. 

Sulph. Veratr. Zinc. 
DIGGING: Arnica. Cann. Cina. 

Dulc. Ferr. Petr. Stann. 
AS IF DILATED : Bry. Stann. 
DEAWING INWAED : Cham. 
DEOPSY: Aeon. Ambra. Arn. Ars. 

Bry. Caps. Chin. Ferr. Hell. Ipec. 

Kali carb. Op. Ehus. Sabacl. Spig. 

Veratr. 
— of chest: Ars. Carbo veg. Coloc 

Con. Dig". Dulc. Kali c. Lyc. Mur. 

ac. Stann. 

DEYNESS, feeling of: Alumina. 

Canth. Ferr. Phosph. Stram. 
AS IF EMPTY: Coccul. Stann, 
AS IF FALLING: N. vom. 
FEEMENTING: Phosph. 
FULLNESS: Aeon. Antim. cruel. 

Arn. Bar. Canth. Caps. Con. Ferr. 



Ign. Lyc. Mosch. Nitr. ac. Phosph. 

Puis. Ehus. Euta. Sabad. Sabina. 

SepiaB. Sulph. Veratr. 
GNAWING: Arg. Euta. 
GEIPING: Veratr. 
GUEGLING: Cina. Kali c. Natr. 

mur. Euta. 
HAMMEEING: Phosph. 
HEAT : Arn. Ars. Aur. Bellad. Bry. 

Calc. Caust. Chin. Cic. N. vom. 

Nitric ac. Opium. Puis. Ehus. 

Buta. Spongia. Stann. Sulph. 
HEAVINESS: Aeon. Alum. Bar. 

Bry. Calc. lod. Phosph. Plat. 

Ehod. Sabacl. Samb. Sepice. Staph. 

Sulph. Zinc. 
INFLAMMATION : Aconit. Arn. 

Bry. Cann. Hyosc. N. vom. Puis. 

Rhus. Euta. Sec. corn. Spong. 
ITCHING: Carbo veg. Kali carb. 

Phosph. Ph. ac. 
JEEKS : Cann. Croc. Con. Lyc. Va- 

ler. 
— as if living : Croc. 

as if loose : Bry. 

as if the lungs adhered: Euph. 

Thuj. 
LUNGS, as if less dilatable: Asa f . 

Bry. Cina. 
— suppurating: Plumb. Puis. 
— inflammation of: Aco. Bell. Bry. 

Lyc. Phosph. Puis. Rhus. Sepiae. 

Sulphur. Tart. emet. 
— phthisis of: Bry on. Calcar. Carbo 

veg. China. Con. Dulc. Ferr. Graph. 

Iod. Kali c. Lyc. Natrum mur. 

Phosph. Pulsat. Buta. Samb. Sep. 

Spig. Stann. 
NAUSEA : Aeon. Arg. Asa feet. Bry. 

Croc. Nux vom. Rhus. Staph. 
PAIN, as if excoriated: Alum. Ars. 

Bar. Bry. Calc. Carb. veg. Caust. 

Cic. Cina. Graph. Ipec. Kali c. 

Lyc. Merc. Mur. ac. Natrum mur. 

Nitric acid. Phosph. Phosph. ac. 

Ehus. Sabina. Sep. Sil. Spongia. 

Stanno Staph. Sulph. Valer. Zinc. 



CHEST. 



63 



— as if bruised: Aco. Alum. Ambr. 
Arn. Bar. Canipli. Caust. Chamoui. 
Chin. Con. Ferr. Kali c. Merc. 
Pliosph. Rhod. Spig. Spong. Stan- 
num. Thuj. Zhic. 

— as if flying to pieces : Bry. Cina. 

— drawing: Asa f. Cann. Capsic. Car- 
bo veg. Cham. Chin. Coccul. Con. 
Digit. Dulc. Kali c. Nux vom. Ni- 
tric ac. Op. Plat. Puis. Ruta. Sep. 
Sil. Spig. Spong. Stann. 

— simple : Alum. Arn. Ars. Bar. Calc. 
Caps. Carbo anim. Carbo veg. 
Caustic. Cham. Chin. Cina. Coloc. 
Conium. Croc. Dulc. Ferr. Graph- 
ites. Iod. Lyc. Mosch. Mur. acid. 
Nitric ac. Phosph. Puis at. Rhod. 
Buta. Selen. Sep. Sil. Spig. Spong. 
Stann. Sulphur. VeratTo Zinc. 

PINCHING: Alum. Bellad. Carbo 
veg. Cina. Dulc. Ign. Kali c. Phos. 
ac. Samb. Spig. Spong. Thuj. 

PRESSING: Alum. Ambra. Bry. 
Graph. Ign. Nitr. ac. Pliosph. 
Sulph. Yeratr. 

— asunder: Euphorb. 

PRESSURE FROM WITHOUT: 
Cann. Chin. Coccul. Ign. N. vom. 

within : Arg. Asa f. Bell. Bry on. 

Cina. Dulc. Valer. Zinc. 

— as from a load: Arg. N. vom. 
Rheum. Sabad. Samb. Spig. 

AS IN THE LOWER PART CF 
THE CHEST: Alum. Arn. Asa 
foet. Chin. Cic. Croc. Hijosc. Plum- 
bum. Ruta. Sabad. Zhie. 

PULSATING: Alum. Bryon. Dig. 
Dulc. 

AS IF RAW: Ambr. Arn. Arsen. 
Bryon. Chin. Coccul. Dig. Hell. N. 
vom. Natr. mur. Rhus. Zinc. 

RESTLESSNESS : Bell. Chin. 
Staph. Thuj. 

RUSH OF BLOOD: Aeon, Arn. 
Bry. Carbo veget. Coccul. Cupr. 
Ferr. Hyosc. >~tix vom. Natrum 
mur. Puis. Rhod. Sep. Spong. Thuj. 



SHOCKS : Aconit. Calc. Cann. Croc. 

Dulc. Mur. acid. Flat. Ruta. 
SHUDDERING: Aeon. 
SPASM: Aconit. Arg. Asa foet. Bry. 

Calc. Cham. Cina. Coccul. Coil. 

Cupr. Dig. Ferr. Ipec. Kali c. Lyc. 

Mosch. Nitr. ac. Pelr. Phos. Puis. 

Sec. com. Sep. Sulph. Thuj. Zinc. 
STITCHES, in left side: Aconit. 

Alum. Ant. cruel. Arg. Am. Asaf. 

Bell. Bry. Calc. Camphor. Cann. 

Cantli. Caps. Carb. veg. Caust. 

Chin. Cic. Cina. Coccul. Con. Croc. 

Dig. Bale. Euphorb. Graph. Hell. 

Ign. Ipec. Kali c. Lyc. Merc. 

Mosch. Mur. ac. Natr. mur. Phosph. 

Ph. ac. Plat. Plumb. Puis. Rhus. 

Ruta. Sabad. Sabin. Samb. Sep. 

Spinel. Spong. Stann. Staphys. 

Sulph. Thuj. Valer. Veratr. Zinc. 
— in right side : Aeon. Alum. Ambr. 

Ant. cruel. Arg. Arn. Asa f. Bell. 

Bry. Cantli. Carb. an. Carb. veg. 

Caustic. China. Cina. Coccul. Co- 
loc. Con. Croc. Dig. Dulc. Graph. 

Hyosc. Ign. Iod. Kali carb. Mere. 

Natr. mur. Nitr. ac. Op. Phosph. 

Ph. ac. Plumb. Rhus. Ruta. Sabad. 

Sep. Sil. Spig. Spong. Stann. Staph. 

Sulph. Thuj. Veratr. Zinc. 
— in middle of chest: Aco. Alum. 

Ant. crud. Bry. Cham. Chin. Iod. 

Phosph. Plumb, 
—in diaphragm : Spig. 
— in sternum: Aeon. Arg. Am. Aur. 

Bell. Bry. Calc. Cantli. Capsic. 

Caustic. China. Con. Dulc. Ferr. 

Graph. Hep. Lyc. Natr. mur. Nitr. 

ac. Phosph. Ph. ac. Plumb. Sabin. 

Spig. Sulph. 
— from the chest through the back : 

Aeon. Ambr. Bryon. Canth. Carb. 

Carb. veg. Chin. Coccul. Ferr. Ly- 

cop. Plumb. Sabin. Sil. Spig. 

Sulph. 
— from within: Argent. Asa f. Bry. 

Canth. Carb. veg. Chin. Muriat. ac. 



64: 



CHEST. 



Nitric ac. Sabad. Spig. Spong. 

Valer. 
AS IF STOPPED UP: Bry. 
TEARING: Arg. Canthar. Carbo 

veg. Caust. Con. Dulc. Graph. 

Kali c. Merc. Natr. mur. Op. Petr. 

Phosph. Puis. Rhus. Spig. Stram. 

Zinc. 
TENSION: Arg. Ars. Bell. Bry. 

Cann. Caustic. Cham. Cic. Coccul. 

Con. Dig. Dulc. Euphorb. Graph. 

Ign. Lye. Mur. acid. N. voni. Natr. 

mur. Phosphor. Pulsat. Rheum. 

Rhod. Rhus. Ruta. Sabin. Sep. 

Spig. Stann. Staph. Sulph. Zinc. 
THROBBING: Aeon. Asa f. Bar. 

Bell. Bry. Cann. Cajjs. Chamom. 

Coff. Digit. Graph. Ign. N. vom. 

Phosph. Sil. Sulph. Thuj. Veratr. 

Zinc. 
TICKLING: Bar. Cham. Chin. Kali 

carb. Phosph. Stann. Veratr. 
AS IE TOO TIGHT: Hell. Pulsat. 

Spig. 
TIGHTNESS, feeling of: Puis. 
TINGLING: Aeon. Arsen. Coloc. 

Phosph. ac. Sep. Spig. Spong. 

Stann. Thuj. 
TREMBLING: Kali carb. Phosph. 

Ruta. Sabin. 
TWITCHING: Cina. Coloc. Croc. 

Dulc. Kali c. Lye. Natr. mur. Sep. 

Spig. Valer. 
ULCERATIVE PAIN: Bry. Puis. 

Staph. 
WARMTH: Bry. Coff. Hell. Nux 

vom. Veratr. 
— unpleasant : Alum. Euphorb Natr. 

mur. 
— feeling of : Merc. 
WEAKNESS: Iod. Kali c. Plat. 

Rhus. Stann. Sulph. 
— feeling of: Carbo veg. Chin. Plat. 

Stann. Staph. 
AS IE WEARY: Am. Carb. veg. 

Spong. 
WRENCHING: Samb. 



2. External Chest 
BLUE SKIN NEAR CLAVICLE: 

Thuj. 
BOILS : Arn. Chin. 
BURNING : Ambr. Arsen. Asa f . Bar. 

Bell. Canth. Caps. Croc. Digit. 

Droser. Euphorb. Eerr. Mur. ac. 

N. yom. Phosph. Ph. ac. Plat. 

Rheum. Rhus. Selen. Sulph. Zinc. 
BONE-PAIN: Chin. 
CHILLINESS: Spig. 
CONTRACTION: Arn. Dap h. Bry. 

Dig. N. vom. Op. Plat. Rhod. Bhus. 

Spig. 
CONTUSIVEPAIN: Ant. cr. Arn. 
CRACKLING: Rheum. 
CRAMPY PEELING: Aeon. Arg. 

Calc. Cham. Cina. Dig. Dulc. Nitr. 

ac. Plat. Sep. Veratr. 
CREEPING: Arn. Dros. 
CREEPING CHILL : N. vom. 
DRAWING : Aeon. Asa f . Carb. veg. 

Cupr. Dig. Dulc. Lycop. Mur. ac. 

N. vom. Puis. Bhus. Spig. Stann. 

Zinc. 
GNAWING: Arg. Calcar. Ruta, 

Spong. 
HEAT : Cham. Cic. Dig. Puis. 
HERPES : Ars. Lye. Petrol. Staph. 
INSENSIBILITY: Rhus. 
ITCHING: Alum. Ant. crud. Bar. 

Calcar. Canth. Capsic. Carb. v. 

Caust. Chin. Coccul. Con. Kali c. 

Lye. Natr. mur. Op. Phosph. Puis. 

Sep. Spong. Staph. Veratr. 
— of the sides of chest : Alum. Arn. 

Canth. Cic. Nitr. acid. Spong. 
JERKING: China. Platin. Pulsat. 

Stann. Stram. 
LAMING PAIN: N. vom. 
PAIN, as if contused: Con. Dulc. 

Merc. Mur. ac. Natr. mur. 
— as if sprained : Arn. Coccul. 
— as if sore: Bar. Bryon. Sep. Staph. 

Veratr. 
— as if bruised: Arn. Chin. Ign. 

Merc. JSf. vom. Natr. mur. Nitr. ac. 



CHEST. 



G5 



Phosph. Ph. ac. Kheum. Spig. 

Staph. Sulph. 
— simple: Ant. cr. Bry. Cann. Cap- 
sic. Chin. Cupr. Dulc. Natr. mur. 

Phosph. Ph. acid. Puis. Khodod. 

Rhus. Sabin. Sep. Silic. Staphys. 

Sulph. Yeratr. 
PECKING: Euta. 
PIMPLES : Ant. crud. Aur. BeU. 

Biy. Ganth. Coccul. Con. Hep. Ph. 

ac. Plumb. Rhus. Staph. 
PINCHING: Nux vom. Phosphor. 

Ehod. Samb. 
PRESSUEE: Alum. Ambra. Arg. 

Arn. Asa f. Aur. Bry. Camph. 

Canthar. Chin. Cina. Coccul. Cupr. 

Dulc. Dros. Hyosc. N. vom. Plumb. 

Eheum. Euta. Sabin. Spig. Stann. 

Staphys. Sulphur. Valer. Yeratr. 

Zinc. 
— from without: Ehus. 
PEICKLING: Plat. 
PULLING: Phosph. 
EASH: Ant. crud. Staph. Yaler. 

Yeratr. 
REDNESS : Aur. Bell. 
EHEUM ATIC PAIN: Ambr. Bry. 

Spig. 
RIBS RAISED: Spig. 
SENSITIVENESS: Cann. Canthar. 

N. vom. Sulph. 
SHUDDERING: Chin. Cina. Nux 

vom. Plat. Ruta. Spig. Staph. 
AS IF TOO SHORT: N. vom. 
GONE TO SLEEP : Merc. 
SPASMS : Cic. Puis. Strain. Yeratr. 
SPOTS, brown: Carta veg. 
— yellow : Ars. Phosph. 
— red: BeU. Carbo veg. Coccul. Lye. 

Sabad. 
STITCHES: Am. Asa feet. Aur. 

BeU. Bry. Calc. Camph. Cann. 

Canth. Caust. Chin. Coccul. Con. 

Croc. Dros. Dulcam. Euphorb. 

Hep. Mur. ac. Nux vom. Nitr. ac. 

Phosph. Ph. ac. Plumb. Puis. 



Eheum. Rhus. Euta. Sabad. Sabin. 

Sil. Spig. Spong. Stann. Staph. 

Sulph. Teuc. Yeratr. Zinc. 
SWEAT : Arg. Arn. BeU. Calc Canth. 

Chin. Coccul. Euphr. Hep. Ipec. 

Lye. Merc. Pbos. Ph. ac. Flumb. 

Ehus. Sabad. Sec. corn. Selen. Sep. 
SWELLING: Bryon. Calc. Can. 

Dulc. Iod. Ehus. Sep. Sil. Sulph. 
TEAEING: Ambr. Bry. Camph. 

Dulc. Iod. Kali c. Lye. Merc. N. 

vom. Ehod. Sabin. Spig. 
— near the clavicle : Lye. Stann. 
TENSION: Asaf. Cham. China. Dig. 

Dros. Dulcan. Euphorb. Pen-. Iod. 

Merc. Mur. ac. N. vom. Natrum 

mur. Phosph. Puis. Ehodod. Ehus. 

Sablna. Spig. Stann. Thuj. 
TUBERCLES : Cann. Caust. 
TWITCHING: Merc. Spig. 
ULCEES : Ars. Hep. Sulph. 
ULCEEATIYE PAIN : Bry. Puis. 
WAEMTH: N. vom. Ehus. 
WEENCHING: Puis. 

3. AxilloB. (Arm pit.) 

BUENING: Carbo veg. 

CRAWLING : Con. Mezer. 

DAMPNESS: Carbo an. Sulph. 

DRAWING: BelL Sil. 

AS IF EXCORIATED: Con. 

INDURATION: Iod. 

INFLAMMATION : Nitric ac. Petr. 
Phosph. Sulph. 

ITCHING: Carbo an. Carbo veg. 
Caust. Con. Dig. Kali. Phos. Sep. 

PAIN GENERALLY : Bellad. Car- 
bo veg. Con. Nitric ac. Sil. 

SENSITIVENESS : Nitr. ac. 

STITCHES : Arn. Con. Sulph. 

SUPPURATION : Calc. Coloc. Hep. 
Petr. Sil. Sulph. 

SWEAT: Dulc. Kali. Natr. mur. 
Phosph. Rhod. Sep. Sulph. 

SWELLING: Bellad. Calc.Phosph. 
Iod. Hep. Lye. Natrum mur. Ni- 
tric ac. Petr. Phosph. Sep. Sulph. 



66 



CHEST. 



Breasts. 

4. Mammary glands. 

BLOTCHES : Bell. Calc. Carl). Carbo 

an. Cliamom. Con. Dulc. Graph. 

Lye. Phos. Euta. Sil. Sulph. 
CANCEB : Arnica. Ars. Calcar. Car- 
bo an. Carbo veg. Caust. Kali. 

Lye. Nitric ac. Phosph. Rhus. Sep. 

Sil. Sulph. 
CONTUSION: Am. 
CEAWLING: Con. 
DBA WING: Cham. 
EEYSIPELAS: Aco. Bell, Bry. 

Phosph. Sil. 
AS IF EXCOEIATED: Con. 
HAEDNESS : Ambr. Bryonia. Cham. 

Com. Phosphor. Plumb. Sil. Sulph. 
HEAT : BeH. Bry. Cann. 
INDUEATION, see Tubercles. 
INFLAMMATION: Aconit. Arn. 

Bry. Carbo veget. Cham. Con. 

Phosph. Pulsat. Sil. Sulph. 
ITCHING: Caust. Con. Kali. N. 

vom. Plumb. Ehus. 
MILK, bitter and'yellow : Eheum. 
— blueish: Lach. 
— too fat : Puis. 
— setting in: Puis. 
— fever : Aeon. Arn. Bryo. Cham. Coff. 

Ign. N. vom. Op. Puis. Rhus. 
— excessive flow of : Aconit. Chin. 
— vanishing of: Agn. Bry on. Calc. 

Cham. Puis. Bhus. Sec. corn. Zinc. 
— increase of : Bryon. N. vom. Puis. 
— stoppage of: Bell. 
—flow of : Bell. Calc. Puis. 
PAIN, simple : Cann. Cliamom. Coloc. 

Con. Mercur. Silic. Veratr. 
PBESSUBE: Bell. Ph. ac. Pulsat. 

Sabin. 
SHUDDEBING: Coccul. N. vom. 
TOO SMALL : Cham. 
STITCHES : Alum. Bar. Bellad. Con. 

Nux vom. Natr. mur. Plumb. Sep. 

Yeratr. Zinc. 
SWELLING : Bell. Bry. Cham. Con. 



Dulc. Merc. Phosph. Plumb. Puis. 

Euta. Sabina. Sil. Sulph. 
TEAEING: Bar. Cham. 
TENSION: Puis. 
ULCEBS: Hep. Merc. Phos. Sil. 

Sulph. 
ULCEEATIVE PAIN: Merc. 
WITHEEING: Cliamom. Con. Iod. 

5. Nipples. 
BUBNING: Cic. Graph. Sulph. 
CEEEPING: Sabin. 
DISCHABGE OF BLOOD AND 

HUMOB: Lye. Plumb. 
HAEDNESS: Merc. 
INDUEATION : Bry. 
INFLAMMATION : Aco. Bryon. 

Cham. Phosph. Puis. Sil. Sulph. 
ITCHING: Con. Pulsatilla. Ehus. 

Sabad. 
PAIN, simple: Graphit. Nux vom. 

Eheum. Sulph. 
EHAGADES : Arn. Graphit. Sulph. 
SENSITIVENESS : N. vom. 
SHOCKS : Bry. 
SOEENESS: Arn. Calc. carbon. 

Cham. Graph. Lye. Puis. Sulph. 
SOEEPAIN: Calc. Zinc. 
STITCHES : Camph. Cann. Coccul. 

Ign. Lye. Mur. ac. Eheum. Sabin. 

Sulph. 
SWELLING: Merc. 
ULCEBATION: Chain. 
6. Heart and region of the heart. 
ANXIETY : Aeon. Alum. Ambr. Ars. 

Aur. Calc. Cann. Canth. Cliamom. 

Cina. Coccul. Croc. Cupr. Ferr. 

Graph. Hell. Lye. N. vom. Nitric 

ac. Op. Phosph. Plumbum. Pulsat. 

Rhus. Sec. corn. Sep. Sil. Stram. 

Sulph. Veratr. 
BEATS OF THE HEAET, inter- 
mittent: Bry. Chin. Digital. Kali. 

Natr. mur. Sulph. 
— slow. Arn. 

— quick : Arn. Asa f . Sabin. 
— unequal : Asa f. Sabin. 
— imperceptible : Ehus. Verat. 



CHEST. 



67 



— stronger: Ars. Aur. Calear. Cliin. 

Dig. Dulcani. Hyosc. Phosph. Sa- 

bina. Spigel. Yeratr. 
—full: Aeon. 

BURNING: Carb. veg. Op. Puis. 
CONTUSIYEPAIN: Natr v aiur. 
CRAWLING: Canth. 
DRAWING: Canth. 
EXCITEMENT, vascular: Carbo 

veg. Nux vom. Sulph. 
HEART, trembling of: Aur. Bell. 

Calc. Camph. Cina. Rhus. Sep. 

Spig. 
— throbbing in the region of the: 

Ars. Bar. Calc. Hell. Lycop. Phos- 
phor. Sep. Sil. Sulphur. Zinc. 
HUMMING: Spig. 
INFLAMMATION: Acou. Arsen. 

Bry. Cann. Coccul. Spig. Puis. 

Rheum. 
JERKING: Arn. N. vom. Plumb. 
OPPRESSION: Bell. Cham. Nux 

vom. Spig. 
PALPITATION, generally: Aeon. 

Alum. Amb. Am. Ars. Aur. Bar. 

Bell. Bryon. Calear. Camph. 

Cann. Canth. Carbo an. Carbo 

veg. Caust. Cham. China. Coccul. 

Coloc. Con. Croc. Cupr. Dig. Graph. 

Hell. Igu. lod. Ipec. Kali. Lye. 

Merc. Mur. ac. Xatruni mur. Nitric 

ac. Xux vom. Petr. Phosph. Phos. 

acid. Plumb. Puis. Rhus. Sabad. 

Sabin. Secale corn. Sep. Sil. Spig. 

Spong. Staph. Sulph. Thuj. Valer. 

Yeratr. Zinc. 
— Avith anguish: Aeon. Alum. Ars. 

Aur. Calc. Cann. Caust. Cham. 

Chin. Coccul. Coloc. Dig. Graph. 

Kali. Lye. Mosch. Natr. mur. Nux 

vom. Phosphor. Plat. Plumb. Puis. 

Sec. corn. Sep. Sil. Sulphur. Spi- 

gel. Thuj. Veratr. 
— without anxiety : Carbo anim. Ipec. 

Sulph. Thuj. Zinc. 
— perceptible: Plumbum. Rhu3. Sa- 
bin. Yeratr. 



— audible : Camph. Dig. Spig. 

— spasmodic: Sec. com. 

— visible : Con. Dulc. Graphites. Iod. 

Rhus. Secale corn. Spig. Sulph. 

Thuj. 

PAIN, simple: Cann. Cantharis. 

Cham. Puis. Ruia. Thuj. 
PRESSURE: Aco. Am. Ars. Asa f. 

Bell. Cann. Canth. Cham. Con. 

Graph. Kali. Lye. Natr. mm*. Nux 

vom. Pulsat. Rhus. Spig. 
QUALMISHNESS: Cham. N. vom. 
RUSH OF BLOOD: Aeon. Asa f. 

Carbo veg. Cham. Ferr. Lye. Nux 

vom. Nitric ac. Phosjjh. Puis. Sep. 

Sulph. 

STITCHES: Arn. Aur. Calear. 

Canth. Capsic. Carbo veget. Caust. 

Cham. China. Croc. Ign. Mur. ac. 

Nux vom. Nitric ac. Petr. Plumb. 

Rhus. Sep. Spig. Sulph. Yaler. 

Zinc. 
TEARING: Canth. Lye. 
WARMTH : Cann. Yeratr. 
— feeling of : Rhod. . 
WEAK FEELING: Rhus. 
WEIGHT: Croc. Puis. 

According to Situation 
and Circumstances. 
1. Aggravated. 
IN THE OPEN AIR : Ambr. Bryon. 
Caust. China. Coccul. Cofiea. Con. 
Euphorb. Graph. Ignat. Lye. Merc. 
Natr. mur. Nux vom. Rhus. Sabad. 
Sep. Spig. Stann. Staph. 
WHEN ASCENDING : Bell. Graph. 
N. vom. Sep. Thuj. Zinc. 

the stairs : N. vom. Rhus. Ruta. 

Spong. Staph. 
WHEN BREATHING: Aeon. Ant. 
crud. Arg. Arn. Ars. Asa f. Aur. 
Bryo. Calc. Cann. Caps. Cnamom. 
China. Cina. Coccul. Dulc. Dros. 
Graphit. Hep. Hyosc. Lycop. Mer- 
cur. Natr. mur. Nitr. ac. Puis. Sep. 
Spig. Stann* 



CHEST 



WHEN DRAWING A LONG 

BREATH: Calc. Merc. Natr. mur. 
AFTER A GOLD: Aeon. Bryon. 

Carbo veg. Cham. N. vom. Rhus. 
IN THE COLD: Rhus. Sabad. 
IN COLD AIR: Aconit. Bryonia. 

Carbo veg. Coccul. Rhus. Sabad. 

Spong. 
BY CONTACT: Aeon. Arg. Arn. 

Bar. Bry. Calc. Canth. Caps. Carbo 

veg. Cham. Chin. Coccul. Cupr. 

Dros. Dulc. Graph. Merc. Nux 

vom. Phosph. Ph. ac. Plumb. 

Rhod. Rhus. Ruta. Sabin. Spig. 

Staph. Sulphur. Veratr. 
AFTER CONTUSIONS : Arn. Puis. 

Rhus. Ruta. 
WHEN COUGHING: Aco. Alum. 

Ambr. Ant. crud. Arn. Ars. Bar. 

Bryon. Calc. Cannab. Caps. Carbo 

veget. Caustic. Chain. Chin. Cina. 

Coff. Con. Dig. Bros. Ferr. Iod. 

Kali. Lye. Merc. Mur. ac. Natr. mur. 

Nitric ac. N. vom. Phosph. Phosph. 

ac. Puis. Rhus. Ruta. Sabad. Sa- 

bina. Sep. Sil. Spigel. Spongia. 

Stann. Staph. Veratr. 
AFTER COUGHING: Cina. Ferr. 
IN DAMP WEATHER: Carb. veg- 
etal*. 
DURING DIGESTION: Lyc» 
WHEN DRINKING: Chin. 
AFTER DRINKING: Arn. China. 

Coccul. Con. Cupr. Nux vom. 

Veratr. 
BY DRINKING COLD : Thuj. 
AFTER DRINKING BEER: Sep. 

wine : Ant. crud. Nux vom. 

WHEN EATING: Arnic. China. 

Coccul. Ign. Phosph. 
AFTER EATING: Aconit. Ambra. 

Ant. crud. Arn. Asa f. Bry. Canth. 

Caps. Carbo an. Caust. Chamom. 

Chin. Coccul. Con. Ferr. Hyosc. 

Ign. Lye. Merc. Nux vom. Phos. 

Puis. Rhus. Ruta. Sep. Thuj. Valer. 

Veratr. Zinc. 



BY EATING WARM FOOD: Eu- 

phorbium. 
BY GETTING WARM IN BED: 

Chamom. Puis. Rhus. 
BY EMOTIONS : Phosph. 
BY BODILY EXERTIONS : N. 

vom. Rhus. Spong. 
AFTER EXPECTORATING : Zinc. 
WHEN FALLING ASLEEP : Sul. 
BEFORE THE FEVER: Chin. 
DURING THE FEVER : Aeon. 

Bryon. Chin. Ipec. 
— the chill : Bry. Ipec. N. vom. Puis. 

Rhus. 
— the heat : Aeon. Caps. China. Ipec. 

Nux vom. Puis. 
AFTER A FRIGHT: Aeon. Cha- 
mom. Ign. Op. 
BETWEEN THE INSPIRATION: 

Ign. Merc. Spig. 
WHEN LIFTING: Bar. Kali. Lye. 
AFTER LYING DOWN: Hell. Ig- 

nat. Nux vom. Puis. Rhus. Sabad. 

Stram. 
WHEN LYING DOWN: Ant. crud. 

Asa f. Calc. Canth. Carbo veg. 

Cham. Ferr. Natr. mur. Nitr. ac. 

Puis. Rhus. Selen. Sulph. 
BY MENTAL LABOR: Ign. N. 

vom. Sep. 
BEFORE THE MENSES: Cupr. 

Puis. Spong. 
DURING THE MENSES : BeU. 

Caustic. Cham. Graph. Phosphor. 

Puis. 
DURING MOTION: Aeon. Alum. 

Arg. Am. Bell. Bry. Calc. Camph. 

Cann. Capsic. Carbo veg. Cham. 

Chin. Coccul. Con. Dig. Euphorb. 

Ferr. Graphit.He-p. Ign. Iod. Lye. 

Mercur. Natrum mur. Nitric ac. 

Nux vom. Op. Phosph. Ph.ac. Puis. 

Rhodod. Ruta. Sabina. Samb. Sep. 

Spigel. Spongia. Stann. Staph. 

Sulph. Veratr. Zinc. 
WHEN MOVING THE ARMS : 

Dig. Plumb. Pub. 



CHEST. 



69 



BY MUSIC : Nux vom. Staph. 
DURING NOSE BLEED: Carbo 

veg. 
WITH NAUSEA : BeU. 
BY PRESSING ON THE ABDO- 
MEN: Asaf. 
BY EXTERNAL PRESSURE: An- 

tim. crud. Bry. Chin. Cina. N. 

vom. Ruta. Spongia. Staphys. Va- 

ler. 
WHEN RAISING ONE'S-SELF: 

Aco. Arg. Bry. Cann. Cic. Dig. 

Ign. Stann. Staph. 
WHEN RISING FROM BED : Ant. 

cruel. Plat. Stann. Staph. 

from a seat : Sil. 

AFTER RISING: Nux vom. Puis. 

Rhus. Spig. 
WHEN READING: Chin. 

loud: Coccul. 

DURING REST: Arg. Am. Bell. 

Caps. Cham. Chin. Ferr. Natr. 

mur. Phos. ac. Puis. Rhus. Ruta. 

Samb. Stann. 
IN THE ROOM: Bry. Croc. Puis. 

Rhodod. Spig. 
BY RUNNING: Bry. Cina. Nux 

vom. Sil. 
BY SINGING: Stann. 
WHEN SITTING: Arg. Ars. Asa 

feet. Bell. Calc. Caps. Carbo anim. 

Carb. veg. Chin. Cina. Coloc. Dros. 

Dulc. EupJiorb. Ferr. Merc. Mur. 

ac. Phos. Puis. Rhus. Ruta. Sabacl. 

Silic. Spigel. Spong. Stann. Staph. 

Sulph. Thuj. Yaler. 

crooked : Argent. China. Rhod. 

Rhus. Spig. Spong. 

erect: Aeon. Natr. mur. 

AFTER SLEEPING : Aconit. Ainbr. 

Bry on. Calcar. Chin. Coccul. 

Euphr. Ignat. Nux vom. Op. Rheum. 

Sabad. 
BY SMOKING: Cic. Ign. Spong. 

Staph. 
WHEN SNEEZING : Aeon. Bryon. 

Cina. Merc. Sil. 



WHEN STANDING : Carb. an. Con. 

Euphorb. Natr. mur. Stann. Sulph. 

Zinc. 
BY MAKING A WRONG STEP : 

Bry. Puis. Spig. 
BY STIMULANTS: Stann. 
BEFORE STOOL: Spig. 
DURING STOOL: Spig. 
AFTER STOOL: Sil. 
WHEN STOPPING THE 

BREATH : Dros. Merc. Spig. 
WHEN EXPIRING AIR: Arabr. 

Ant. cr. Arg. Ars. Aur. Bry. Carb. 

veg. Cham. Chin. Cic. Cina. Ign. 

Iod. Mur. ac. Phosph. ac. Ruta. 

Sabad. Sep. Spigel. Stann. Staph. 

Zinc. 
WHEN INSPIRING AIR: Aco. 

Ars. Am. Aur. Bar. Bry. Calc. 

Camph. Cann. Canth. Caps. Carb.v. 

Caust. Cham. Chin. Cic. Cina. Coc- 
cul. Coloc. Con. Dulc. Euphras. 

Hell. Hyosc. Iod. Kali. Lye. Merc. 

Mur. ac. Natr. mur. Nitr. ac. Op. 

Phos. Ph. ac. Plat. Plumb. Pulsat. 

Rhus. Ruta. Sabad. Sabin. Sep. 

Sil. Spinel. Spong;. Stann. Sulph. 

Yaler. Veratr. Zinc. 
WHEN DRAWING A LONG 

BREATH : Aeon. Arg. Arn. Bryon. 

Canth. Caps. Cina. Dros. Ign. Puis. 

Rhus. Sabin. Spig. 
WHEN STOOPING: Aeon. Alum. 

Arg. Arn. Asa f. Bry. Cann. Caps. 

Carb. veg. Chin. Coccul. Coloc. 

Dig. Dros. Hell. Ign. Merc. Nitr. 

ac. N. vom. Phos. Ph. ac. Puis. 

Rhodod. Rhus. Sine. Spigel. Spong. 

Stann. Staph. Yaler. Zinc. 
WHEN STRAINING: Rhus. 
WHEN TALKING: Bry. Cann. 

Canth. Chin. Coccul. Ignat. Puis. 

Rhus. Stram. 
WHEN TALKING LOUD : Carb. v. 

Kali. Mur. acid. Natr. mur. Stann. 
BY TIGHT CLOTHES : N. vom. 

Spong. 



70 



BACK. 



BY TURNING TO THE EIGHT 

SIDE: Spig. 
WHEN TUBNING IN BED: Aeon. 

Cairn. Caps. Garb. veg. Nux vom. 

Staph. 
BEFOEE VOMITING: Cupr. 
WHEN WAKING: Ant. cr. Arn. 

Dig. Euphr. Ign. Puis. Bhus. Sa- 

bad. 
WHEN WALKING: Aconit. Arn. 

Bry on. Camph. Caps. Chin. Cic. 

Coccul Ferr. Ign. Nux vom. Euta. 

Spigel Spong. Staph. Valer. Ve- 

ratr. 
AFTEE WALKING: Pulsat. Ehus. 

Valer. 
WHEN WALKING IN THE OPEN 

AIE: Bry. Chin. Coff. N. vom. 

Ehus. Spig. Spong. Staph. 
AFTEE WALKING IN THE OPEN 

AIE : Ferr. N. vom. Rhus. Sabad. 
WHEN WALKING FAST: Chin. 

Spig. 
WHEN WRITING: Asa f. Chin. 

Coccul. Valer. 

2. Believed. 

IN THE OPEN AIE: Bry. Natr. 
mur. Puis. 

BY WAEM AIE: Carb. veg. 

BY BENDING BACK: Aeon. Cann. 
N. vom. Puis. 

BYBEEATHING: Asa f . Cina. 

BY EXPIEATIONS: Cina. Merc. 

BY INSPIRATIONS: Cina. Merc. 

BYDEAWINGALONGBEEATH: 
Dig. Stann. 

DUEING CONTACT: Mur. ac. 

AFTEE DEINKING: Bry. Ferr. 

AFTEE EATING: Bry. Ehus. Sa- 
bad. 



AFTEE EBUCTATIONS: Ambr. 

Canthar. Kali. N. vom. Petr. Sep. 

Zinc. 
AFTEE EMISSION OF FLATU- 
LENCE : Spig. Strom. Veratr. 
BY FEICTION: Calc. 
WHEN LYING DOWN : Alum. Bry. 
Canth. Iod. Nux vom. Sabad. 
Zinc. 

on one side : Alum. 

on the back : Arn. Bry. Ign. 

Puis. Sabad. 

on the painful side : Ambr. Arn. 

Bry. Cham. Ign. Nux vom. Puis. 

on the painless side : Ign. N. 

vom. 
BY MOTION : Arg. Arn. Cham. Cina, 

Dros. Euphorb. Mur. ac. Ph. ac. 

Plumb. Puis. Ehus. Sabad. Sep. 
BY PBESSUBE EXTEENALLY: 

Asa f. Bry. Chin. Cina. Dros. Ign. 

Puis. Veratr. 
DUEING BEST: Arn. Bry. Chin. 

N. vom. Sabin. Staph. 
BY EISING: Canth. Carb. anim. 

Dulc. N. vom. Puis. Ehus. 
IN THE EOOM: Bry. Cham. Nux 

vom. 
BY SITTING UP: Alum. Asa f. 

China. Dig. Puis. Spig. 
WHEN SITTING: Alum. Bry. Caps. 

N. vom. 
WHEN STANDING: Chin. Cicut. 

Euta. 
BY STOOPING: Chin. Ign. Valer. 
AFTEE SWEAT: Canthar. Cham. 

N. vom. Puis. 
WHEN WALKING: Chin. Cicut. 

Dros. Ferr. Mosch. Plumb. Puis. 

Rhus. Euta. Staph. 



Sensations. 

1. Scapulae. {Shoulder Blade.) 
BOILS : Amm. mur. Led. 



XXIII. BACK. 

BURNING: Aeon. Bar. Carb. veg. 
Chel. Iod. Lye. Sep. Sil. Sulph. 



Veratr. 



BACK. 



71 



CHILLINESS: Alum. Elms. 
CONTRACTION: Chin. Lach. Lye. 

Rhus. Viol. trie. 
CEAMPY FEELING: Baryt. Bel- 
lad. Kali. Merc. Elms. 
CRAWLING: Laur. 
CUTTING: Oalcar. carbon. Elms. 

Sulpli. ac. 
DISLOCATION PAIN: Chin. 

Coloc. Mur. ac. Petr. Plmnb. 

Ehod. 
EEUPTION: Bell. Bryon. Caust. 

Lye. Merc. Phosph. Ph. acid. 

Squilla. 
GNAWING : Alum. Merc. Phos. ac. 
HEAT : Mur. ac. Puis. 
HEAVINESS: Menyanth. 
ITCHING: Amn. mur. Arn. Bell. 

Da ph. Laur. Mercur. Oleand. Spig. 

Stront. 
PAIN, as if sore : Coloc. Plat. 

bruised: Anac. Bar. China. Hell. 

Kali. Merc. Natr. mur. N. vom. 
Sulph. Thuj. 
PRESSURE: Anac. Arn. BeUad. 

Bry. Calc. Caust. Chin. Laur. Mur. 

ac. Seneg. Sil. Sulphur. Siann. 

Zinc. 
RIGIDITY: Ang. Bellad. Caustic. 

Led. 
AS IF GONE TO SLEEP : Anac. 
STITCHES: Alumin. Amm. mur. 

Anac. Asa f. Aur. Bry. Bell. Bov. 

Camph. Cann. Canthar. Caps. 

Caust. Chin. Cina, Cocc. Colch. 

Dulc. Ferr. Hep. Kali. Lach. Laur. 

Mur. acid. Natr. Natr. mm-. Nitr. 

Nitric ac. N. vom. Plumb. Puis. 

Ran. bulb. Sabad. Samb. Sassap. 

Sepiae. Spig. Spong. Stannum. 

Thuj. Zinc. 
TEARING AND Dl.AWING : 

Alum. Anac. Asa f. Aur. Calc. 

carb. Carbo veg. Canst. Chamom. 

Dulc. Lach. Lye. Mur. magn. Phos. 

Plumb. Rhod. Rhus. Sep. Stann. 
TENSION: Alum. Bar. Carbo an. 



Coloc. Colch. Kali. Kreosot. Natr. 

Rhus. Sep. Sil. Sulph. 
THEOBBING: Baryt. Kali. Merc. 

Phosph. 
TUBEECLES : Amm. mur. 
TINGLING: Anac. Dulc. Sabad. 

Sil. 
TWITCHING : Calc. carb. Phosph. 

Rhus. Squilla. 

2. Back. 

AS IF ALIVE : Plumb. 
BOEING : Aconit. Agar. Coccul. 

Spig. Thuj. 
BUENING: Aeon. Agar. Arnica. 

Ars. Bar. Carbo an. Carbo veg. 

Chel. Lye. Merc. Mur. ac. Nitric 

ac. Nux vom. Phosphor. Plat. Sep. 

Sil. Sulph. Veratr. 
CHILL: Bellad. Calc. carb. Dulc. 

Lach. Lye. Nux vom. Phosph. 

Ehus. Sep. Sil. Stann. Sulph. 
COLD FEELING: Carbo veget. 

Con. Mur. ac. 
CEAMPY FEELING: Carbo vege- 

tab. Euphr. Merc. Nitr. Puis. 
CEAWLING: Aeon. Bell. Graphit. 

Laur. Natr. Sec. corn. 
CUEVATUEE OF THE SPINE: 

Bell. Calc. carb. Lycop. Merc. Puis, 

Rhus. Sil. Staphys. Sulph. 
CUTTING: Calc. carb. Sep. Sil. 
DIGGING: Aeon. Sep. 
DISLOCATION-PAIN: Agar. Ar- 

nir. Calcar. Cocc. Mur. ac. Rhus. 

Sulph. 
EEUPTION: Bar. Bell. Calc. carb. 

Carbo veg. Caust. Cocc. Led. Merc. 

Natr. mur. Pulsat. Sel. Sep. Squil- 
la. Sulph. 
HEAT: Con. Merc. Natrum mur. 

Phosph. ac. Puis. Sulph. 
HEAVINESS: Ambra. Carbo veg. 

Phosph. Sep. Sulph. 
ITCHING: Alumina. Amm. mur. 

Baryt. Calc. carb. Causticum. 

Daphne. Laur. Kali. Lycop. Merc. 



72 



BACK. 



Natr. Nitric ac. Phos. Sassap. Sil. 

Sulph. Thuj. 
JEBKS : Calc. carb. Staph. 
LAMENESS: Agar. Cocc. Natr. 

mm*. Phosph. 
MUSCLES, twitching of : Carbo 

veg. 
OPISTHOTONOS : Ang. Bell. Can- 

thar. Cham. Cicut. Lgn. Nux vom. 

Op. Rhus. Stann. Stram. 
PAIN, sore : Kali. Plat. Staph. 
— as if bruised : Agar. Alumina. Amm. 

mur. Am. Ars. China. Dros. Lach. 

Merc. Natr. mur. N. vom. Ehus. 

Buta. Stann. Stram. Veratr. 
—simple : Agar. Alum. Arsen. Asa f . 

Aur. Bov. Calc. carb. Cann. Carbo 

animalis. Hyosc. Kreos. Lye. Hep. 

Lach. Natr. mur. Nitric ac. N. Yom. 

Op. Petr. Sep. Sil. Sulph. Veratr. 
PKESSUEE: Aconit. Agar. Arn. 

Bell. Calc. carb. Carbo veget. Caust. 

Cocc. Dulc. Graphit. Kali. Lye. 

Mur. ac. Natrum mur. Nux vom. 

Pulsat. Bhus. Sep. Stannum. Staph. 

Veratr. Zinc. 
AS IP GONE TO SLEEP : Mer- 

cur. Bhosph. 
EIGIDITY: Ang. Petr. 
SHUDDEBING: Ang. Bell. Canth. 

Chel. Cocc. Daph. Colchic. Graph. 

Lach. Led. Natr. mur. Nux vom. 

Buls. Bhus. Sabad. Staph. Sulph. 

Thuj. 
SPASM: Agar. Bell. Iod. Lye. 
SPOTS : Sep. Carbo veg. 
STIFFNESS : Agar. Alum. Carb 

veg. Caust. Kali. Led. Nux vom. 

Petr. Pulsatilla. Sep. Sulph. 
STITCHES : Aeon. Ant. cruel. Ar- 
gent. Arn. Asa f. Bry. Calc. carb. 

Cann. Caps. Caust. Chin. Colch. 

Con. Cycl. Dros. Dulc. Hep. Kali. 

Lachesis. Lycop. Muriatic acid. 

Natr. Oleand. Platina. Plumb. 

Puis. Ehus. Ehod. Sabin. Spig. 

Sil. Stann. Thuj. Valer. Verb. 



SWEAT : Chin. Ipec. Lye. Nux vom. 

Phosph. Pulsat. Sepise. Stram. 

Sulph. 
SWELLING: Baryt. Bell. Puis. 

Staph. 
TEAEING AND DEAWING: Aco- 
nit. Ars. Bell. Bry. Calc. carb. 

Canth. Caps. Carbo veg. Caustic. 

Cina. Cham. Cocc. Ferr. Hep. Kali. 

Lach. Led. Lye. Mang. Mez. Natr. 

Natr. mur. N. vom. Op. Phosph. 

Puis. Bhus. Sep. Sil. Stann. Stram. 

Sulph. 
TENSION: Amm. mur. Bell. Con. 

Hep. Mosch. Natr. Natrum mur. 

Sulph. Zinc. 
TETANUS : Ang. Cicut. Nux vom. 

Op. Petr. Plumb. 
THEOBBING: Baryt. Lye. Phos. 

Puis. 
TEEMBLING: Coff. Merc. 
TUBEECLES : Ant. crud. Caust. 
WAEMTH, feeling of: Carbo veg. 

Coff. Laur. 
WEAKNESS : Agar. Arn. Carb. yegr. 

Lach. Lye. Nitric ac. IS. vom. Pe- 
trol. Phos. Plat. Sulph. Sec. corn. 
3. Small of tlie back. 
BOEING: Aeon. 
BUENING : Aeon. Mur. ac. Nux vom. 

Phosphor. Ehus. Sepise. Thuj. 
CHILLINESS : Lach. Lycop. Puis. 

Sabin. 
COLDNESS: Carbo veg. Spong. 
— feeling of : Hell. 
CONTUSIVE PAIN : Arn. Euta. 
CEACKING: Sulph. Zinc. 
CEAWLING: Alum. Menyanthes. 

Sassap. 
CEAMP Y FEELING : Bryon. Caust. 

Chin. Nux vom. 
CUTTING: Aur. Bellad. Canthar. 

Natr. Natr. mur. Puis. Zinc. 
EEUPTION: Calc. carb. Natrum. 

Sep. Thuj. 
GNAWING: Amm. Canth. Phos. 

Sulph. 



STOOL AND ANUS. 



73 



GRIPING : Cham. Graph. Merc. 
ITCHING: Carboveget. Canst. Kali. 

Merc. Natr. mirr. 
JERKS : Asar. Bry. Chin. Rhus. 
LAMENESS: Cocc. Dulc. Lach. 

Natr. mur. Nux vom. Selen. Sil. 
NUMB FEELING: Carboveg. Plat. 

Spong. 
AS IF FLASHING THROUGH : 

Natrum mur. 
PAIN, as if dislocated : Agaric. Arn. 
Rhus. Sulph. 

sore : Caust. Natr. Sulph. ac. 

bruised : Aco. Alum. Amm. mur. 

Arg. Am. Aur. Br yon. Caust. 
Cham. Cina. Graph. Ign. Lach. 
Magn. mur. Nux mosch. Nux 
vom. Platina. Rhus. Ruta. Stront. 
Sulph. Thuj. Yeratr. 
— simple : Aconit. Agar. Amm. mur. 

Am. Baryt. Bov. Bry.. Calc. carb. 

Carbo an. China. Kali. Ign. Ipec. 

Led. Lycop. Iff, vom. Puis. Petr. 

Rhod. Rhus. Ruta. Sabadilla. 

Sepire. Stront. Sulph. Zinc. 
PRESSURE: Aeon. Bryon. Carbo 

veg. Caust. Graph. Kali. Lach. 

Lye. Men. Mosch. Nitric acid. 

Puis. Rhus. Sep. Spong. Staphys. 

Sulph. Yeratr. 
PULSATIONS: Caust. Natr. mur. 



SPASMODIC PAIN: Bellad. Cocc. 

Sil. Sulph. 
STIFFNESS: Aeon. Ambra.Amm. 

mur. Bary t. Bell. Bry. Carbo veget. 

Caustic. Kali. Lach. Lycop. Pulsat. 

Rhus. Sil. Sulph. 

STITCHES: Aeon. Ambra. Anac. 

Arg. Arn. Bell. Bry. Canthar. Carbo 

veg. Carbo an. Caust. Chin. Cocc. 

Con. Graph. Ign. lod. Lach. Lye. 

Magn. carb. Merc. Natr. Natr. mur. 

Nux vom. Phos. ac. Puis. Rhus. 

Sab. Sep. Sil. Stront. Tart. Thuj. 
TEARING AND DRAWING : 

Alum. Ars. Baryt. Bry. Calc. carb. 

Canth. Carbo veg. Caustic. Cham. 

Chin. Cocc. Hep. Kali. Kreos. 

Lach. Lye. Natrum mur. Nux vom, 

Phosph. ac. Rhus. Sab. Sep. Sil. 

Sponga. Stann. Stram. Stront. 
TENSION: Aeon. Barit. Carbo veg. 

Caustic. Nitric ac. Nux vom. Sil. 

Thuj. 
THROBBING: Graphit. Ign. Nux 

vom. Natr. mur. Sep. 
TWITCHING: Calc. carb. Caustic. 

Chin. Con. Puis. Staph 
WEAKNESS : Ars. Cocc.Lach. Merc. 

Natrum mur. Nux vom. Phosph. 

Sep. 



XXIV. STOOL AND ANUS. 



Constipation. 

1. Cliaracter of Stool. 

ACRID: Ars. Bry. Cham. Lach. 

Merc. Puis. Veratr. 
ASH-COLORED : Asar. Dig. 
BILIOUS: Arsen. Chamom. Chin. 

Dulc. Ipec. Merc. Puis. Sulph. 

Veratr. 
BLACK: Ars. Calc. c. Camph. Chin. 

Cupr. Hep. Merc. Op. Squill. 

Stram. Veratr. 

53 



BLOODY: Ant. crud. Arn. Ars. 

Asar. Bry. Canth. Carb. veg. Chin. 

Cupr. Didc. Ipec. Lye. Merc. Nitr. 

ac. N. mosch. N. vom. Phosph. Puis. 

Rhus. Sep. SIL Sulph. acid. Tart. 

Yeratr. 
BLOOD, lined with: Alum. Ambr. 

Con. Bry. Ipec. Merc. Nux vom. 

Puis. Rhus. Thuj. 
BROWN: Arnic. Bryon. Chin. Mer- 



n 



STOOL AND ANUS. 



cur. Rheum. Sec. SquilL Sulph. 

Yeratr 
BRIGHT-COLORED : Anac. Carbo 

veg. Caust. 
BURNING : Ars. Lack. Merc. 
CADAVEROUS SMELL: Bism. 

Carb. veg. Strain. 
CLAYEY: Calc. Carb. 
CONSTIPATED : Aeon. Amm. mur. 

Arn. Aur. Bar. Bell. Bry. Calc. carb. 

Cann. Canth. Carbo veg Caustic. 

Cham. Chin. Cina. Coccul. Coloc. 

Con. Crot. Daph. Eerr. Graph. Hep. 

Kali bich. Lach. Laur. Lye. Merc. 

Mosch. Natr. mur. Nux vom. Op. 

Plat. Plum. Puis. Rhodod. Rhus. 

Sabad. Seneg. Sep. Sil. Spong. 

Staph. Sir am. Sulph. Thuj. Yeratr. 

Zinc. 
DIARRHGEIC : Aeon. Amm. mur. 

Ant. crud. Ant. carb. Ars. Asa feet. 

Aur. Bell. Bism. Bry. Calc. carb. 

Calad. Caps. Carb. veg. Carb. an. 

Chamom. Chin. Coloc. Cicut. Cocc. 

Coffea. Cupr. Dulc. Ferr. Graph. 

Hep. Hell. Hyosc. Ign. Ipec. Lach. 

Lye. Magn. carb. Merc. Natr. Natr. 

mur. Nitr. acid. N. mosch. JSf.vom. 

Op. Petr. Phosph. Phosph. ac. 

Puis. Ran. seel. Rheum. Rhodod. 

jUhus. Sabad. Sec. Sepise. Spigel. 

Bpong. Squill. Stann. Staph. 

Stram. Sulph. Tax tar. Valer. Yeratr. 

Zinc. 
DIARRHOEA, from cold: Bell. Bry. 

Cham. Bulc. Merc. Nux vom. Puis. 

Rhus. Sulph. 
— after drinking beer : Ferrum. Rhus. 
— after eating : Arsen. China. Coloc. 

Lach. 
— after getting heated : Bry on. Coff. 

Nux vom. 
— after a fright : Aco. Op. Verat. 
—after a fit of joy: Coff. Op. 
— with vomiting: Antim. tart. Ars. 

Asar. Cupr. Ipec. Nux vom. Phos. 

Rheum. Yeratr. 



— after eating fruit : Ars. Chin. Puis. 
— after eating milk : Bry. Lye. Sulph. 
— after a cold drink : Ars. Bry. Carb. 

veg. Puis. 
— after drinking: Arsen. Caps. N. 

vom. 
— of children: Cham. Ipecac. Merc. 

Rheum. Sulph. 
— chronic : Arsen. Calc. Canth. Chin. 

Graph. Ipec. Nitr. ac. Phosph. 

Rhus. Sulph. 
— nocturnal: Ars. Bry. Cham. Chin. 

Bulc. Kali. Merc. Phosphor. Puis. 

Rhus. Sulph. Yeratr. 
— dysenteric : Ars. Caps. Carb. veg. 

Coloc. Chamom. Colehic. Merc. N. 

vom. Op. Pulsat. Rhus. Sulph. Ye- 
ratr. 
— frothy: Calcar. carb. China. Rhus. 

Sulph. 
— painless: Arsen. Carbo veg. Cha- 
mom. Chin. Ferr. Hyosc. Lye. 

Merc. Op. Phosph. Sec. Sulph. 

Stram. 
— watery : Ant. crud. Ant. tart. Ars. 

Calc. Carb. Caps. Cham. China. 

Cupr. Ferr. Helleb. Hyosc. Ipec. 

Natr. mur. Nux vom. Petr. Phosph. 

Ph. ac. Puis. Rhus. Sec. cor. Sulph. 

Tart. Yeratr. 
— spirting : Ars. Merc. N. vom. 
DIFFICULT: Amm. mur. Anac. 

Ant. Arn. Aur. Bar. Bry. Canth. 

Carb. v. Chin. Cocc. Graph. Hep. 

Ign K.ali. Lye. Magn. mur. Natr. 

mur. Nux mosch. Nux vom. 

Oleand. Petrol. Phosph. Plat. Pul- 
sat. Rhodod. Ruta. Sassap. Silic. 

Staph. Sulph. Thuj. 
FERMENTED: Ipec. 
FETID : Ars. Bry. Calc. Carbo veg. 

Chin. Lach. Merc. Nitr. acid. Puis. 

Sil. Sulph. 
WITH FLOCKS : Ipec. Yeratr. 
HAYING A FOUL SMELL : Ars. 

Bry. Carb. v. Cham. Chin. Nitr. 

ac. N. vom. Sec. cor. Sulph. 



STOOL AND ANUS. 



75 



FREQUENT, too : Anac. Arn. Ars. 

Bellad. Calc. curb. Caps. Cham. 

Chin. Cocc. Coff. Coloc. Dale. 

Ferr. Graph. Ignat. Natr. mur. 

Nitr. ac. N. vom. Phosph. Ph. ac. 

Petr. Puis. Pan. seel. Rhus. Silic. 

Thuj. Yaler. 
GRAYISH: Asar. Digit, Mercur. 

Phosph. ac. Rheum. 
GREENISH: Arsen. Aur. Bellad. 

Cham. Cupr. Dulc. Ipec. Merc. 

Phosph. Phos. ac. Puis. Stann. 

Sulph. Yeratr. 
HARD : Agar. Amm. Amm. mur. 

Ant. crud. Asa feet. Aur. Bar. 

Bell. Bry. Calc. carb. Cann. Carb. 

yesr. Caustic. Cham. Ciua. Coccul. 

Con. Daph. Graph. Hyosc. Guaj. 

Hep. Ign. Kali. Laur. Led. Lycop. 

Magn. mur. Merc. Natl*, mur. 

X. vom. Op. Petr. Phosph. Phosph. 

acid. Plumb. Puis. Rheum. Rho- 

dod. Rhus. Ruta. Sabad. Sec. 

corn. Selen. Sep. Sil. Spong. Stann. 

Staph. Sulph. Sulph. acid. Thuj. 

Yeratr. Yerb. 
HARD AND LOOSE ALTER- 
NATELY: Ant. crud. Ars. Iod. N. 

vom. 
INSUFFICIENT: Anac. Alum. 

Arn. Ars. Calc. Chin. Daph. Hep. 

Kali. Lach. Lye. Mur. magn. Natr. 

X. vom. Sep. Sil. Sulph. 
INVOLUNTARY: Aeon. Am. Bell. 

Calc. Chin. Hyosc. lunch.. Nat. mur. 

N. vom. Op. Phosph. ac. Rhus. Sec. 

corn. Sulph. Yeratr. 
— at urinating : Mur. ac. 
— during sleep : Arn. Puis. Rhus. 
LEAD-COLORED: Plumb. 
LOOSE: Ant. crud. Canth. Chin. 

Ign. Merc. N. mosch. Rheum. Sep. 

Sulpjh. 
LUMPY: Agar. Bar. BeU. Graphit. 

Lach. Magn. mur. Nux vom. Op. 

Plumb. Sil. Sulph. Sulph. ac. Thuj. 
PAPESCENT: Agar. Antim. crud 



Arn. Asa i. Bell. Chin. Daph. 

Dros. Euphorb. Lack. Mezer. Nitr. 

Phosph. ac. Puis. Rheum. Rhod. 

Selen. Sil. Sulph. Tart. 
PITCH, like: Hep. Lach. Merc. 

Sassap. 
PURULENT: Arn. Canthar. Iod. 

Lach. Merc. Sulph. 
SHEEP-DUNG, like: Brom. Magn. 

mur. Plumb. 
SLIMY: Agar. Amm. m. Ant. cr. 

Arn. Ars. Asar. Bell. Bor. Canth. 

Caps. Cham. Carb. veg. Coloc. 

Chin. Colch. Dulc. Graph. Hell. 

Hyosc. Kali. Ipec. Merc. Mur. 

magn. Natr. mur. N. vom. Phospli* 

Ph. ac. Puis. Rhus. Ruta. Sec. 

Spig. Stann. Staph. Sulph. Tart. 

Yeratr. 
SMARTING: Merc. Puis. 
SMELLING SOUR: Calc. carb. 

Chamom. Dulc. Hepj. 
SOFT: Aeon. Amm. mur. Antim. 

crud. Bryon. Calc. Carb. an. Carb. 

veg. Chin. Cocc. Coff. Con. Dros. 

Dulc. Graph. Guaj. Kali. Mur. ac. 

Natr. mur. Nitr. Nitr. ac. Phosph. 

Ph. ac. Puis. Rhodod. Sep. Sulpjh. 

Yeratr. Yiol. trie. Zinc. 
STIRRED EGGS, like: 'Chamom. 

Chin. Merc. N. mosch. Pulsat. 

Rhus. Sulph. Yiol. trie. 
TENACIOUS: Ars. Canst. Hell. 

Kali. Laches. Mercur. Plumb. Zinc. 
UNDIGESTED : Antim. crud. Am. 

Arsen. Bryon. Cham. Chin. Ferr. 

Lach. Merc. Nitr. ac. Oleand. 

Phosph. Ph. ac. Sulph. Yeratr. 
WITH TiENIA: Calc. Carb. veg. 

Filix m. Graph. Magn. mur. Merc 

N. vom. Petrol. Sabad. Sab. Stann. 

Sulph. Yaler. 
WITH ASCARIDES: Aconit. Aw. 

Calcar. Cham. Chin. Cina. Ferr. 

Ignat. Merc. N. vom. Squill. Spong. 

Sulph. Teucr. 



76 



STOOL AND ANUS. 



WITH LUMBKICI: Aconit. Anac. 

Bell. Oalc. curb. Chain. Cicut. Cina. 

Graph. Lycop. Merc. JSfatr. mur. 

Nux vom. Ruta. Sabad. Sec. corn. 

Spigel. Sulph. Val. 
WHITISH: Aeon. Ars. Caustic. 

Cham. Chin. Colch. Digital. Iod. 

Merc. Nux vom. Plumb. Phosph. 

Pulsat. Rhus. Sec. Spong. Sulph. 

Veratr. 
YELLOWISH: Ars. Asa feet. Calc. 

carb. Chamom. China. Coloc. Cocc. 

Dulcam. Merc. Petr. Phosph. Puis. 

Rhus. Yeratrum. 
2. Accompanying Ailments. 

a. BEFORE STOOL. 

BACK-ACHE: Veratr. 

COLIC: Agar. Amm. mur. Ant. 

tart. Ars. Asar. Bry. Canth. Chin. 

Croc. Dig. Kali. Ignat. Laur. Merc. 

Nitr. Nux vom. Petr. Puis. Rheum. 

Rhus. Stann. Staph. Sulph. Verat. 
CHILLINESS: Mercur. Nux vom. 

Veratr. 
DEE AD OF MEN: Ambr. 
FLATULENCE, distress from : 

Agar. Amm. mur. Arn. Calc. 

phosph. Dulc. Ferr. Phosph. Ph. 

ac. Puis. Spig. Stront. 
HEAT: Merc. Phosph. 
NAUSEA : Aeon. Rhus. Veratr. 
PAINS IN THE ANUS: Carbo 

anim. Colchic. Kali. Lach. Oleand. 

Phosph. Plat. 
RECTUM, pain in: Nux vomica. 

Puis. Rhus. 
SMALL OF BACK, pain in: Dulc. 

Sulph. 
PROSTATIC JUICE, discharge of: 

Selen. Sulph. Ph. ac. 
RUSH OF BLOOD TO THE 

HEAD: Opium. 
SCREAMING OF CHILDREN: 

Cham. Rheum. Rhus. 
SWEAT: Aeon. Bell. 
URGING TO STOOL: Cocc. Con. 



Lach. Merc. Rhus. Sil. Staphys. 
Thuj. 
VOMITING: Ant. tart. Veratr. 

b. DURING STOOL. 

BACK-ACHE: Puis. 

CHILLINESS: Veratr. 

COLIC : Agar. Amm. mur. Anac. 

Ant. cruel. Arn. Ars. Asa feet. Bry. 

Calad. Canth. Carbo an. Cham. 

Cupr. Dulc. Drosera. Fen> Graph. 

Hep. Ignat. Ipec. Kali. Merc. Natr. 

mur. Nitric ac. Nux vom. Phosphor. 

Plumb. Puis. Rheum. Rhus. Sep. 

Spig. Sulph. Sulph. ac. Veratr. 
DROWSINESS : Nux mosch. 
FAINTING: Petr. Sassap. Spig. 
FLATULENCE, discharge of : Calc. 

carb. Calc. phosph. Cocc. Sab. 

Staph. 
— distress from : Amm. muriat. Arn. 

Hyosc. Nux vomica. Sab. Spong. 
HEAT : Rhus. Sulph. 
LABOR-LIKE PAIN: Op. 
NAUSEA: Ant. tart. Ars. Asar. 

Cupr. Hell. Merc. Nitric acid. 

Prun. Sulph. Veratr. 
PALPITATION OF HEART : Ant. 

tart. Nitric acid. 
PROSTATIC JUICE, discharge of: 

Ign. Phosph. ac. Sil. 
RECTUM, pain in: Asar. Calcar. 

Merc. Magn. mur. N. vom. Puis. 

Sab. Sulph. Veratr. 
— falling of : Ars. Asar. Calcar. Daph. 

Ignatia. Merc. Nux vom. Puis. Ruta. 

Sepiae. Sulph. 
RUMBLING IN BOWELS: Ar- 
senic. Calc. carb. Lycop. Olean- 
der. Phosph. Phosph. acid. Sulph. 

aeid. 
RUSH OF BLOOD TO THE 

HEAD: Rhus. 
SHUDDERING: Bell. Nitric acid. 

Rheum. Veratr. 
SWEAT: Bell. Mercur. Stramon. 

Veratr. 



STOOL AND ANUS. 



77 



TENESMUS: Aeon. Ars. Colch. 

Laur. Merc. Nux vom. Op. Rhus. 

Selen. Sulph. Veratr. 
THIRST: Ars. Cham. Chin. 
VARICES, protrusion of: Angust. 

Kali. Merc. Nux vom. 
VERTIGO: Cham. Veratr, 
VOMITING: Arg. Ant. tart. Ars. 

Ciipr. Kali bichr. Ipec. Rheum. 

Sulph. Veratr. 
WEAKNESS, feeling of: Veratr. 

C. AFTER STOOL. 

ANIXETY: Caust. 
AS IF BRUISED : Calc. 
CHILLINESS : Canth. Mezer. Puis. 
CHILL: Daph. Mez. Plat. 
COLIC : Agar. Amm. mur. Anac. 

Carbo veget. Con. Dros. Dulc. Iod. 

Kali bichr. Lye. Nux vom. Natr. 

mur. Op. Phos. Pulsat. Rheum. 

Stann. Sulph. Veratr. 
CONGESTION OF THE HEAD: 

Lach. 
DROWSINESS : Nux moseh. 
ERUCTATIONS: Baryt. Merc. 
FLATULENCE, discharge of: Agar. 

Calc. Carbo veget. Hep. Lye. Nux 

vom. Phosph. Puis. Suljjhur. Thuj. 
HEAD-ACHE: Ambr. Sab. Sil. 
LANGUOR: Am. Ars. Bry. Calc. 

carb. Chin. Colic. Cuprum. Daph. 

Ferr. Hyosc. Ipec. Lach. Lye. 

Phosph. Puis. Sec. corn. Veratr. 
MUCUS, discharge of: Asarum. 

Merc. Phosph. Stann. 
NAUSEA : Aeon. Caust. Veratr. 
SMALL OF BACK, pain in : Puis. 
PALPITATION OF THE HEART : 

Caustic. Con. 
RECTUM, pressure in : Hellebor. 

Ignat. 
— pain in : Cham. Nux vom. 
— constriction of : Nux vom. 
— prolaj^sus of: Merc. 
SWEAT: Aeon. Caust. 
TENESMUS: Capsic. Ipec. Merc. 



Nitr. Phosph. Rheum. Rhus. Sulph. 
Staph. 
THIRST: Caps. 
VERTIGO : Carbo an. Zinc. 
VOMITING: Veratr. 

3. Anus, with rectum and 
perineum. 

a. ANUS AND RECTUM. 

BLEEDING BETWEEN STOOL: 

Alum. Ant. cruel. Caps. Carbo veg. 

Merc. Phosph. Puis. Sabin. Sep. 

Stram. Sulph. 
BORING IN THE RECTUM: Va- 

ler. 
BURNING IN THE ANUS : Am- 
nion, mur. Ant. tart. Ars. Baryt. 

Bov. Bry. Caps. Carbo anim. Carbo 

veget. China. Cocc. Coloc. Graph. 

Iod. Ipec. Kali. Laur. Merc. Mur. 

ac. Natr. Natr. mur. Nitric ac. N. 

vom.Oleand. Phosph. Puis. Sepice. 

Stront. Sulph. Thuj. Verat. 
— in the rectum : Alumina. Aur. Ars. 

Calc. Carbo an. China. Con. Eu- 

pliorb. Lye. Mur. ac. Magn. mur. 

Natr. mur. Nitric ac. Petr. Phosph. 

Puis. Sep. Stront. Sulph. Veratr. 
CONTRACTION: Camph. Conium. 

Natr. mur. Nux vom. Op. 
— in annus: Alum. Ang. Carbo an. 

Cocc. Graph. Ign. Nitric ac. Nux 

vom. Plumb. Sec. Sep. Sulph. 
— in rectum : Amm. Bell. Calc. Chin. 

Coloc. FeiT. Ign. Nux vom. Phosph. 

Sep. Thuj. 
CREEPING : Calc. Colchic. Croc. 

Kali. Natr. Nux vom. Plat. Rhus. 

Sabad. Sep. Zinc. 
CUTTING IN ANUS : Arsen. Chin. 

Caust. Kali. Laur. Lye. Natr. Nux 

vom. Phosph. Staphys. Sulph. 
— in rectum: Canth. Caust. Chin. 

Lye. Mang. Nux vom. Phosph. 

Sep- Sulph. 
DRAWING IN: Plumb. 
EXCORIATION: Cham. Graph. 



78 



STOOL AND ANNUS. 



— in anus : Alum. Amm. Arsen. 

Graph. Hep. Merc. Nux vom. 

Phosph. Puis. Sassap. Yeratr. 
— in rectum : Campli. Natrum mm. 

Phosph. Ph. ac. Puis. 

FIGWARTS: Nitric acid. Sabina. 

Thuj. 
FISTULA KECTI : Calc. Caust. 

Petr. Sil. Sulph. 
GNAWING: Ang. Merc. Phosph. 
HEAT: Canth. Con. 
HEKPES : Natr. mur. 
ITCHING IN ANUS : Aeon. Alum. 

Ambr. Ant. crud. Baryt. Bell. Bry. 

Calc. Carbo veg. Caust. China. 

Cina. Croc. Euph. Ign. Kali. Lye. 

Merc. Nitric ac. Nux vom. Op. 

Phosphor. Platin. Rhus. Sabad. 

Sassap. Sep. Sil. Stann. Staph. 

Sulph. Teuc. Thuj. Zinc. 
— in rectum: Aco. Ambr. Asar. Bell. 

Cic. Cin. Chin. Euphorb. Ferr. Ign. 

Nitric ac. Nux vom. Ruta. Sabad. 

Sep. Sil. Spigel. Stann. Sulph. 

Teuc. Valer. 
MUCUS, discharge of, between stool : 

Antim. Caps. China. Colchic. Hell. 

Graph. Merc. Phosph. Puis. Rhus. 

Sep. Spig. Sulph. Tart. 
PAIN, simple : Aconit. Canthar. Car- 
bo an. Caust. Lye. Merc. Natr. 

mur. Nux vom. Phosph. Seneg. 
— in rectum : Aeon. Ambr. Camphor. 

Merc. Magn. mur. Sep. 
PINCHING: Merc. Natrum mur. 

Sabad. 
PRESSURE IN ANUS: Aeon. 

Baryt. Calc. Cyclam. Laur. Nitric 

ac. Nux vom. Petr. Phosphor. Puis. 

Seneg. Staph. 
— in rectum : Arn. Bell. China. Kali. 

Lye. Nitric ac. Nux vom. Opium. 

Phosph. Sen. Stann. 
RECTUM, prolapsus of: Antim. 

crud. Ars. Asar. Bry. Colch. J>ulc. 

Ign. Lach. Merc. Natrum muriat. 

Nux vom. Ruta. Sep. Sulph. 



REMAINING OPEN, always: Phos. 
SORENESS : Ars. Carbo an. Cau- 
stic. Hep. Graph. Merc. Nitric ac. 

Phosph. Sep. Sulph. 
— pain as of: Amm. Ars. Caust. 

Graph. Hep. Ign. Mur acid. Natr. 

mwr. Nux vom. Phosph. Puis. Sep. 

Spongia. Sulphur. Yeratr. 
SPASM, (in anus): Colch. Lach. 

Kali bichr. 
— in rectum : Calc. Caust. Chin. Colch. 

Lach. Lye. 
SPHINCTER ANI, lameness of: 

Bell. Cole. Hyosc. 
STITCHES IN ANUS : Aeon. Ars. 

Bry. Canth. Carbo an. Carbo veg. 

Chin. Con. Croc. Graph. Ign. Ipec. 

Kali. Lye. Natrum. Natr. mur. N. 

vom. Phos. Phosph. ac. Plat. Ran. 

bulb. Sab. Sep. Sil. Sulph. 
— in rectum : Alum. Ant. tart. Bell. 

Bov. Carbo an. Caustic. Chin. 

Graph. Ign. Lye. Magn. mur. Natr. 

mur. Nux vom. Phosph. Puis. Ru- 
ta. Sep. Sil. Sulph. Yaler. 
SWELLING: Camph. Graph. Hep. 

Ign. Nux vom. 
TEARING IN THE ANUS : Colchic. 

Daph. Kali. Nux vom. Phos. ac. 

Sep. Thuj. 
— in rectum : Carbo veg. China. Lye. 

Kali. Nux vom. Phosph. ac. Ruta. 

Sabad. 
TENESMUS: Aeon. Arn. Arsen. 

Bellad. Bov. Calc. Canthar. Caps. 

Colch. Daph. Euphorbium. Hep. 

Ipec. Kali. Laur. Merc. Natr. Ni- 
tric ac. Nux vom. Phosph. Plat. 

Rheum. Rhus. Ruta. Sep. Staph. 

Sulphur. Veratr. Zinc. 
THROBBING: Grat. Lach. Natr. 

mur. 
TORPOR: Alum. Carb. veg. Chin. 

Ign. Kali. Lycop. Natr. mur. Nux 

vom. Op. Ruta. Sep. Staph. Thuj. 

Yeratr. 
ULCERS : Caust. Sassap. 



URINE AND URINARY ORGANS. 



79 



URGING TO STOOL : Alum. Anac. 

Am. Ars. Asa f. Bar. Bellad. Calc. 

Camph. Canth. Carb. v. Caustic. 

Coccul. Colch. Coloc. Con. Ferr. 

Graphit. Hepar. Hyosc Ign. Kali. 

Lack. Lye. Merc. Magn. mur. Na- 

triim. Natr. mur. Nitr. ac. N. moscli. 

N. vom. Petr. Phos. Puis. Rheum. 

Rhodod. Rhus. Ruta. t Sabad. Sep. 

Sil. Stann. Staph. Sulphur. Veralr. 

Verb. 
— with emission of flatulence : Carb. 

an. Lach. 
— with falling of rectum : Ruta. Merc. 
— at night: Merc. Pals. Sulph 
— with erections: Thuj. 
— painful: Ars. Caust. Sulph. 
— ineffectual : Aeon. Anac.Arn. Asa 

f. BeH. Calc. Carb. Caps. Carb. veg. 

Caust. Coccul. Colch. Con. Graph. 

Hell. Ign. Lach. Lye. Kali bich. 

Merc. Magn. mur. Natr. Natr. mur. 

Nitr. ac. Sux vom. Phosph. Plumb. 

Pulsat. Rheum. Rhus. Ruta. Sa- 

bad. Sassap. Sep. Sil. Spig. Stann. 

Staph. Stram. Sulph. Thuj. Veratr. 
VARICES : Ambra. Amnion, mur. 

Anac. Antlm. cruel. Ant. tart. Ars. 

Bar. Bell. Brom. Calc. Caps. Carb. 

an. Carb. veg. Caust. Coloc. Ferr. 

Graph. Hell. Ignat. Kali. Lach. 

Lye. Magn. Merc. Mur. as. Natr. 

mur. Nitr. ac. Nhx vom. Phosph. 

Ph. ac. Plumb. Puis. Rhus. Sabin. 

Sep. Sil. Stram. Sulph. Sulph. ac. 

Thuj. 
— protruding: Calc. Caustic. Ferr. 

Graph. Merc. Puis. Sep. Sulph. 

Thuj. 



— with colic: Carb. veg. Nux vom. 

Sulph. 
— blue : Carb. veg. Mur. ac. 
— blind : Ars. Cham. Ign. Nux vom. 

Puis. Sulph. Veratr. 
— bleediug: Aconit. Amm. Antlm. 

crud. Bell. Calc. Caps. Carb. veg. 

Chin. Cupr. Ferr. Ipec. Ign. Mere. 

Nux vom. Phosph. Puis. Sab. Sep. 

Stram. Sulph. 
— burning: Ant. crud. Arsen. Calc. 

carb. Caps. Carb. an. Graph. Nitr. 

ac. Sulph. ac. 
— inflamed : Aeon. Arsen. Nux vom. 

Sulph. 
— swollen : Alum. Calcar. carb. Carb. 

veg. Graph. Nux vom. Puis. 
—ulcerated: Nux vom. Puis. Sulph. 
— itching: Aeon. Graph. Phosph. 

Sulph. Sulph. ac. 
— humid: Sulph. 
— excoriated: Cham. 
— stinging: Ars. Baryt. Caust. Puis. 
— suppressed flow of : Carb. veg.K. 

vom. Sulph. 
— as if sore : Merc. Mur. ac. Phosph. 

Puis. Stann. 

b. PERINEUM. 

BURNING : Ant. crud. Rhodod. 

CONTRACTION: Sep. Sulph. 

CUTTING: Lye. N. vom. 

HERPES: Petr. 

INFLAMMATION: Plumb. 

ITCHING: Agn. Ars. Carb. veg. N. 
vom. Petr. Seneg. Tarax. 

PAIN, simple: Caust. Lye. Phos. 

SORENESS: Carb. v. Merc. Rhod. 
| STITCHES: Alum. Merc. Nat. Sep. 
I TEARING: Daph. 



XXV. URINE AND URINARY ORGANS. 

1. Quality Thereof. 
ACRID : Ant. tart. Am. Borax. Cal- 
car. Cann. Canth. Caust. Clem. 



Creos. Graph. Hep. Iod. Kali. Merc. 
Natr. mur. Rhus. Sassap. Seneg. 
Thuj. Verat. 



80 



URINE AND URINARY ORGANS. 



AMMONIACAL: Asa f. Carbo veg. 

Creos. Iod. Mosch. Nitr. acid. Petr. 

Phosh. 
BILIOUS: Valer. 
BLOODY: Aeon. Ambr. Ant. tart. 

Am. Ars. Calc. carb. Cann. Canth. 

Capsic. Carbo veg. Chin. Coloc. 

Con. Hep. Ipec. Lye. Merc. Mezer. 

Nitr. acid. Nux vom. Op. Phosph. 

Ph. ac. Puis. Sec. com. Sep. Squil- 

la. Sulph. Zinc. 
BEOWN: Aeon. Ambr. Am. Ars. 

Asa f. Bell. Bry. Calc. Caust. Colch. 

Dig. Merc. Nitr. ac. Petr. Phosph. 

Bhodod. Puis. Sep. Sulph. Tart. 

Valer. 
BURNING: Aeon. Arsen.\ Camph. 

Cann. Canthar. Caps. Creos. Digit. 

Hep. Merc. Phosph. Staph. Veratr. 
BLACKISH: Colch. 

CAT'S UBINE, smelling like: Viol. 

tart. 
— like garlic : Phosph. 
— sour. Ambr. Calcar. Graph. Merc. 

Natr. 
— pungent : Asa"f . Bor. Merc. 
— like 'sulphur : Phosph. 
— foul: Carbo veg. Dulc. Merc. Nitr, 

ac. Phosph. ac. Puis. Bhod. Sulph. 

Viol. trie. 
— like violets : N. mosch. Tereb. 
CLEAR: Amm. muriat. Euphr. Hy- 

osc. Laches. Nitr. Squill. Stramm. 
COLD : Agar. Nitric acid. 
COLOBLESS (see pale) : Puis. 
COPIOUS: Aeon. Alum. Ambra. 

Amm. mur. Arg. Arn. Ars. Aur. 

Baryt. Bell. Bism. Bryo. Canth. 

Carbo veg*. Carbo an. Chin. Cicut. 

Clem. Coloc. Creos. Cycl. Daph. 

Digital. Euph. Guaj. Hyosc. Ign. 

Iod. Laur. Led. Lycopod. M. arct. 

Merc. Mur. ac. Natrum. Nitric. 

Oleand. Petr. Phosph. Phosph. ac. 

Pulsat. Rhus. Sab. Sassap. Selen. 

Senega.' Spig. Squilla. Staph. Sulph. 

Tar. Thuj. Valer. Verat. Verb. Vi- 
ola trie. Vit. 



LIKE CUED : Ambr. Cina. 

D ABK : Aco. Ant. tart. Arn. Asa f. 

Bell. Bry. Carbo veg. Chin. Colch. 

Dig. Hell. Hep. Iod. Ipec. Lach. 

Lycop. M. arct. Merc. Nitric acid. 

Op. Phosph. Rhus. Selen. Sep. 

Staph. Sulphur. Tart. Veratr. 
DIMINISHED: Aco. Agar. Ambr. 

Ammon. mur. Ant. tart. Am. Ars. 

Aur. Bell. Bry. Calcareacarb. Cann. 

Canth. Carbo veg. Caust. Cham. 

Chin. Coccul. Coff. Colch. Con. Cupr. 

Daph. Dig. Dulc. Graph. Grat. Hell. 

Hep. Hyosc. Iod. Ipecac. Kali. 

Laur. Led. Lye. Merc. Mur. acid. 

Nitric ac. Nux mosch. Nux vomica. 

Op, Petr. Phosph. Phosphoric ac. 

Plumbum. Puis. Ruta. Sabad. Sas- 
sap. Sec. com. Selen. Seneg. Squil- 
la. Stannum. Staph. Sir am. Stront. 

Sulph. Veratr. Zinc. 
FIBRES, full of: Cann. 
FIERY: Aeon. Bry. Cann. Colch. 

Plumb. 
LIKE FLOUR: Calc. Graph. Mep. 

Natrum mur. 
FROTHY: Lach. Laur. Lycopod. 

Seneg. 
GREENISH: Ars. Camph. Iodine. 

Kali. Pihod. Euta. Veratr. 
HOT: Aeon. Ars. Bry. Canthar. 

Cham.[Colchic. Dulcam. Hep. Lach. 

Nitric ac. 
INODOROUS: Ambr. Dros. 
LIGHT-YELLOW: Ambra. China. 

Sec. corn. 
LITTLE AT A TIME: Aconit. 

Agar. Bell. Cann. Canth. Caust. 

Colchic. Dig. Euphorb. Hell. 

Hyosc. Iod. Kali. Laur. Led. Merc. 

Nitric ac. Nux vom. Op. Petr. 

Phosph. Puis. Rhus. Ruta. Sil. 

Staph. Sulph. Tart. Veratr. 
LOAM-COLORED : Anac. Canthar. 

Ign. Sabad. Sassap. Sep. Sulphur. 

Zinc. 



URINE AND URINARY ORGANS. 



81 



MILKY : Aur. Carbo veg. Dulc. Iod. 
Phosph. ac. 

OPALESCENT : Iodine. Phosphor. 

Puis. 
PALE : Agar. Alum. Am. Aur. Bell. 

Bism. Canth. Chel. Chin. Cocc. 

Colchic. Coloc. Con. Creos. Dig. 

Hep. Ignat. Iod. Lach. Laur. Mur. 

acid. Nitr. N. jugl. Nux vom. 01. 

an. Par. Phosph. Phos. ac. Pulsat. 

Rhod. Rhus. Sassap. Secale corn. 

Staph. Strain. Strontia. Snlph. 

Sulph. ac. Zinc. 
PURULENT: Cann. Canth. Clem. 

Lye. Nux vom. Sabin. Sep. 
RED : Aco. Ant. crud. Antim. tart. 

Am. Bell. Bry. Calc. Camph. Cann. 

Canth. Carb. veg. Chin. Colch. 

Coloc. Con. Dig. Hep. Ipec. Kali 

bichr. Merc. Nux vom. Op. Phos. 

Plumbum. Puis. Sassap. Sep. Sil. 

Squilla. Staph. Sulph. 
SEDIMENTOUS: Aconit. Alum. 

Ambr. Ant. crud. Am. Arisen. Aur. 

Baryt.Bry. CaZc. carb. Camph. Cann. 

Canth. Carbo an. Carbo veg. Caust. 

Cham. Chin. Chinin. Cicut. Col- 
chic. Coloc. Con. Creos. Dulcam. 

Graph. Hep. Hyoscyam. Iod. Ipec. 

Kali. Lach. Laur. Lol. tern. Lye. 

Mang. Mercur. Mezer. Natr. mur. 

Nitr. Is Uric ac. Nuxmosch. Oleand. 

01. an. Opium. Pelr. Phosph. 

Phosph. ac. Puis. Rhus. Ruta. Sas- 
sap. Selen. Seneg. Sepiae. Sil. 

Spong. Squilla. Sulph. Sulph. <v>. 

Tar. Thuj. Yaler. Zinc. 
SEDIMENT, blueish: Prun. 
--bloody : Aconit. Calcar. carb. Cann. 

Canth. Caps. Coloc. Dulc. Lye. 

Merc. Phosphor. Phosph. ac. Puis. 

Sep. Sulph. Sulph. ac. Zinc. 
— brown : Ambr. Lach. Yaler. 
— thick: Camph. Laur. Mercur. Se- 
cale corn. Spong. Sulphur. Yaler. 
— dark : Iod. 



— purulent : Canthar. Clem. Con. 

Lye. Puis. Sep. 
— fibrous : Cann. Canth. Cham. Merc. 

Mezer. Sassap. Seneg. Tart. Zinc. 
— flocculent: Cannab. Cham. Merc. 

Nitr. Nitric ac. Seneg. Tart. 
— gelatinous: Puis. 
— yellow : Ammon. mur. Bry. Cham. 

Chin. Cupr. Lye. Phos. Sil. Spong, 

Sulph. Sulph. ac. Zinc. 
— of yellow sand: Sil. 
— gray: Ant. tart. Con. Spong. 
— gravelly: Ambra. Ant. crud. Calc. 

car*b. Canth. Chin. Lach. Lye. Natr. 

mur. Nitric acid. Nux mosch. Nux 

vom. Op. Phosph. Puis. Ruta. Sas- 
sap. Sep. Sil. Thuj. Yaler. Zinc. 
— clayey — Amm. m. Anac. Kali. /Sas- 
sap. Sep. Sulph. Sulph. ac. Zinc. 
— floury: Ant. tart. Calc. Graph. 

Merc. Hyos. Natr. mur. Phosph. 

ac. Tart. 
— reddish: Aeon. Ambr. Amm. mur. 

Ant. crud. Am. Ballad. Canth. 

Chin. Coloc. Con. Creos. Dulc. 

Graph. Iod. Ipec. Kali. Lach. Lye. 

Mang. Mez. Natr. mur. Nitr. ac. 

Op. Petr. Phosph. Puis. Sec. corn. 

Selen. Sep. Sil. Squill. Thuj. Yaler. 
- —like blood : Amm. 
— like red sand : Natr. mur. Nitr. ac. 

Sil. 
— slimy: Ant. crud. Ars. Aur. Bry. 

Calc. carb. Carb. veg. Caust. Chin. 

Cina. Coloc. Con. Dulc. Hep. Ipec. 

Merc. Natr. Natr. mur. Nitr. acid. 

N. vom. Phosph. Phosph. ac. Puis. 

Rheum. Sassap. Seneg. Sulphur. 

Va ler. 
— turbid: Alum. Con. Rhus. Zinc. 
— violet: Puis. 
— whitish : Amm. Baryt. Bell. Calcar. 

Canth. Caps. Colch. Coloc. Con. 

Dulc. Graph. Hep. Ignat. Nitr. ac. 

Oleand.. Petr. Phosph. Phosph. ac. 

Prun. Puis. Bhodod. Rhus. Sep. 

Spig. Spong. Sulph. Valer. Zinc. 



82 



URINE AND URINARY ORGANS. 



— whitish-turbid : Con. Rhus. 

— cloudy: Alum. Ambr. Bryon. 

Caust. Kali. Laur. Merc. Nitr. 

Petr. Phosph. ac. Plat. Seneg. 

Thuj. Valer. 
—brick-dust : Aeon. Arn. Chin. Ipec. 

Puis. 
TENACIOUS : Canth. Cupr. Creos. 

Dulc. Phosph. ac. 
THICK: Camph. Con. Dulc. Iod. 

Nux vom. Plumb. Sabad. Seneg. 

Sulph. ac. 
TUEBID: Ambr. Anac. Ant. tart. 

Ars. Aur. Bell. Cann. Canth. Car- 

bo an. China. Chlorof. Cina. Clem. 

Colch. Coloc. Con. Cycl. Dig. Dulc. 

Hep. Ignat. Iod. Kali. Lach. Lye. 

Merc. Mosch. Mur. ac. Nitr. acid. 

Phosph. Plumb. Pulsat. Rhus. 

Sabad. iSassap. Sep. Sulph. Sulplt. 

ac. Valer. Veratr. Zinc. 
— becoming : Ambr. Ang. Arn. Aur. 

Bry. Caust. Cham. Cina. Con. Dig. 

Graph. Hep. Iod. Laur. Mercur. 

Mezer. Nitr. Petr. Phosph. ac 

Rhus. Sassap. Seneg. Sepise. 

Sulph. Thuj. Valer. 
WHITISH: Ang. Arn. Aur. Cann. 

Carb. veg.> 'Cina. Con. Iod. Merc. 

Phosph. Ph. ac. Rhus. Sassap. 

Sulph. 
WHITISH-YELLOW: Amm. Phos. 
WHITISH-GKEEN: Camph. 
WHITISH-TURBID : Cann. China. 

Con. 
YELLOW: Ant. crud. Arn. Ars. 

Bell. Bry. Canth. Cham. Chin. 

Daph. Hyosc. Iodine. Ipec. Lach. 

Led. Magn. m. Nitr. Petr. Rheum. 

Samb. Sassap. Veratr. Zinc. 

2. Urine After Stool. 

BURNING URINE: Cann. Canthr*r. 

Caps. N. mosch. Puis. Staph. 
Yeratr. 
DIABETES : Aeon. Argent. Bell. 



Cann. Cupr. Clem. Dig. Hyosc. 

Led. Nitr. ac. Pulsat. Rhus. Squill. 

Stram. Tar. Veratr. 
— with emaciation: Merc. 
— with head-ache : Veratr. 
— with back-ache : Phosph. ac. 
— with sweat: Aeon. Bell. 
MICTURITION, nocturnal: Agaric. 

Ambr. Amm. mur. Anac. Arn. Ars. 

Bry. Bov. Calc. Canth. Con. Graph. 

Iod. Kali. Lach. Lye. Natr. Natr. 

m. Nitr. ac. Puis. RIlus. Ruta. 

Sep. Sll. Stront. Sulph. Thuj. Zinc, 
—too frequent: Aeon. Anac. Ant. 

crud. Arg. Arn. Ars. Aur. Bar. 

Bell. Bry. Calc. carb. Calc. phosph. 

Camph. Can. Caps. Caust. Chel. 

Chin. Coff. Con. Creos. Cyclam. 

Daph. Euphorb. Graph. Hell. 

Hyosc. Ign. Iod. Kali. Laches. 

Led. Lye. M. austr. Merc. Mur. ac. 

Natr. Natr. mur. Nitr. N. vom. 

Oleand. Petr. Phosph. Phosph. ac. 

Plumb. Rhus. Sassaj). Selen. Sil. 

Spig. Spong. Squill. Staph. Sulph. 

Tar. Thuj. Valer. Veratr. Verb. 
— difficult : Aeon. Agar. Bellad. 

Camph. Cann. Cantli. Cic. Dig. 

Euphorb. Hyosc. Hep. Nux mosch. 

Op. Phosph. Plumb. Sec. corn. 

Thuj. 
— too seldom: Aeon. Agar. Ammon. 

mur. Apis. Arn. Arsen. Aur. Bell. 

Bry. Camph. Canthar. Carb. veg. 

Chin. Cic. Colch. Cupr. Dig. Graph. 

Hep. Hyosc. Iod. Laur. Led. M. 

austr. Mane. Merc. Nitr. ac. N. vom. 

Op. Phos. Plumb. Puis. Ruta. Sec. 

corn. Squill. Staph. Stram. Sulph. 

ac. Verat. 
— drop by drop: Agar. Am. Bell. 

Camph. Cann. Canth. Caps. Caust. 

Chin. Clem. Colchic. Con. Dig. 

Dros. Dulc. Euphorb. Graph. M. 

austr. Merc. N. mosch. Nux vom. 

Petr. Phosph. ac. Puis. Rhus. Ruta. 

Sil. Staph. Stram. Sulph. Thuj. 



URINE AND URINARY ORGANS. 



83 



— interrupted: Agar. Carb. an. Caust. 

Clem. Con. Dulc. Led. M. austr. 

Op. Phosph. acid. Puis. Sulph. 

Thuj. Zinc. 
— involuntary: Aeon. Ant. tart. Am. 

Ars. Bell. Bry. Calc. Cantliar. 

Carb. veg. Caust. Chin. Cic. Cilia. 

Creos. Dig. Dulc. Ferr. Hep. 

Hyosc. Iod. Lack. Laur. Led. Lye. 

M. austr. Merc. Xatr. mur. Nitr. 

ac. Nux voni. Petr. Phosph. ac. 

Puis. Rhus. Ruta. Sep. Sil. Spig. 

Squill. Strain. Sulph. Yeratr. 

when coughing : Bry. Caust. 

Natr. rnur. Yeratr. 
— at night, in bed: Aeon. Ars. Bell. 

Bry. Carb. v. Caust. Cham. Cina. 

Con. M. austr. Natr. Op. Puis. 

Rhus. Ruta. Sep. Sil. Strain. 

Sulph. 

in the first sleep : Sep. 

— in the day-time : Ferr. 
ISCHURIA : Aconit. Agar. Arn. Aur. 

Bellad. Camph. Cann. Canthar. 

Chin. Cic. Coloc. Con. Dig. Eu- 

phorb. Graphit. Hep. Hyosc. Laur. 

Lycop. Nitric ac. Nux vom. Op. 

Plumbum. Pulsat. Ruta. Sabina. 

Strain. Sulph. Yeratr. Zinc. 
STREAM, double : Canth. 
— thin : Camph. Canth. China, Led. 

Mercur. Puis. Spongia. Staph. 
— scattering: Cann. Canth. 
— slow: Camph. Merc. Plat. 
— strong: Agn. Cic. Yit. 
TENESMUS OF BLADDER: Aco- 
nit. Arn. Camphor. Cann. Canth. 

Caps. Colch. Merc. Nux vom. Puis. 

Sab in. Sassap. Squilla. Sil. Viol. 

trie. 
URGING TO URINATE: Aeon. 

Agar. Alum. Ambra. Ammon. mur. 

Ant. tart.Arg. Arn. Ars. Bar. Bell. 

Bor. Bovist. Bry. Calc. carb. Cann. 

Canth. Caspic. Carbo an. Canst. 

Chamom. Cicut. Cocc. Colchic. 

Coloc. Con. Copaiv. Creos. Dig. 



Dulc. Euphorbium. Graph. Guaj. 

Hell. Hyosc. Ignat. Iod. Ipec. Kali. 

bichr. Lach. Lycop. M. austr. 

Mur. magn. Men. Merc. Mur. ac. 

Natr. Nitric, ac. N. jugl. N. voni. 

Petr. Phosph. Phos. ac. Plumb. 

Puis. Rhod. Rhus. Ruta. Sabadilla. 

Sabina. Sambuc. Sassap. Selen. 

Sep. Sil. Spig. Squill. Stann. 

Staph. Sulphur. Tar. Tart. Thuj. 

Veratr. Zinc. 
— with scanty discharge : Aeon. Anac. 

Ant. cruel. Antim. tart. Bell. Bry. 

Calc. carb. Cann. Canth. Caps. Carb. 

veg. Caust. Cocc. Colch. Cuprum. 

Con. Digit. Dros. Euphorb. Hell. 

Hyosc. Iod. Led. M. austr. Men. 

Merc. Natr. Nitric ac. Nux mosch. 

Nnx voni. Petr. Phosph. Phosph. 

acid. Plumb. Puis. Ruta. Sabad. 

Samb. Sassap. Staph. Sulph. Ve- 
ratr. 
— with copious discharge : Agar. Alum. 

Ant. tart. Arg. Ars. Bellad. Bism. 

Carbo an. Cin. Calc. Cycl. Creos. 

Lach. Mur. ac. Natr. mur. Rhus. 

Spig. Squilla. Stann. Sulph. Tar. 

Verb. Viol. trie. 
— irresistible : Baryt. Bell. Bry. Calc. 

Chin. Ign. Merc. Nitr. ac. Phosph. 

Phosph. acid. Pulsat. Rhus. Ruta. 

Squilla. 
— ineffectual: Aco. Arnica. Camph. 

Canth. Caps. Caust. Cham. Chin. 

Dig. Hell. Hyosc. Merc. Mur. acid. 

Nux vom. Petr. Ph. ac. Plumb. 

Pulsat. Sabina. Sassap. Sec. corn. 

Sep. Squill. Sulph. 

3. Accompanying Ail- 
ments. 
a. Before urination. 
BURNING IN THE URETHRA: 
Arn. Cann. Natr. Nux vom. Puis. 
Zinc. 



84 



URINE AND URINARY ORGANS. 



CUTTING IN THE URETHRA: 

Canth. 
— in the abdomen • Puis. 
DRAWING IN RENAL B-WION: 

Clem. 
— in penis : Cic. 
GENERALLY: Arn. Bor. Bryon. 

Bellad. Canth. Chin. Cic. Coloc. 

Creos. Digit. Dulc. Hep. Nux vom. 

Phosph. ac. Plumb. Puis. Rhod. 

Rhus. Sulphur. Tar. 
PAIN IN THE BLADDER: Nux 

vom. 
SORE PAIN IN URETHRA: Cop. 

Nux vom. Phosph. 
STINGING IN THE BLADDER: 

Canth. 
TEARING IN THE GLANS : Chin. 

b. During urination. 

BURNING IN BLADDER: Aconit. 

Camph. Lach. Staph. 
^- in urethra : Ambra. Ars. Bar. Calc. 

Cann. Canth. Caust. Cham. Clem, 

Chin. Colch. Dulc. Ferr. Hep. Ipec. 

Kali bichr. Merc. Nitric ac. Nux 

vom. Phosph. ac. Puis. Sabad. Sas- 

sap. Sep. Staph. Sulphur. Thuj. 

Veratr. 
GENERALLY: Aeon. Anac. Apis. 

Ars. Bell. Bor. Bry. Calcar. Camph. 

Cann. Canthar. Caps. Carbo veg. 

Caust. Chin. Clem. Colch. Con. 

Cupr. Dig. Dulcam. Graph. Hell. 

Hep. Ipec. Kali. Lye. Mur. magn. 

Merc. Mezer. Mur. ac. Natr. mur. 

Nitric ac. Nux vom. Petr. Phosph. 

Phosph. ac. Puis. Rhod. Rhus. 

Sassap. Sec. corn. Seneg. Sep. 

Spigel. Staph. Stram. Sulph. Thuj. 

Veratr. Zinc. 
GNAWIN G IN URETHRA : Caust. 
HEAT IN URETHRA: Caust. 
ITCHING IN URETHRA: Alum. 

Ambra. Arn. Canth. Daph. Lye. 

Natr. mur. Nux vom. Thuj. 
LANCINATIONS IN URETHRA: 

Ant. crud. Calc. Canth. Con. Dig. 



Graph. Merc. Phos. ac. Puis. Zinc 
— in bladder: Canth. Lye. Thuj. 
— in renal region : Canth. Merc. 
OS COCCYX, pain in: Graph. 
PRESSURE IN BLADDER : Aeon. 

Con. Nitric ac. Spig. Staphys. 

Veratr. Zinc. 
— in the urethra : Canth. Puis. 
— in renal region : Bell. Lye. 
PROSTATIC JUICE, discharge of: 

Natr. Phosph. ac. 
STITCHES IN BLADDER: Canth. 

Lye. Sulph. 
—in urethra: Bry. Can. Canth. Chin. 

Clem. Con. Cupr. Daph. Graph. 

Ign. Lach. Merc. Natr. mur. Sulph. 

Thuj. 
— in kidneys : Aco. Bell. Canth. Hep. 

Phosph. ac. 
— in bowels : Nitric ac. 
STOOL INVOLUNTARY: Muriat. 

ac. Squill. 

c. After urination. 

BURNING IN URETHRA: Con. 

Graphit. Lye. Merc. Nitric acid. 

Rhod. Sulph. 
CUTTING IN URETHRA: Canth. 

Con. Staph. Sulph. 
DRIBBLING OF URINE: Bryon. 

Calc. carb. Lach. Petr. Selen. Thuj. 
DRIBBLING OF BLOOD: Daph. 

Zinc. 
GENERALLY: Anac. Antim. tart. 

Arn. Asa f. Aur. Bell. Calad. Calc. 

Cann. Canth. Capsic. Chin. Clem. 

Coloc. Con. Creos. Dig. Hep. Kali. 

Lach. Lye. M. arct. Mercur. Mur. 

ac. Natr. Natr. mur. Nitr. ac. Nux 

vom. Par. Phos. Plat. Puis. Rhod. 

Ruta. Selen. Seneg. Sep. Stann. 

Staph. Sulph. Thuj. Veratr. Zinc. 
ITCHING IN URETHRA: Canth. 

Lye. Sassap. 
MUCUS, discharge <rf: Con. Natr. 

mur. 
NAUSEA: Dig. 



URINE AND URINARY ORGANS. 



PRESSURE IN URETHRA : Stann. 

— on the bladder : Con. Stann. Zinc. 
SORENESS IN URETHRA: Nux 

vom. Thuj. 
STITCHES IN URETHRA: Am. 

Caps. Merc. Mnriat. acid. Phosph. 

Veratr. 
— in bladder: Guaj. 



— in kidneys : Ambr. 

TEARING IN URETHRA: Carbo 

veg. Lye. 
URETHRA, as of a drop in: Lact. 

Thuj. 
URGING TO URINATE : Bar. Dig. 

Mercur. Ruta. Stann. Staj^h. Zinc. 



uRTJsrjLRY onaA.Jsrs. 



1. Bladder. 
BURNING : Aeon. Ars. Canth. Lach. 

N. vom. Phosph. ac. Puis. Staph. 
CATARRH: Ant. Dale. Nux vom. 

Puis. Sulph. 
CONSTICTION: Caps. Cic. Phos. 

ac. Puis. Sassap. 
CUTTING: Canth. Kali. Lye. Nux 

vom. Puis. Thuj. 
DRAWING : Calad. Rhod. 
FULLNESS, feeling of: Caladium. 

Ruta. 
GENERALLY : Aeon. Alum. Ambr. 

Ant. cruel. Am. Ars. Aurum. Bell. 

Bry. Cede. Camph. Cann. Canth. 

Caps. Carbo veget. Chin. Cic. Coff. 

Clem. Colch. Dig. Dulc. Graph. 

Hyosc. Ign. Kali. Lycop. M. austr. 

Mere. Mezer. Natr. mur. Nitr. ac. 

>\ vom. Phosph. Phos. ac. Puis. 

Rhus. Ruta. Sabin. Sassap. Sep. 

Staph. Sulph. Thuj. Zinc. 

HEMORRHOIDS: Aconit. Borax. 
Carbo veg. Dulcam. Nux vovi. 
Puis. Sulph. 

INFLAMMATION: AconiL Camph. 

Canth. Dig. Merc. N. vom. Puis. 

Squilla. Sulph. 
— of neck of bladder: Aconitum. 

Canth. Con. Dig. Nux vom. Puis. 

Sulph. 
INSENSIBLE: 11 austr. Staun. 



PARALYSIS : Ars. Bell. Canth. Cic. 

Dulc. Hyosc. Laur. M. austr. 
PRESSING: Alum. Carbo veget. 

Chin. Colch. Nux vom. 
PULSATION: Canth. 
PRESSING: Hyosc. 
PRESSURE: Asar. Bellad. Bryon. 

Camph. Carbo veg. Con. Ign. Lach. 

Natr. mur. Nitric acid. Pulsat. Sas- 
sap. Sep. Squilla. Staph. Zinc. 
RELAXED : Mur. ac. 
SPASMS: Asa f. Camph. Canth. 

Caps. Phosph. ac. Sep. 
SPASMODIC PAIN: Prun. 
STITCHING: Aur. Canth. Cham. 

Guaj. Lye. Puis. Rhus. 
STONE : Amb. Ant. crud. Calc. carb. 

Cann. Lye. Nux vom. Phosph. 

Ruta. Sassap. Sil. 
SUPPURATION: Canth. Puis. 
SWELLING OF NECK OF 

BLADDER: Puis. 
THICKENING: Dulc. 

2. Urethra. 

BURNING: Arsen. Baryt. Bryon. 
Calc. carb. Cann. Canth. Caust. 
Clem. Colch. Cupr. Ipec. Kali 
bichr. Lye. Mercur. Natr. Nitric 
ac. Petr. Phosph. Phosph. acid 
Sassap. Sepia3. Staph. Sulph. Thuj. 



URINE AND URINARY ORGANS. 



CUTTING: Ant. cruel Gale. Carb. 

Cann. Canlh. Carbo veg. Colchic. 

Con. Cupr. Dig. Ignat. Lye. Merc. 

Nux vom. Phosph. ac. Rhod. Sep. 

Sulph. Thuj. 
DISCHARGE: Agn. Calc. carbon. 

Cann. Canthar. Caps. Dulc. Hep. 

Merc. Mtr. ac. Nux vom. Petr. 

Puis. Sassap. Sulphur. Thuj. 
— bloody : Calc. carbon. Lycop. Merc. 

Nitric ac. Zinc. 
— thick: Merc. 
— purulent: Cann. Canthar. Clem. 

Mercur. Nitric acid. Sassap. Sulph. 

Thuj. 
— yellowish: Cann. Mercur. Natr. 

mur. Nitric ac. Thuj. 
— greenish : Merc. Nitric ac. 
— slimy: Ant. Cann. Caps. Dulc. 

Merc. Mezer. Nitric ac. Phos. ac. 

Puis. Sulph. 
— watery: Cann. Merc. Sulph. 
DRAWING: Cole. Kali. Lye. Puis. 

Sabad. Sulph. Zinc. 
GENERALLY: Aeon. Alum. Ant. 

crud. Antim. tart. Arn. Arg. nitr. 

Aur. Boy. Bryon. Calc. carb. Cann. 

Cantli. Capsicum. Caust. Chel. 

China. Clem. Coff. Colch. Con. 

Cop. Cupr. Dulc. Ferr. Graph. 

Hep. Ign. Kali. Lach. Lycop. M. 

austr. Merc. Mezer. Natrum mur. 

Nitric ac. Nux vomica. Phosph. 

Phosph. ac. Puis. Rhus. Sabin. 

Sep. Staph. Sulphur. Thuj. Ye- 

ratr. Zinc. 
INFLAMMATION: Aeon. Bovista. 

Cann. Canth. Clem. Digital. Hyosc. 

Merc. Nux vom. Puis. Squilla. 

Sulph. 
ITCHING: Agar. Arn. Bov. Bry. 

Canth. Chin. Lye. Merc. Natrum 

mur. Nux vom. Sulph. Thuj. 

PRESSURE: Canth. Colch. Nux 
vom. Puis. 



PULSATING: Canth. Merc. 
SORENESS, as from: Bar. Daph. 

Natr. mur. Phosphor. Teucr. Zinc. 
SPASM: Chin. Carbo an. 
STITCHING: Arn. Bryon. Cann. 

Canth. Capsic. Con. Cuprum. 

Daph. Graph. Ign. Iod. Lach. 

Lye. Merc. Mur. ac. Natrum mur. 

Nux vom. Phosphor, ac. Squilla. 

Sulph. Thuj. 
STRICTURE : Camph. Canth. Carbo 

veg. Clem. Dulc. Lye. N. vom. 

Petr. Puis. Rhus. Sulph. 
SWELLING: Canthar. Merc. Nitr. 

Rhus. 
TEARING: Cann. Carbo vegetab. 

Clem. Colch. Lycop. Natrum. Sas- 
sap. Sulph. 
TICKLING: Canth. 
TWITCHING: Con. Natr. Phosph. 
ULCER : Merc. Nitric ac. 

3. Kidneys. 

BURNING: Bell. 
DRAWING: Clem. 
GENERALLY: Aeon. Alum. Bell 

Cann. Canth. Carbo veget. Clem. 

Colchic. Hep. Kali. Lye. Nitric ac. 

Nux vomica. Phosph. Phosph. ac. 

Pulsat. Rheum. Ran. seel. Sassap. 

Sep. Sulph. Thuj. Zinc. 
GRAVEL: Alum. Calcar. carbon. 

Cann. Canth. Lye. Nitric ac. Nux 

vom. Petr. Phosph. Ruta. Sil. Sas- 
sap. Sulph. 
INFLAMMATION: Bell. Cann. 

Canthar. Hep. Lye. N. vom. Puis. 
JERKING: Canth. 
PULSATIONS: Canth. 
PRESSURE: Thuj. Zinc. 
AS IF SORE: Zinc. 
SPASMODIC PAINS : Sulph. 
STITCHES: Aeon. Bell. Canthar, 

Hep. Kali. Phosph. ac. Zinc. 



87 



XXVI. SEXUAL ORGANS AND FUNCTIONS. 

MA.LE ORG-JLJSTS cltlcL THEIR EUJSrCTTOJVS. 



1. Penis. 
BLUENESS: Am. 
BURNING: Canth. Euphorbium. 

Merc. Mux. ac. Plumb. 
COLDNESS: Lye. Merc. Sulph. 
DEADNESS: Lye. Merc. 
DRAWING: Canllt. Cic. Iod. Kali. 

M. austr. Merc. Ran. sc. Zinc. 
ERUPTION: Graph. Phosph. acid. 
GANGRENE: Ars. Canth. 
GENERALLY: Alum. Ambr. Anac. 

Ant. crud. Am. Ars. Bovista. Bry. 

Calc. carb. Camphor. Cann. Canth. 

Caps. Carbo veg. Canst. Chin. 

Clem. Colch. Con. Cupr. Dig. Ferr. 

Graph. Hep. Ign. Iodine. Ipec. 

Kali. Lach. Lye. M. austr. Merc. 

Mezer. Mur. ac. Natr. Natrum 

mur. Nux vom. Op. Phosphor. 

Phosph. ac. Plat. Plumbum. Puis. 

Ran. Rhus. Sabin. Selen. Sep. Sil. 

Spigel. Staph. Sulph. Thuj. Viol. 

trie. Zinc. 
GONORRHOEA: Cann. Cantharis. 

Caps. Clem. Dulc. Ferr. Lye. Merc. 

Natr. mur. Nitric ac. Nux vom. 

Puis. Sabina. Sec. corn. (?) Selen. 

Sulph. Thuj. 
— acute : Cann. Canth. Merc Nitr. ac. 
— chronic : Cann. Capsic. Dulc. Ferr. 

Merc. Nitr. ac. N. vom. Sep. Sulph. 
— green : Cann. Merc. 
— white : Cann. Caps. Ferr. 
— clear: Merc. Sulph. 
— yellow: Cann. Merc. Nitric ac. 

Sulph. 
INFLAMMATION: Canthar. Merc. 

Plumb. Sulph. 
ITCHING: Ars. Con. Spig. Sulph. 
PAIN AS IF BRUISED : Arn. 
PRESSURE: Viol. trie. 
PUSTULES: Bovist. 



REDNESS: Arn. Cann. 
RELAXED : Calc. Lye. Merc. Prun. 
SORE, painful as if: Arn. Cann. 

Cicut. 
SPASM: N.mosch. 
STITCHES: Asa feet. Lye. Merc. 

Puis. Spig. Sulph. Thuj. 
SWELLING: Arn. Cann. Canthar. 

Merc. Plumb. 
TEARING: Con. Kali. M. austr. 

Merc. Thuj. 
TWITCHING: Lye. 
TENSION: Arn. Graph. 
ULCER: Merc. 

2. Glans. 
BURNING : Ars. Cann. Chin. Lye. 

Merc. Stann. Tart. 
COLDNESS: Lye. Merc. 
CREEPING: Alum. Merc. Natr. 

mur. Tart. 
CUTTING: Lye. Thuj. 
DAMPNESS: Alum. Lye. Merc. 

Natr. mur. Nitr. ac. N. vom. SulpJi. 

Thuj. 
DRAWING: Alum. Asa foet. Iod. 

Lye. 
ERUPTION: Calad. Lycop. Nitr. 

Petr. Sep. 
FORMICATION: Alum. 
GENERALLY: Alum. Antim. crad. 

Ars. Calc. carb. Cann. Canth. Carb. 

veg. Caust. Chin. Colch. Dig. 

Graph. Ign. Iod. Lach. Kali. Lye. 

M. austr. Merc. Mez. Natr. Natr. 

mur. Nitr. ac. N. vom. Petr. 

Phosph. Puis. Rhus. Sabin. Sep. 

Sil. Stann. Staph. Sulph. Thuj. 
HARDNESS: Cann. 
INFLAMMATION : Arnic. Cannab. 

Cupr. Merc. Rhus. 
ITCHING: Ambr. Angust. Ars. 

Cann. Euphr. Hell. Iod. Mang. 



88 



SEXUAL ORGANS AND FUNCTIONS. 



Merc. Natr. Nitr. ac. N. vom. 

Phosph. ac. Sep. Sil. Thuj. 
PRESSURE: Lye. Yiol. trie. 
REDNESS: Arsen. Cann. Merc. 

Sabin. 
SMEGMA : Merc. Nitr. ac. 
SORENESS, as from: Nux vom. 

Sabin. 
SPOTS, red : Cann. Carbo veg. Lacli. 

Nitr. ac. 
SWELLING: Ars. Cann. Cantli. 

Merc. Rhus. 
— on one side: Spig. 
STITCHES: Aeon. Am. Ars. Eu- 

phorb. Euphr. Lycop. Merc. 

Phosph. Rhod. Sabin. Sulph. Thuj. 
TEARING: Daph. Euphorb. Kali. 

Lye. Merc. 
TUBERCLES: Hell. 
ULCERS: Merc. Nitr. ac. Sep. 

Sulph. Thuj. 
— chancrous: Merc. Nitr. ac. Rhus. 

Sulph. Thuj. 
ULCERATIVE PAIN: Ambr. Ign. 
VESICLES: Merc. Phosph. acid. 

Rhus. 

3. Prepuce. 

BURNING: Arsen. Cann. Merc. N. 

vom. 
CREEPING : Croc. Merc. Ph. ac. 
DRYNESS : Calad. Ign. Sil. 
ERUPTION: Aur. Graph. Merc. 

Nitr. ac. Rhus. Sulph. 
GENERALLY: Aeon. Arn.] Arsen. 

Calad. Calc. carb. Cannab. Canth. 

Caust. Chin. Euphorb. Graph. Hep. 

Ign. Lach. Lye. M. arct. Merc. 

Mezer. Natr. mur. Nitr. ac. Nux 

vom. Phosph. ac. Plumb. Puis. 

Rhod. Rhus. Selen. Sep. Sil. 

Staph. Sulph. Thuj. Yiol. trie. 

Zinc. 
HARDNESS: Lach. Merc. Sulph. 
HERPES : Caust. Dulc. Hep. Merc. 

Nitr. ac. Phosph. ac. Sep. 
INFLAMMATION: Calc. carb. 



Cann. Merc. Nitr. ac. Sulph. 
ITCHING: Aco. Agar. Bry. Calad. 

Carb. veg.* Cann. Caust. Euphras. 

Merc. Nitr. ac. N. vom. Puis. Sep. 

Sil. Sulph. Thuj. 
PAIN AS IF SORE: Calad. Cham. 

Ign. N. vom. 
PARAPHIMOSIS : Bell. Coloc. Ign. 

M. arct. Merc. N. vom. 
PHIMOSIS : Cannab. Canthar. Merc. 

Nitr. ac. Rhus. Sulph. Thuj. 
REDNESS: Calc. Cann. Merc. 
SCURFS : Caust. Nitr. ac. (Comp. 

Herpes.) 
STITCHES: Ars. Bry. Cann. Eu- 
phras. Hep. Merc. Puis. 
SMARTING: Calad. Merc. Nux 

vom. Puis. 
SPOTS, red: Nitr. ac. Rhus. 
SORENESS: Calad. Cann. Carbo 

veg. Ign. Nitr. ac. N. vom. 
STRICTURE: Cann. Merc. Sep. 

Sulph. 
SUPPURATION: Merc. 
SWELLING : Calad. Cann. Graph. 

Mercur. Nitric ac. Rhus. Suljjh. 

Thuj. 
ULCERS: Aurum. Caustic. Hep. 

Merc. Nitric ac. Bhus. Sep. 

Sulph. Thuj. 
— chancrous: Kali bichr. Mercur. 

Nitric ac. Rhus. Thuj. 
VESICLES : Merc. Rhus. 

4. Testicles. 
BURNING: Iod. Plat. Staph. 
COLD FEELING: Merc. 
CONSTRICTION: N. vom. Plumb. 
DRAWING: Amm. Clem. Ipecac. 

M. arct. Merc. Phos. Puis. Rhod. 

Staph. Zinc. 
DWINDLING: Aur. Lye. 
GENERALLY : Agn. Amm. Antim. 

crud. Arn. Aur. Bell. Calc. carb. 

Canth. Carbo veg. Caustic. Chin. 

Clem. Cocc. Con. Dig. Graph. 

Ignat. Iod. Kali. Lye. M. austr. 



SEXUAL ORGANS AND FUNCTIONS. 



89 



Merc. Natruni. Nitric at'. Nux vom. 

Phos. Phospli. ac. Plat. Plumbum. 

Puis. Rliod. Rhus. Selen. Sep. Sil. 

Spong. Staph. Sulpli. Tar. Thaj. 

Zinc. 
GNAWING: Plat. 
HANGING DOWN:2/?ff. ac. Puis. 
HARDNESS : Agn. Arg. Arnica. 

Aur. Clem. Iod. Merc. N. vom. 

Rliod. Spong. 
HEAT: Am. 
— feeling of : Sulph. ac. 
HERNIA : Lach. N. vom. Rhus. 
INDUEATION: Amm. Ignatia. M. 

austr. Plumb. 
INFLAMMATION : Aco. Aur. Clem. 

Lye. Mercur. Nux vom. Puis. 

Staph. Zinc. 
ITCHING : Iod. Ign. Merc. Nux 

vom. Spig. 
JEEKS : M. austr. 
PAIN AS IF BRUISED : Am. 

Clem. Con. Dig. 
PRESSING TOWARD THE 

TESTICLES: Iod. 
PRESSURE: Aur. Bism. Cannab. 

Caust. Ign. Lach. Phos. ac. Puis. 

Squilla. Staph. Zinc. 
SENSITIVENESS: Am. Asa feel. 

Cann. Phosph. ac. Zinc. 
SPASM: Phosph. 
STITCHES: Am. BeU. M ere. Nux 

vom. Rhod. Spig. Thuj. 
SWELLING : Arn. Arsen. Aur. Can- 

thar. China. Clem. Con. Iod. Lye. 

Merc. Nitric acid. Nux vom. Puis. 

Rliod. Ruta. Spong. Staph. Zinc. 
— of epidydimis : Sulph. 
TEARING: Chin. M. austr. Phos. 

ac. Puis. Staph. 
TENSION: Arn. Sulph. 
TURNING: Sabad. 

5. Scrotum. 
BLUENESS: Arn. 
BURNING: Euphorb. Rhod. 
CONTRACTION: Petr. Puis. 

54 



COLDNESS: Caps. 

CREEPING: Arn. Carboveg. Selen. 

Thuj. 
DAMPNESS: Petr. Rhus. Sulph. 
ERUPTION: Petr. Phosphor, ac. 

Rltus. 
ERYSIPELAS: Ars. 
GENERALLY: Aeon. Ambr. Ant. 

crud. Arn. Ars. Baryt. Bell. Calc. 

carb. Camphor. Cannab. Carbo 

veg. Caust. Chin. Clem. Con. Eu- 
phorb. Graph. Hep. Ign. Iod. Kali. 

Lye. M. austr. Mezer. Nalr. Nitric 

ac. Nux vom. Petr. Phosph. PIlos. 

ac. Plumbum. Puis. Rliodod. Rhus. 

Selen. Sep. Sil. Staphys. Sulph. 

Thuj. Viol. trie. Zinc. 
HERPES : Calc. carb. Dulc. Petr. 
HYDROCELE: Arn. Graph. Nux 

vom. Puis. Rliodod. Rhus. Sil. 
INFLAMMATION : Ars. Phosph. ac. 

Plumb. 
ITCHING : Ambr. Amm. Aurum. 

Baryt. China. Cocc. Graphit. Lye. 

Meph. Nux vom. Petr. Pulsat. 

Rliodod. Rhus. Selen. Staph. 
PAIN AS IF BRUISED : Aeon. 

Arn. Kali. 
PULLING: Petr. 
RASH: Rhus. 
REDNESS: Puis. 
RELAXED : Chin. Lye. 
SHRIVELING: Rhod. 
SORENESS : Arn. Petr. Plumb. 

Sulph. 
STITCHES: Arn. Merc. Sulphur. 

Thuj. 
SWELLING: Am. Canth. Carbo 

veg. Graph. Plumbum. Puis. Rhus. 

Sep. 
SWEAT :, Baryt. Ignat. Rliodod. 

Thuj. 
TENSION: Arn. 

6. Spermatic Chord. 

BURNING: Staph. 

DRAWING: Agn. Canthar. Clem. 



90 



SEXUAL ORGANS AND FUNCTIONS. 



M. austr. Merc. N. vom. Puis. 

Ehod. 
GENERALLY: Alum. Amm. max. 

Ant. crudum. Am. Oanthar. Clem. 

Iod. Kali. M. auslr. Mercur. Nitric 

ac. Nux vom. Phosph. acid. Plumb. 

Puis. Sabin. Spong. Staphys.Thnj. 

Veratr. 
HARDNESS : Phosph. ac. 
PRESSURE: Nux mosch. Spong. 

Sulph. Thuj. 
STITCHES : Amm. mur. Am. Grat. 

Staph. Thuj. 
SWELLING: Cann. Phos. Puis. 

Spong. 
TEARING: Colch. Puts. 
TENSION : Cann. M. austr. 
THROBBING : Amm. mur. 
TWITCHING: Plumb. 

7. Prostate Gland. 
HARDNESS: Iod. 
INFLAMMATION : Agn. Iod. Merc. 

Puis. 
PROSTATIC JUICE, discbarge of: 

Alum. Anac. Calcar. Con. Hep. 

Lycop. Nitric acid. Petr. Phosph. 

ac. Plat. Selen. Sep. Sil. Staph. 

Sulph. Zinc. 
— when urinating: Anac. Calc. Sep. 

Sulph. 
— at stool: Alum. Calcar. Hep. Ign. 

Selen. Sil. Snlph. 
— after stool : Selen. 
— before stool : Selen. 
— with relaxed parts: Calcarea. 

Phosph. ac. 
SWELLING: Puis. 

8. General Symptoms. 

COLDNESS: Agn. Capsic. Lycop. 

Merc. 
ERUPTION: Aur. Calad. Caustic. 

Dulc. Graph. Merc. Nitric ac. Petr. 

Phosph. ac. Rhus. Sep. Sil. Sulph. 

Thuj. 



— on the hairy part of 'the parts : Ka- 
li, bichr. Lach. 
FETID SMELL : Natr. mur. Sassap. 
FIGWARTS: Euphr. Lye. Nitric 

ac. Phosph. ac. Sabin. Sassap. 

Thuj. 
— bleeding: Thuj. 
— flat : Nitric ac. Thuj. 
— like cock's-crest : Nitric acid. Thuj. 
— humid: Nitric acid. Sulph. Thuj. 
— dry: N. vom. Sulph. Thuj. 
GANGRENE: Ars. Canth. 
HAIR, falling off: Natrum mur. 

Nitric ac. Rhus. Selen. 
HERPES: Aur. Dulc. Nitric acid. 

Petr. Phosph. ac. Sulph. 
RELAXED: Calc. Lye. Phos. ac. 

Selen. 
SWEAT : Calad. Merc. Phos. ac. 

Sep. Sulph. Thuj. 
WEAKNESS : Agn. Calc. Lycop. 

Mang. Sep. Sulph. 

9. Sexual Instinct, 
Functions. 

ERECTIONS: Agar. Alum. Ambr. 

Anac. Am. Ars. Aur. Baryt. Bell. 

Bov. Calc. carb. Cann. Canth. Caps. 

Carbo animal. Carbo veg. Chin. 

Clem. Colch. Con. Big. Graph. Ig- 

natia. Kali. Lach. Lycop. M. arct. 

Mur. magn. Merc. Mosch. Natr. 

Natr. mur. Nitric ac. Nux vom. Op. 

Phos. Phosph. ac. Plat. Plumbum. 

Puis. Rhus. Sabin. Sep. Sil. Spig. 

Staph. Sulph. acid. Tar. Thuj. Viol. 

trie. Zinc. 
— in the evening : N. vom. Phos. 

Staph. 
— in the morning : Ambr. Anac. Arn. 

Brora. Caps. Lach. Natrum. N. vom. 

Phos. Plumb. Puis. Ehus. Thuj. Vit. 
— at night : Canth. Merc. Natr. mur. 

Nitric ac. Plumb. Puis. Staph. 

Sulph. ac. Zinc. 
— in the day-time: Cann. Hyosc. 

Lach. Puis. 



SEXUAL ORGANS AND FUNCTIONS. 



01 



. -Jay and night: Canth. 
— too short : Calad. Calc. Con. Selen. 
— deficient: Agn. Calad. Camphor. 

Con. Graph. Hell. Lack. Lye. Magn. 

carb. Nux mosch. Puis. Teucr. Vit. 
— too feeble : Baryt. Caladium. Lach- 

esis. Lye. Mercur- Selen. SulpJu 
— too strong: Canthar. Creos. Lach. 

Natr. mur. Nux vom. Op. Phos. 

Puis. Sabin. Zinc. 
— too painful: Cann. Canth. Graph. 

Ign. Kali. Merc. Nitric ac. Nux 

vom. Plumb. Sabad. Sulph. Thuj. 
— -without sexual lust : Ambra. Calad. 

Cann. Caps. Graphit. Lach. Magn. 

Natrum muriat. Phosph. ac. Sabad. 

Sabin. Sil. Spig. 
SEMEN BLOODY: Canst. Canth. 

Led. Merc. 
— thin: Selen. 
— inodorous: Selen. 
— watery: Led. Sulph. 
— flow of: Agar. Alum. Anac. Arg. 

Arn. Ars. Aur. Baryt. Bell. Bism. 

Bov. Brom. Calad. Calc. Canth. 

Carbo an. Carbo veg. Caustic. 

China. Cicut. Con. Ferr. Graphites. 

Guaj. Kali. Lach. Led. Lye. Magn. 

Merc. Natr. Natr. mur. Nitric ac. 

Nux mosch. Nux vom. Op. Petr. 

Phosph. Phosph. ac Puis. Ban. 

bulb. Bhus.Ruta. Sangv. Selen. Sep. 

Silicca. Stann. Staph. Sulphur. 

Thuj. Verb. Yit. Zinc. 
in the day-time : Canthar. Car- 
bo an. Caust. Graph. Lach. 
not taking place during inter- 
course: Calad. Graph. Kali. 
Lach. Lye. 

with relaxed penis : Bellad. Con. 

Graph. Mosch. N. vom. M. arct. 
Plumb. Selen. 

at stool : Phosph. ac. 

— weakening : Baryt. Carbo an. uhin. 

Kali Lach. Lye. Nux vom. Phosph. 

Phosph. ac. 



— too soon: Bor. Calad. Calcar. Lye. 

Phosph. Sel. Zinc. 
— too often : Bar. Calc. carbon. Canth. 

Carbo veg. Chin. Ci: Con. Kali. 

Lye Nitric ac. Petr. Phosph. 

Phosph. ac. Sep. Sil. Sulph. 
— during the siesta : Alumina. Caust. 

Clem. Mercur. Staph. Sulph. 
— without force: Canthar. Con. 

Phosph. Selen. 
— deficient: Calad. Calc. Camphor. 

Kali. Lach. Lye. Natr. mur. 
— followed by languor: Baryt. Calc. 

carb. 

by anxiety : Carbo an. 

by head-ache : Calcar. Lach. Sil. 

irresistible desire : Rhus. 

heaviness in the limbs next 

day : Puis. 

amorous fancies : Alumina. Ars. 

Aur. Baryt. Bism. Calc. Chin. 
Grat. Led. Natr. Nux vom. Ole- 
and. Op. Phosphor. Plumb. Sa- 
bad. Samb. Sassap. Sil. Staph. 
Viol. trie. 
SEMEN, followed by dryness of the 

skin: Baryt. 

contractive feeling in urethra: 

Thuj. 

voluptuous dreams : Calcar. ph. 

Kali carb. 
— early in the morning: Lach. N. 

vom. Plumb. Puis. 
— after midnight : Samb. 
— several nights in succession: Aur. 

Caust. Carb. an. Con. 
— after onanism: Calc. Carbo veg. 

Chin. Natr. mur. Ph. ac. Sep. Staph. 
— without dreams : Anac. Ant. crud. 

Bism. Calc. Cic. Guaj. Phosph. 

Puis. Ban. sc. Buta. Stann. Verb. 

Zinc. 

fancies: Phosph. 

thrill : Anac. Natr. Carb. Sulph. 

ac. Plat. 
— painful: Calc. Cann. Canth. Clem. 

Mosch. Natr. carb. Sassap. Thuj. 



92 



SEXUAL ORGANS AND FUNCTIONS. 



— with cutting in urethra : Bor. 

— with cutting in urethra afterwards : 

Natr. mur. 
— too late: Agar. Calc. Lack. Lye. 

Petr. 
SEXUAL INTERCOURSE, aver- 
sion to : Agar. Gann. Caust. Clemat. 

Kali. Lye. Phosph. Rhod. 
— desire for: Calcar. Canth. Chin. 

Lach. Mosch. Phos. Puis. Stann. 

Veratr. 
— falls asleep during : Bar. Lye. 
— followed by mental languor : Calc. 

Sep. 

by pain in urethra : Canth. 

by dullness of head : Bo v. Chin. 

Lye. 

by ill-humor : Petr. 

by back-ache : N. vom. 

— with relaxed penis: Con. Lye. N. 

vom. 
— followed by weakness : Agar. Calc. 

Kali. Lycop. JSfitr. ac. Selen. 
— — by sweat : Agar. 

by bruised feeling : Sil. 

by tremor of the legs : Calc. 

carb. 
SEXUAL LUST : Calc. carb. Canth. 

Carb. veg. Chin. Graph. Hyosc. 

Lach. Mosch. Natr. mur. N. vom. 

Phosph. Plat. Puis. Sep. Stann. 

Stram. Veratr. Zinc. 
SEXUAL DESIRE TOO STRONG : 

Agar. Alum. Ant. crud. Aur. Baryt. 

Bov. Calc. Cann. Canth. Carb. veg. 

China. Coff. Con. Dig. Dulc. Eerr. 

Graph. Hyosc. Ign. Iod. Kali. Lach. 



Lycop. Mane. M. arct. M. aust. 

Men. Merc. Mosch. Natr. mur. N. 

vom. Op. Petr. Phos. Plat. Plumb. 

Puis. Rhus. Ruta. Sabin. Sep. Sil. 

Staph. Stram. Sulph.Jerair. Zinc. 
SEXUAL DESIRE, like priapism: 

Canth. Graph. Natr. mur. N. vom. 

Phosph. Plat. Puis. Staph. 
— like satyriasis: Canth. Merc. N. 

vom. Phosph. Sulph. Verat. 
— deficient : Amm. mur. Bellad. Bor. 

Calc. carb. Camph. Con. Graph. 

Hep. Kali. Lach. Lye. Magn. c. 

Nitr. ac. Phosphor, ac. Rhod. Stann. 

Sulph. 
— too feeble : Alum. Ambr. Bar. Bell. 

Bor. Calad. Calc. Carbo an. Caust. 

Clem. Eerr. Graph. Hep. Kal. Lact. 

Lye. Magn. c. Mur. ac. Natr. mur. 

Nitr. ac. Op. Petr. Phosph. ac 

Ehod. Selen. Sep. Spong. Stann. 

Sulph. Teucr. 

— with impotence : Agar. Graph. Se- 
len. 
SEXUAL POWER, too feeble : Agar. 
Bar. Calad. Calc. Canth. Chin. Con. 
Ignat. Mang. N. mosch. Selen. Sep. 
Sulph. Vit. 
deficient : Agar. Agn. Ant. crud. 

Baryt. Calatl. Calc. Camph. Cann. 

Carb. v. Caust. Chin. Chlor. Con. 

Cupr. m. Ferr. Graph. Hep. Ign. 

Iod. Laches. Lye. Mosch. Mur. 

acid. Natr. mur. Nitr. acid. N. 

mosch. N. vom. Phosph. Plumb. 

Rhus. Selen. Sep. Sil. Sulph. Thu}. 

Vit. Zinc. 



A. SEXUAL ORGANS. 



FEMA.LE SJEJZUAL OR&A.JSTS JlND 
FUNCTIONS. 

Petr. Sabin. Sil. Staph. Sulph. 

Thuj. 
DAMPNESS : Aur. Sulph. 
ERUPTIONS: Calc. Caust. Dulc. 

Graph. Merc. Nux vom. Petr. Rhus. 

Sep. Staph. Sulph. Veratr. 



1. External Organs. 

APHTHAE: Carb. veg. 
BURNING: Calc. Canth. Carbo veg. 
Caust. Kali. Lye. M. austr. N. vom. 



SEXUAL ORGANS AND FUNCTIONS. 



93 



GENERALLY: Aeon. Agar. Alum. 

Ambr. Amm. Ant. crud. Arn. Asa 

f. Aur. Bar. Bell. Bry. Calc. Canth. 

Carbo veg. Cham. Chin. Coff. Con. 

Creos. Dulc. Ferr. Graph. Hyosc. 

Kali. Lye. Meph. Merc. Natr. Natr. 

mur. Nitr. ac. Nux voni. Petr. 

Phosph. Platin. Pnlsat. Rhus. Sec. 

corn. Sep. Silic. Staph. Sulph. 

TIiuj. Yeratr. 
GNAWING: Kali. Lye. Nux vom. 
HAIR, falling out : Natr. mur. Nitr. 

ac. 
HEAT: Aur. Canth Carbo veg. M. 

austr. Merc. Nux vom. 
ITCHING : Agar. Alum. Ambr. Calc. 

Carbo veget. Creos. Con. Dulc. Kali 

bichr. Kali carb. Lye. Merc. Natr. 

mur. Nux vom. Sep. Staphys. Sil. 

Sulph. 
NETTLE-RASH: Ant. tart. 
PAINFULLNESS : Kali bichr. Merc. 

Staph. 
PIMPLES : Graph. Kali. Merc. 
PUSTULES : Bry. Merc. 
REDNESS: Carbo veg. 
SWELLING: Ambra. Amm. Aur. 

Canth. Carbo veg. Meph. Mercur. 

Nitric ac. Nux vom. Sec. corn. Sep. 

Thuj. 
SORENESS: Ambr. Amm. Carbo 

veget. Caust. Daph. Graph. Hep. 

Kalic bichr. Lye. Merc. Petr. Rhus. 

Sep. Sil. SuIjjJl. Thuj. 
SORE PAIN : Ambr. Brom. Cham. 

Creos. Ferr. m. Rhus. Thuj. 
STITCHES: Aur. Con. Croc. Gra- 

phit. M. austr. Merc. Phosph. Sep. 

Staph. Thuj. 
TUBERCLES : Calc. Merc. Phos. 
ULCER: Graph. Merc. Nitric ac. 

Sec. corn. Sep. Thuj. 
VARICES: Calc. carb. Carbo veg. 

Lye. 
VESICLES: Graph. Staph. 



2. Vagina. 

BURNING: Aur. Cham. Hyosc. Lye. 

Sulph. Thuj. 
CONTRACTION: Mosch. Rhus. 

Sep. Thuj. 
DRYNESS: Bell. Lye. 
GENERALLY : Alum. Ambra. Aur. 

Ars. Bell. Calc Canth. Capsic. Car- 
bo veg. Caust. China. Coff. Con. 

Creos. Dulc. Ferr. Ferr. m. Graph. 

Hep. Iodine. Kali. Lye. Mur. magn. 

Mercur. Natr. Natr. mur. Nitric ac. 

N. vom. Petr. Phosph. Plat. Puis. 

Rhus. Sabina. Secale corn. Sep, 

Sil. Stann. Staph. Sulph. Sulph. 

acid. Thuj. 
HEAT : Aur. Creos. Merc. 
INDURATIONS: Bell. Sep. 
INFLAMMATION: Merc. Nitric 

acid. 
—with swelling : Merc. 
ITCHING : Con. Creos. Sulph. 
— with voluptuous feeling : Creos. 
LABOR-LIKE PRESSING: Croc. 

Moschus. Sil. 
PAIN DURING INTERCOURSE: 

Ferr. 
PROLAPSUS: Creos. Ferr. Merc. 

Nux vom. Sep. Stann. 
SORENESS: Hyosc. Kali bichr. 
— with burning : Hyosc. 
— painful: Ferr. m. Rhus. 
SPASMODIC PAIN : Nux vomica. 

Staph. 
STITCHES : Ars. Berb. Con. Mur. 

ac. Nitric ac. Puis. Rhus. 
SWELLING: Kali bichr. Merc. 

3. Uterus. 
CANCER: Ars. Bell. Calc. Carb. an. 

Clematis. Creos. Graph. Iod. Kreo- 
sota. Lach. Phosph. Rhus. Sabin. 
Sec. corn. Sil. Sulph. Thuj. 

CONTRACTION: Sop. Thuj. 

CORROSIVE ULCERATION OF 
OS TINCE : Ars. Bell. Merc. Ni- 
tric ac. Sep. Thuj. 



SEXUAL ORGANS AND FUNCTIONS. 



CUTTING IN THE OS UTEEI: 

Puis. 
DESCENSION: Sec. corn. 
DISTENSION: Lye. Phosphor, ac. 

Sep. 
DBA WING: Puis. Ehus. 
GENEEALLY: Aeon. Antim. crud. 

Arn. Asa f. Aur. Bell. Bov. Bryon. 

Calc. Carbo an. Carbo veg. Caust. 

Cham. China. Cocc. Coff. Con. Cre- 

os. Croc. Ferr. Geum urb. Graph. 

Hyoscyam. Ign. Iod. Ipecac. Kali. 

Lack. Magn. carb. Magn. mur. 

Mosch. Natr. Natr. mur. Nux mosch. 

Nux vom. Op. Phosph. ac. Plat. 

Puis. Ehus. Sabadilla. Sabina. Sec. 

corn. Sep. Stann. Stram. Sulphur. 

Thuj. Zinc. 
H^EMOBEHAGE: Aeon. Arg. nit. 

Aloe. Arn. Bell. Bry. Calc. Canth. 

Carbo an. Carbo veg. Cham. Chin. 

Coffea. Creos. Croc. Ferr. Hyosc. 

Iod. Ipec. Lye. Mag. m. M. austr. 

Merc. Mill. Natr. carb. Nitric ac. 

Nux mosch. Nux vom. Phosph. Plat. 

Psor. Pulsat. Ehus. Sabin. Sec. 

corn. Sep. Sil. Squill. Stram. Sulph. 
INDUEATION: Aur. Bell Carb. 

an. Chin. Clem. Cocc. Con. Iod. 

Magn. mur. Ehus. Sep. Staph. 
INFLAMMATION: Aeon. Bellad. 

Bry. Canth. Cham. Chin. Coff. Con. 

Dulc. Ign. Lach. Merc. Nux vom. 

Plat. Puis. Sabin. Sec. corn. 
LABOE-LIKEPAIN: Cham. Mur. 

ac. Op. Sec. corn. Sep. 
POLYPI: Calc. Staph. Thuj. 
PEOLAPSUS : Aur. Bell. Calc. Cre- 
os. Merc. N. vom. Sep. Stann. 
PUTEEFACTION: Carbo an. Sec. 

corn. 
SENSITIVENESS OE NECK OF 

UTEBUS: Chin. 
SOEE, pain as if: Mur. ac. Ehus. 
SPASMS : Bell. Bryon. Caustic. 

Chamom. Cic. Cocc. Con. Geum 

urb. Hyosc. Ignatia. Magn. Magn. 



mur. Natr. mur. Nux vom. Plat 

Pulsat. Sep. Stann. 
SPASMODIC PAIN: Cocc. Ignat. 

Nux vom. Thuj. 
STITCHES: Muriat. acid. Phosph. 

Plat. 
SWELLING: Bell Merc. N. vom. 

Sec. Sep. 

4. Ovaries. 
DEOPSY: Apis. Ars. Canthar. Dul- 

cam. Iod. Mercur. Sepise. Staph.( ?) 
GENEEALLY: Aeon. Agar. Ambr. 

Ant. crud. Apis. Ars. Asa f . Aur. 

Bell. Canth. Carbo an. Carbo veg. 

Chin. Coloc. Con. Graph. Hyosc. 

Ign. Iod. Kali. Lach. Lye. Merc. 

Mezer. Nux vom. Plat. Plumb. 

Ean. bulb. Sabin. Sassap. Sec. 

corn. Sep. Staph. Sulphur. Thuj. 

Vit. Zinc. 
INDUEATION: Apis. Aur. Bellad. 

Carbo an. Iod. Lach. 
INFLAMMATION: Aconit. Ambra. 

Ant. carb. Apis. Ars. Bell. Bry. 

Canth. China. Coloc. Con. Dulc. 

Ign. Lach. Mercur. Plat. Puis. Sa- 
bin. Staph. 
SENSITIVENESS: Apis. Plat. 
SWELLING: Apis. Graph. Iod.(?) 

Lach. 

5. General Symptoms. 

FIGWAETS : Nitric ac. Thuj. 

PAIN AS IF BEUISED : Bar. m. 

PEESSING TOWAEDS THE 
PAETS: Bell Bov. Chin. Cha- 
mom. Con. Croc. Graph. Ipec. 
Kali. Merc. Mosch. Natr. Plat. Pul- 
sat. Sep. Sulph. Thuj. 

EUSH OF BLOOD: Bell. China. 
Croc. Ign. Nux vom. Phosph. Plat. 
Sec. corn. Sulph. 

SOEENESS BETWEEN THE 
THIGHS: Arsen. Caust. Creos. 
Graph. Hep. Lye. Nitric acid. 
Phosph. Ehod. Sep. Sulph. 

WEIGHT, feeling of: Nux vom. 



SEXUAL ORGANS AND FUNCTIONS. 



95 



SEXUAL FUNCTIONS ANP 
INSTINCT. 

BLOOD, loss of, between the pe- 
riods : Ainbr. Arn. Bell. Bov. Calc. 
Cham. Chin. Coc. Coff. Croc. 
Hyosc. Ivali. Ipecac. Merc. Magn. 
niur. Nux vom. Petr. Phosphor. 
Prim. Ehus. Sabin. Sec. corn. Sep. 
Sil. Sulph. Strain. 

— of pregnant females : Cham. Cocc. 
Kali. Phosph. Sablna. Sec. corn. 

— of nursing females : Sil. 

INTERCOURSE, aversion to : Cann. 
Caust. Chlor. Cub. Kali. Lye. 
Natr. mur. Petr. Phosph. 

— desire for: Calc. Creos. Kali. Sa- 
bin. Sulph. ac. 

— with pains : Creos. Ferr. mur. Kali. 

— with too ready conception: Bor. 
Canth. Merc. Natr. 

— with nausea : Sil. 

— without thrill : Ferr. m. 

MISCARRIAGE: Ago. Apis. Arn. 
Asar. Bell. Bry. Calc. Calend. 
Canth. Caps. Carbo an. Carbo veg. 
Cham. China. Cocc. Croc. Cycl. 
Ferrum. Hyosc. Ipec. Iod. Kali. 
Lach. Lycop. Merc. Nitric ac. Nux 
mosch. Nux vom. Op. Phosph. 
Plat. Plumbum. Puis. Rhus. Ruta. 
Sabin. Sec. corn. Sep. Sil. Sulpli. 
Zinc. 

— disposed to : Asar. Calcarea. Carb. 
veg. Cocc. Creos. Ferr. Kali carb. 
Lye. Nux mosch. Plumb. Puis. Ru- 
ta. Sabin. Sabad. Sep. Sil. Sulph. 

— of chlorotic females : Carbo veg. 
Chin. Ferr. Sep. Sulph. 

— with congestion of blood to the 
womb : Bell. N. vom. Plat. Sep. 

— with 'spasms: Cham. Hyosc. Ipec. 
Nux vom. 

— with leucorrhcea : Calc. Ferr. Sep. 
Sulph. 

— at the outset of pregnancy: Sabin. 



Confinement, Ailments 

Incident to. 

AFTER-PAINS TOO VIOLENT, 

LONG: Arn. Bryon. Bell. Calc. 

carb. Cham. Coff. Cupr. Ferr. Ign. 

Kali. Nux vom. Puis. BJius. Ruta. 

Sabina. Sep. Sulph. 
INJURY OF PARTS DURING 

DELIVERY: Arn. 
PAINS SPURIOUS: Bell. Cham. 

Cocc. Coff. Cupr. Hyosc. Ign. Ipec. 

Kali. Nux mosch. Nux vom. Op. 

Puis. Sec. corn. Sep. Stann. 

with urging on the rectum : Nux 

vom. 

violent : Aeon. Coff. 

with contraction of the womb : 

Bell. 
— too feeble: Arn. Bell. Camphor. 

Carb. veg. Cham. Chin. Cocc. Coff. 

Graph. Ign. Kali. Lye. Magn, mur. 

Mosch. Natr. Natr. mur. N. mosch. 

Nux vom. Op. Puis. Rhus. Ruta. 

Sec. corn. Sep. Sulph. Sulph. ac. 

after a fright : Op. 

of feeble persons : Sec. corn. 

with spasmodic pains : Puis. 

— too strong: Aeon. Arn. Aur. Bell. 

Cham. Cocc. Coff. Con. Hyosc. N. 

vom. Sec. corn. Sep. 
PLACENTA ADHERING : Bell. 

Puis. Sec. corn. 
SEXUAL INSTINCT EXCITED : 

Bell. Calc. Canth. Chin. Coff. Con. 

Creos. Ferr. Graph. Hyosc. Kali. 

Mane. Mosch. Nux vom. Plat. 

Phosph. Puis. Strum. Sulph. 

Sulph. ac. Thuj. Yeratr. Zinc. 
— unto nymphomania : Bell. Canthar. 

Hyosc. Merc. Natr. mur. Phosph. 

Plat. Puis. Puiph. sat. Stram. 

Yeratr* 
SPASMS : Bell. Chnm. Or. Cocc. 

Hyosc. Ignat. Ipecac Mosch. Plat. 

Stram. Yeratr. 



96 



SEXUAL 0KGANS AND FUNCTIONS. 



UTERINE HAEMORRHAGE : Bell. 
Cliamom. Chin. Croc. Ferr. Ipec. 
Plat. Sabin. Sec. corn. 

Menses. 

MENSES, pale, watery: Alum. Am. 

Bell. Berb. Bov. Calc. Carb. an. 

Carbo veg. Cocc. Con. Creos. Dig. 

Ferr. Graph. Hell. Hyosc. Ipec. 

Kali. Led. Lye. Magn. Mane. M. 

austr. Merc. Natr. m. Nitr. ac. N. 

mosch. Phosph. Plat. Puis. Rhus. 

Sabin. Sec. corn. Sep. Sulph. Tart. 
— brown: Bry. Calc. Carb. veg. Con. 

Rhus. 
— thick: Arn. Croc. Cupr. Magn. 

c. N. mosch. N. vom. Plat. Puis. 

Sulph. 
— dark, black : Amm. Ant. crud. Arn. 

Asar. Bell. Bism. Bry. Canth. Carb. 

an. Carb. veg. Cham. Chin. Creos. 

Croc. Ferr. Ign. Lach. Magn. Nitr. 

Nitr. ac. Nux vom. 01. an. Plat. 

Puis. Sec. corn. Selen. Sep. Sulph. 
—thin: Ferr. Graph. Sabin. Sec. 

corn. 
— flesh colored : Sabin. Stront. 
— too soon: Alum. Ambr. Amm. 

Arn. Asa f. Asar. Bell. Bor. Bov. 

Bry. Calc. Canth. Carb. an. Carb. 

veg. Cham. Chn. Cin. Cocc. Colch. 

Coloc. Con. Creos. Croc. Dulcam. 

Ferr. Fluor, ac. Gent. Graph. Grat. 

Hell. Hep. Ign. Iod. Ipec. Kali. 

Laur. Led. Lye. Magn. M. austr. 

Mang. Mosch. Mur. ac. Natr. mur. 

Nitr. ac. Nux mosch. Nux vom. 

Petr. Phosph. Phosph. ac. Plat. 

Puis. Rhod. Rhus. Sabin. Sec. 

corn. Sep. Silic. Spong. Stann. 

Staph. Sulph. Sulph. ac. Veratr. 

Zinc. 
— light-colored : Am. Bell. Bry. Calc. 

Canth. Carb. veg. Dros. Dulc. 

Hyosc. Led. M. austr. Phosph. 

Rhus. Sabin. Sec. corn. Stront. 



— too short : Amm. Bar. Con. Dulc. 

Graph. Lach. Magn. mur. M. arct. 

Mang. Mercur. Phosph. Plat. 

Puis. Ruta. Sulph. 
— too long: Aeon. Ars. Asar. Bar. 

Bryon. Canth. Carb. an. Caust. 

Chin. Coff. Croc. Cupr. Dulc. 

Ferr. Ign. Lye. M. austr. Natr. 

mur. Nux vom. Phosph. Plat. Puis. 

Sabin. Sec. corn. Sil. Sulph. 

Sulph. acid. 
— at night: Bov. Magn. carb. Sabm. 
— by fits and starts: Cham. Puis. 

Sabin. 
— acrid: Amm. carb. Ars. Canth. 

Carb. v. Graph. Kali. Nitr. Phosph. 

Puis. Sassap. Silic. Sulph. Sulph. 

ac. 
— frothy: Arn. Ferr. Ipec. 

— slimy: Cocc. Puis. 

— too scanty: Aco. Alum. Amm. Arn. 

Asa. Baryt. Bor. Bry. Calc. Carb. 

veg. Caust. Cicut. Coccul. Con. 

Creos. Crot. Cupr. Dig. Dulc. Ferr. 

Graphit. Ign. Iod. Kali. Kali hydr. 

Lach. Lye. M. arct. Magn. Merc. 

Natr. mur. Ol. an. Phosph. Puis. 

Ruta. Sabad. Sassap. Sep. Sil. 

Staph. Sulph. Veratr. Vit. Zinc. 
— too late: Aeon. Amm. Ast. Aur. 

Bell. Bry. Caust. Chamom. Chel. 

Cic. Cocc. Con. Croc. Cupr. Dulc. 

Ferr. Graph. Hyosc. Hyp. Iod. 

Kali. Lach. Lye. Magn. Merc. 

Natr. carb. Natr. mur. Nic. Nitr. 

ac. Nux mosch. Petr. Phosph. Puis. 

Rhus. Sabad. Sabin. Sassap. Sep. 

Silic. Stront. Sulph. Vitr. Zinc. 
— too copious: Aco. Agar. Ambr. 

Amm. mur. Ant. cr. Arg. nitr. Ars. 

Bar. carb. Bell. Bor. Bry. Calc. 

Canth. Carb. v. Cham. Chel. Chin. 

Cina. Coff. Creos. Croc. Cycl. 

Dulc. Ferr. Hyosc. Ign. Iod. Ipec. 

Laur. Led. Lye. M. austr. Merc. 

Mosch. Mur. ac. Natr. mur. Nitr. 

ac. N. mosch. Nux vom. Phell. 



SEXUAL ORGANS AND FUNCTIONS. 



97 



Phosph. Platin. Plumb. Rhus. 

Ruta. Salmi. Sauib. Sec*, corn. Sep. 

Sil. Spoug. Strom. Sulph. Sulph. 

ac. Verat. Vine. Zinc. 
— too copious at nignt : Amm. carb. 
— lumpy: Amm. carb. Arn. Bell. 

Canth. Cham. Chin. Croc. Ferr. 

Fluor, ac. Hyosc. Ipec. N. vom. 

Plat. Puis. Rhus. Sabina. Stram. 

Stront. 
— irregular: Cocc. Iod. N.vom. Puis. 

Ruta. 
— suppressed: Aeon. Agn. Alum. 

Amm. Ars. Baryt. Bell. Bry. Calc. 

Caust. Cham. Chin. Cocc. Coloc. 

Con. Croc. Cupr. Dulc. Ferr. 

Graph. Hyosc. Ign. Iod. Kali carb. 

Lye. M. arct. Magn. mur. Mercur. 

Natr. mur. N. mosch. Paeon. Petr. 

Phosph. Puis. Rhod. Rhus. Ruta. 

Sabad. Sang. Sassap. Sep. Sllic. 

Staphys. Stram. Sulph. Valer. 

Yerat. Yit. Zinc. 
— of young girls, delaying: Bry. 

Calc. Caust. Cocc. Con. Dulc. 

Graph. Kali. Lach. Lye. Magn. 

Natr. mur. Petr. Puis. Sabin. Sep. 

Stramon. Sulph. 
— fetid: Bell. Bry. Carb. an. Cham. 

Chin. Croc. Ign. Kali. Merc. Phos. 

Rheum. Sabin. Sil. Sec. corn, 
—repeating: Alum. Bry. Ferr. M 

arct. Natr. mur. N. vom. Phosph. 

Ph. ac. Puis. Rhus. Sep. Yeratr. 

Zinc. 

Menses and the Accompa- 
nying Ailments. 
1. Previous to the menses. 

ABDOMEN, distended: Amnion. 

mur. Creos. Lye. 
— distention: Creos. Lye. 
ANXIETY: Ammon. Cocc. Con. 

Merc. Natr. mur. Stann. 
B.ACK-ACHE: Ann. Bar. Brom. 

Calc. Caust. Hyosc. Magnes. carb. 



Mosch. Nitr. N. mosch. Nux vom. 

Spong. 
BREAST, spasm of: Cocc. Cupr. 
BREASTS SWOLLEN: Bry. Calc. 
— painful: Calc. Con. 
BURNING IN PUDENDUM: Calc. 
CANINE HUNGER: Magn. carb. 
CARDIALGIA: Lach. Nux mosch. 

Puis. Sep. 
CATARRH: Graph. Puis. 
CHILL: Lye. Puis. Veratr. 
COLDNESS OF THE TRUNKS: 

Mang. 
COLIC: Amm. Bell. Calc. Cham. 

Puis. Sep. 
— labor-like: Hyosc. 
— with fainting : Sep. 
—with vomiting : Puis. 
— with pressing : Magn. carb. 
COLIC: Alum. Amm. mur. Cham. 

Croc. Ferr. Hyosc. Nux vom. 01. 

an. Plat. Puis. 
COUGH: Graph. Sulph. Puis. 
DELIRIUM: Lye. Hyosc. 
DIARRHCEA: Bov. Sil. Veratr. 
DREAMS: Calc. Caust. Con. 
DROWSINESS: Puis. 
EXCITED NERYES : Creos. Lye. 
ERUPTION IN NAPE OF NECK: 

Carbo veg. 
EXPECTORATION, bloody: Phos. 
FACE HOT: Alum. Lye. 
— pale: Puis. 
— blue: Yeratr. 
— bloated: Chin. 
IN GENERAL: Alum. Amm. Asar. 

Bar. Bry. Calc. Carbo veg. Caustic. 

Cham. Chin. Coceul. Coff. Con. 

Creos. Cuprum. Ferr. Glon. Graph. 

Iod. Kali. Lach. Lye. Mane. Mang. 

Merc. Mur. ac. Natr. mur. N. 

mosch. Nux vom. 01. an. Phosphor. 

Phos. ac. Plat. Puis. Rhus. Sep. 

Sulph. Sulph. ac. Yeratr. 
GUMS SWOLLEN: Baryt. Mercur. 

Phosph. 
HARD HEARING: Creos. 



SEXUAL ORGKNS AND FUNCTIONS. 



HEAD-ACHE: Carbo veg. Cupr. 

Ferr. Iod. Lach. Natr. mur. Sulph. 

Veratr. 
HEARTBURN: Sulph. 
HEAT: Calc. 

INCLINATION TO YOMIT: Ve- 
ratr. 
ITCHING HERPES: Carbo veg. 
— of the parts : Graph. Sulph. 
LABOR-LIKE PAIN: Rhus. Plat. 
LANGUOR: Alum. Nux mosch. 
LAUGHTER: Hyosc. 
LEGS WEARY AND HEAVY : Bar. 

Lye. 
LEUCORRHCEA: Alum. Calcar. 

Ferr. Sulph. 
LIMBS AS IF BRUISED: Nitric 

acid. 
LIVER, stitches in : Con. 
— pains in the : Nux mosch. 
LOSS OF APPETITE : Bell. 
LOSS OF CONSCIOUSNESS: 

China. Sep. 
MELANCHOLY: Caust. Lye. Natr. 

mur. 
NAUSEA: Veratr. 
NOSEBLEED : Sulph. Veratr. 
PAINS IN THE BKEASTS : Con. 
PALPITATION OF HEART: Al- 
umina. Cupr. Iod. Sep. Spong. 
PEEVISH : Cham. Natr. mur. 
PRESSING TOWARD THE 

PARTS : Magn. carb. Plat. 
PUPILS DILATED : Lye. 
RUSH: Dulc. 

RESTLESSNESS : Creos. Kali carb. 
RUSH OF BLOOD: Alum. Cupr. 

Mane. Merc. 
— to the head : Merc. 
SENSITIVENESS: Sep. 
SHUDDEBING: Sep. 
SLEEP, RESTLESS : Alum. 
SORENESS OF PARTS: Kali 

carbon. Sil. 
SPASMS, abdominal: Cham. Cupr. 
SPASMS : Cham, Cocc. Coff. Cupr. 

Hyosc. Merc. 



— hysteric: Hyosc. 

— in abdomen : Carbo veget. Cham. 

2. At the apjpearance of the menses. 

COLIC : Graph. Staph. 

DIARRHCEA: Veratr. 

FLATULENCE: Staph. 

IN GENERAL: Aco. Bryon. Caust. 

Chain. Graph. Hyosc. Ign. Iodine. 

Merc. Natr. mur. Plat. Puis. Sep. 

Sil. 
HEAD-ACHE: Hyosc. 
NAUSEA: Hyosc. 
PAINS IN LIMBS : Sep. 
SPASMS : Aeon. Cham. Coff. Plat. 
SWEAT: Hyosc. 

URGING TO URINATE: Sassap. 
VOMITING: Carbo veget. Phosph. 

Puis. 

3. During the menses. 
ABDOMEN DISTENDED : Alum- 
ina. Natr. Zinc. 
— co'dness in : Kali carb. 
— pinching in : Alum. 
— pressure in : Cocc. Con. Nux vom. 

Sec. corn. 
— cutting in : Sulph. 
ANXIETY: Bell. Natr. mur. Zinc. 
BACK-ACHE: Amm. carb. Caust. 

Lye. 
BLOODY EXPECTORATION: 

Phos. 
BURNING IN ANUS : Amm. mur. 
BURNING IN THE HANDS AND 

FEET: Carbo veg. Calc. 
COLIC: Alum. Amm. Bar. Bell. 

Calc. Carbo an. Carbo veg. Cham. 

Cocc. Con. Graph. Kali. Ign. Lach. 

Lye. Magn. carb. Natr. Nitr. Nux 

vom. Phos. Plat. Sec. corn. Sil. 

Stront. Sulph. Zinc. 
CONSTIPATION: Natr. mur. Sil. 
CONVULSIONS : Chin. Cham. 
DELIRIUM: Hyosc. 
DISCHARGE OF BLOOD AT 

STOOL : Amm. mur. , 

EARS, humming in : Petr. Verat. 



SEXUAL ORGANS AND FUNCTIONS. 



99 



ERUCTATION: Bry. Graph. Kali 

carb. 
EYES, agglutinated : Calc. carb. 
— black before the : Puis. 
EEUPTION: Kali. Sil. 
FACE, pale : Amm. Graph. Lye. Puis. 
— blue: Teratr. 
— color of, changing : Zinc. 
— jaundiced: Caust. 
FAINTING: Ign. Lye. Natr. mur. 

Nux voni. 
FEVER (chill and heat) : Natr. mur. 

Phosph. 
CHILL : Graph. Nux vom. Puis. 
— and shaking : Natr. carb. 
FLATULENCE : Cocc. Kali carb. 
IN GENERAL: Aeon. Alum. Amm. 

carb. Amm. mur. Bell. Bov. Calc. 

Canth. Carbo an. Caust. Cham. 

Chin. Cocc. Coffea. Con. Creos. 

Cupr. Graph. Hyosc. Ign. Kali. 

Laches. Lye. Magn. m. Mur. ac. 

Natr. Natr. mur. Nux vom. Phosph. 

Plat. Pulsat. Sabin. Sep. Sil. Stan- 

num. Sulph. Yeratr. Zinc. 
GUMS SWOLLEN : Merc. mtr. ac. 
HEAD : congestion of : Calcarea. 

Caust. Chin. Con. Glon. Iod. Merc. 

Phosph. 
— ache: Alum. Bry. Calcar. Carbo 

veg. Graph. Hyoscyam. Kali carb. 

Laur. Lye. Magn. carb. Natr. mur. 

Nux vom. Phosph. Puis. Plat, 

Sepise. Sulph. Yeratr. 
— heat in : Calc. Cham. 
HEAT : Magn. mur. N. vom. Sep. 
LANGUOR: Alum. Bov. Carbo an. 

Graph. Ijrn. Iod. Kali. Magn. carb. 

Magn. mur. ftux vom. Petr. Puis. 

Phosphor. Sec. corn. Zinc. 
LEGS, languor in the: Sulph. 
— drawing in the : Spong. 
LEUCORRHCEA: Coccul. 
LIMBS AS IF BRUISED : Phosph. 
BODY AS IF BRUISED: Ambr. 

Conium. Petr. 



SMALL OF BACK AS IF 

BRUISED: Caust. 
LIMBS, cold: Cham. 
— pain in: Pry. Con. Graph. Magn. 

mur. Nux vom. Sep. Yeratr. 
LOINS, pain in : Berb. Sec. com. 
LOSS OF CONSCIOUSNESS: 

Cham. 

LOSS OF APPETITE : CuprMagn. 

carb. 
LOWER LIMBS GO TO SLEEP: 

Puis. 
LOWER LIMBS, pain in the : Cha- 

mom. Nitr. Yeratr. 
— blueness of the : Ambr. 
MELANCHOLY : Mane. Natr. mur. 

Sep. 
MENTAL DERANGEMENT : Hy- 

osc. Yeratr. 
NAUSEA . Amm. Calc. Graph. Lye. 

Magn. carb. N. vom. Phosph. Puis. 

Veratr. 
— with water-brash : Puis. 
NIGHT-SWEAT : Bell. Graph. 
NOSE-BLEED: Sep. 
OPPRESSION: BeU. Ign. Nitr. ac. 
PAIN, labor-like : Cham. Graph. Hy- 

osc. Lach. Sabin. 
PALPITATION OF HEART : Crot. 

Ign. Iod. Phosph. Sep. 
PARTS, burning in the : Rhus. Sil. 
— itching in the : Hep. Lycop. Sulph. 

Zinc. 
— pains in the : Canth. Sep. 
PRESSING DOWNWARD: Amm. 

carb. 
PRESSURE IN PIT OF STOM- 
ACH: Caps. Sulph. 
— in small of back : Puis. 
— in vertex : Calc. caust. 
DIARRHOEA : Amm. mur. Bov. 
RESTLESSNESS: Plat. Sep. 
RUSH OF BLOOD TO THE 

HEAD : Calc. Chin. 
SLEEP, restless : Alum. Calcar. Kali 

carl). 
SLEEPLESSNESS : Amm. Sep. 



100 



SEXUAL ORGANS AND FUNCTIONS. 



SMALL OF BACK, pains in : Amm. 

Amm. mnr. Bell. Berb. Calc. Carbo 

vegetabil. Cham. Cocc. Creos. Croc. 

Graph. Ign. Iod. Kali. Lack. Lye. 

Natr. Nux Yom. Phosph. Puis. Se- 

cale corn. Sulph. 
SNEEZING: Magn. carb. 
SOBENESS BETWEEN THE 

THIGHS : Graph. Kali carb. Sas- 

sap. 
— of the parts : Graph. Kali carbon. 

Sil. 
SPASMS : Aeon. Chain. Cocc. Coff. 

Cupr. Jlyosc. Ign. Lach. Nitric ac. 

Puis. 
— in abdomen: Cham. Cocc. Graph. 

Mane. Nux vom. Puis. Sulph. 
— with pressure down : Sep. 
— in the chest : Phosph. Puis. 
STITCHES IN THE PARTS : Sul- 
phur, acid. 
STOMACH, pressure in : Amm. Bry. 

Puis. Sassap. 
SWEAT : Graph. Hyosc. Magn. mur. 
SWOLLEN CHEEKS: Graph. 
SWOLLEN EEET: Calcar. Graph. 

Lycop. 
THIGHS, pain in the : Con. Magn. 

mur. Sassap. 
THIRST: Nitr. Veratr. 
TOOTH-ACHE : Amm. Calc. Cham. 

Carbo veget. Kali. Laur. Phosph. 

Sep. 
TREMBLING: Hyosc. Sil. 
TRISMUS: Hyosc. 
URGING TO STOOL, ineffectual: 

Calc. Puis. 
URINATION, involuntary: Calcar. 

carb. 
URINATE, urging to : Puis. Sabin. 
VERTIGO: Calc. Caustic. Iodine. 

Phosph. Puis. Veratr. 
VOMITING : Amnion, mur. Carbo 

veg. Lye. Phosph. 
WHINING MOOD : Plat Zinc. 
YAWNING: BeU. Carbo animal. 

Phosph. 



4. After the menses. 
ANXIETY: Phosph. 
BACK, coldness in: Kali. 
CARDIALGIA: Kali carb. 
CHILL: Graph. Puis. 
COLIC : Graph. Lye. Nux vom. 
DIARRHOEA: Graph. 
ERYSIPELAS: Stram. 
EXHAUSTION: Alum. 
EAINTNESS : Alum. Phos. Plat. 
IN GENERAL: Alum. Berb. Bor. 

Bryon. Calc. Carbo an. Con. Creos. 

Cupr. Graph. Kali. Lye. Merc. 

Natr. mur. Nux vom. Phosph. 

Phosph. acid. Plat. Puis. Sep. Sil. 

Stramon. Veratr. Zinc. 
HEAD, heavy: Natr. mur. 
LEUCORRHCEA: Alum. Bov. 

Canth. Creos. Merc. Phosph. acid. 
— bloody: Sil. 
— yellowish: Phosph. acid. 
PALPITATION: Iod. 
PARTS, pain in the: Creos. Natr. 

mur. 
PRESSING TO THE PARTS: 

Creos. 
RELAXED: Alum. 
SMALL OF BACK, pain in: Magn. 

carb. Puis. 
SPASMS, abdominal : Creos. 
STERILITY: Amm. Calc. Cann. 

Caust. Cic. Con. Croc. Ferr. Graph. 

Merc. Natr. mur. Phosph. Plat. 

Plumb. Puis. Ruta. Sabin. Sepias. 

Sulph. Sulph. ac. 
STOOL, bloody: Graph. 
TOOTH-ACHE : Calc. Magn. 
VOMITING: Puis. 

Whites. 
LEUCORRHCEA: Alum. Ambra. 
Amm. Amm. mur. Anac. Ant. 
crudum. Ars. Bell. Bor. Bov. Bry. 
Calc. Carbo an. Carbo veg. Caust. 
Cham. Chin. Coccul. Con. Creos. 
Drosera. Ferr. Graph. Guaj. Hep. 
Iod. Kali. Lye. Magn. Magn. mur. 



SEXUAL ORGANS AND FUNCTIONS. 



101 



Merc. Mezer. Natr. Natrum mur. 

Nitric ac. Nux vom. Petr. Photiph. 

Pulsat. Ran. bulb. Ruta. Sabina. 

Sassap. Sep. Sil. Squill. Stannum. 

Sulph. Sulph. ac. Thuj. Vit. Zinc. 
1. According to its Quality. 
LEUCORRHCEA, old: Iod. 
— smarting: Cham. Ferr. Lack. 

Phosph. Merc. 
— blistering: Pliosph. 
— pale-yellow : Merc. corr. 
— bloody: Canth. Carbo vegefc. Chin. 

Cocc. Creos. Nitric ac. Sep. Sulph. 

ac. 
— blood-red : Chin. Lye. 
— brown: Amm. mur. Carb. an. 

Nitric ac. 
— burning: Calc. Carbo an. Con. 

Creos. Puis. Sulph. ac. 
— thick : Ars. Bov. Caust. Kali bichr. 

Natr. mur. Puis. Sabina. Zinc. 
— tliick-slimy : Bov. Con. 
— thin: Carbo veg. 01. an. Puis. 

Sulph. 
— transparent : Sep. Stann. Sulph. ac. 
— purulent: Calc. Chin. Coccul. 

Creos. Ign. Merc Nitric ac. Sabin. 

Sep. 
—albuminous: Amnion, muriat. Bor. 

Bov. Mez. Petr. Plat. 
— staining the linen : Creos. 
— flesh-colored : Cocc. Nitr. ac. 
— yellow: Aeon. Alum. Arsen. Bov. 

Carbo an. Cham. Creos. Kali carb. 

Kali bichr. Lycop. Natr. Nuxvom. 

Sabin. Sep. Stann. Sulph. 
— staining yellow : Carb. an. 
— yellow-green: Bov. 
— greenish : Bov. Carbo veget. Lach. 

Merc. Sep. 
— green-reddish: Sep. 
—ichorous: Sabin. 
— itching: Alum. Ars. Calc. Creos. 

Kali. Merc Natr. m. Sabin. Sep. 
— milky. Amm. Calc Carbo veg. 

Creos. Ferr. Lye. Phos. Puis. Sil. 

Sabin. 



— milk-colored : Carbo veg. 

— reddish: Calcar. China. Cocc. 

Nitric ac. Phosph. 
— in fits and starts : Calc. Cham. Lye. 
— acrid: Alum. Amm. Arsen. Bov. 

Calc. Carb. veg. Cham. Con. Creos. 

Ferr. Ign. Iod. Kali. Kali. hydr. 

Lye. Merc Mezer. Natr. mur. 

Phospli. Puis. Ran. bulb. Ruta. 

Sep. Sil. Sutyh. 
— slimy: Alum. Amm. m. Bor. Bov. 

Calcar. Coccul. Creos. Daph. Ferr. 

Graph. Guaj. Lach. Magn. Merc. 

Mezer. Natr. Natr. mur. Nitr. acid. 

N. vom. 01. an. Plumb. Puis. Sabin. 

Sassap. Stann. Sulph. Thuj. Zinc. 
— painless : Creos. N. vom. Puis. 
— excoriating : Alum. Natr. mur. 
— starch like : Sabin. 
— fetid : Chin. Creos. Natr. Nitr. ac. 

N. vom. Sabin. Sep. 
— watery: Amm. Ant. tart. Carb. 

veg. Cham. Creos. Graph. Merc. 

Mezer. Mur. ac. Puis. Sep. Sil. 
— white, slimy : Graph. 
— tenacious: Aeon. Bar. Bov. 

Mezer. Phosph. Sabin. Stann. 
2. Accompanying Ailments. 
ABDOMEN, distended: Amm. m. 

Sep. 
— pains in: Bell. Caustic. Con. 

Creos. Ign. Lye. Magn. mur. 

Puis. Sil. Sulph. 

labor-like: Dros. 

AT URINATING: Sil. 
AFTER URINATING: Carb. veg. 
DISCHARGED IN THE MORN- 
ING : Natr. mur. 
FACE, pale : Ars. Puis. Sep. 
IN GENERAL : Alum. Ambr. Amm. 

mur. Ars. Bell. Bov. Calc. Carb. 

an. Caust. Cham. Cocc. Con. Cop. 

Creos. Ferr. Graph. Ign. Kali 

Lye. Magn. Magn. mur. Merc. 

Natr. mur. Phosph. ac. Prun. Puis. 

Sabin. Sec. corn. Sep. Sil. Sulph. 

Sulph. ac. Zinc. 



102 



UPPER EXTREMITIES. 



PRESSING DOWN: Natr. mur. 
SMALL OF BACK, pains in : Bar. 
Caust. Graphit. Kali. Magn. mur. 



SPASMS, abdominal: Magn. mur. 
STITCHES IN UTERUS: Sep. 
WEAKNESS: Alum. Ctem, Sep. 



XXVn. EXTREMITIES. 



UJPPJEH. 



Arm-Pit. 
BORING: Arg. Phosph. 
BURNING : Carbo veg. Cocc. Men. 

Phosph. Plumb. Puis. Rhus. Sep. 
CREAKING: Croc. Daph. Merc. 
CRAWLING: Cocc. 
DISLOCATION-PAIN : Magn. 

Phos. 
ERUPTION: Alum. Ant. crudum. 

Kali. Sulph. 
IN GENERAL : Aeon. Alum. Ambr. 

Amm. mur. Asa feet. Bell. Bry. 

Carbo veg. Caust. Chin. Colch. 

Creos. Digit. Euphorb. Ferr. Kali. 

Lach. Laur. Led. Lycop. Magn. 

Magn. mur. Merc. Mezer. Natr. 

Nux vom. Phosph. Pals. Rhod. 

Rhus. Sep. Sil. Squill. Stann. 

Stront. Sulph. Thuj. Viola, tricol. 

Zinc. 
HEAVINESS : Aeon. Am. Phosph. 

Puis. 
ITCHING: Caustic. Magn. Ignat. 

Natr. Op. 
LAMENESS : Lach. Puis. Sil. 
MUSCLES, twitching of: Croc. 

Spig. Spong. 
PAIN AS IF BRUISED: Aco. 

Alum. Coccul. Ferr. Ign. Lye. 

Magn. Plumb. Spig. Sulph. Zinc. 
PAIN, simple: Bry. Daph. Graphit. 

Kali. Magn. 
— laming: Ambr. Chin. Euphor- 

bium. Mur. ac. Nux vom. 
PRESSURE: Am. Bell. Bryon. 

Caust. Colch. Creos. Digital. Laur. 



Lycop. Natr. Oleaiad. Phosph. ac. 

Ran. bulb. Rhus. Sep. Staph. Sulph. 

Zinc. 
RAISED: Merc. 
GONE TO SLEEP: Ferr. 
SPOTS, brown: Ant. crud. 
STITCHES: Aeon. Alum. Asa f. 

Bell. Bry. Calc. Caust. Cicc. Cocc. 

Ferr. Graph. Guaj. Ign. Kali. 

Lach. Laur. Lye. Nitric acid. Phos. 

Plumb. Pulsat. Rhus. Sil. Staph. 

Stann. Sulph. Thuj. Zinc. Veratr. 
SWELLING: Aeon. 
— feeling of : Bell. 
TEARING: Aeon. Ambr. Argent. 

Bell. Bov. Bry. Caust. Canth. Carb. 

veg. Chin. Graph. Iod. Kali. Laur. 

Led. Lye. Natrum mur. Nux vom. 

Phos. Rhus. Stront. Zinc. 
TENSION: Dig. Euphorb. Hyosc. 

Kali. Petr. Teucr. Zinc. 
THROBBING: Daph. Magn. mur. 

Rhod. Sulph. Tar. 

Arms. 

Upper arms.*) 

BLUE SKIN: Cupr. Lach. Secale 

corn. Veratr. 
BORING : Canth. Plumb. Rhus. 
BURNING: Agaric. Aur. Borax. 

Carbo veg. Dulc. Kali. Lach. Nux 

vom. Phosph. Rhus. Sep. Zinc. 
BONE-PAINS: Bar. Bell. Lycop. 

Merc. Nitric ac. Thuj. 
COLDNESS: Bell. Camph. Cham. 

Hyosc. Kali bichr. Rhus. Veratr. 



*) U. means Upper, L. Lower arms. 



UPPER EXTREMITIES. 



103 



— feeling of : Graph. Rhus. Sec. corn. 
CONTRACTION : Bism. Calc. 
CONTUSIVE PAIN: CycL Hell. 
CONVULSIONS: Bell. Chamom. 

Cocc. Cupr. Hyosc. Ipecac. Op. 

Rhus. Squill. Secale corn. Stram. 

Veratr. 
CRAMPY : Calc. Cln. Dulc. Men. 

Oleand. Phosph. Valer. 
CREEPING: BeU. Cocc. Sec. corn. 

Sep. 
ERUPTION : Ant. crudum. Cane. 

Carbo veg. Dulc. Kali. Phos. ac. 

Sep. 
ERYSIPELAS : BeU. Rhus. 
FAINTNESS: Alumin. Anac. Am. 

Asar. Calcar. Cupr. Cycl. Guaj. 

Ign. Kali Led. Natr. mur. N. vom. 

Plat. Plumb. Rhod. Sep. Stann. 

Valer. 
IN GENERAL : Amm. rnur. Antim. 

cruel. Asa feet. Aur. Bell. Bryon. 

Canth. Carbo an. Carbo veg. Chel. 

Clem. Coccul. Con. Cupr. Dig. 

Feir. Hep. Ign. Iod. Kali. Lach. 

Lycop. M. arct. Mang. Mezer. Mur. 

acid. Natr. mur. Nitr. Oleand. Petr. 

Plumb. Phos. Puis. Rhodod. Rhus. 

Selen. Sep. Sil. Stann. Staphys. 

Sulph. Sulphur, ac. Valer. 
HEAT : Bryon. Natr. mur. Nitr. acid. 
FEELING OF HEAT: Bry. Graph. 

Nitric ac. Staph. 
HERPES : Kali carb. Natr. mur. 

Sulph. 
— U. and L. : Bov. Con. Dulc. Graph. 

Natr. muriat. Phosph. Sil. 
ITCHING: Daph. Dulc. Euphorb. 

Lach. Laur. M. austr. Nux vom. 

Oleand. Ran. sc. Ruta. Stront. 

Thuj. 
JERKS : Anacard. Oleand. Ruta. 

Stann. 
LAMENESS: Agar. Bism. Caust. 

Chel. Cocc. Kali Lach. Nux vom. 

Phos. ac. Staph. 



MUSCLES, twitching of : Coccul. 

Men. Valer. 
NUMBNESS : Ambr. Aur. Bell. 

Cham. Coccul. Iod. Plat. Puis. 

Veratr. 
PAIN, simple : Agar. Baryt, Bell. 

Bry. Calc. Cupr. Graph. Puis. 

Zinc. 
— laming: Bell. Chamom. Dig. Natr. 

mur. Rhod. Sil. Zinc. 
— as if dislocated: Alum. Bry. Eu- 
phorb. Rhod. 
—as if bruised : Bellad. Coccul. Cycl. 

Daph. Ferr. Hep. M. austr. Magn. 

mur. Natrum mur. Nitric ac. Plat. 

Plumbum. Puis. Sep. Sulph. Thuj. 

Veratr. 
PARALYSIS : Agar. Bell. Caustic. 

Chel. Lach. Oleand. Rhus. 
PRESSURE : Ammon. mur. Anac. 

Arg. Asa feet. Aur. Bell. Calcar. 

Camph. Cycl. Daph. Euphorb. Led. 

Nux vom. Petr. Puis. Rhod. Sabin. 

Stann. Staphys. Sulph. Vit. 
GONE TO SLEEP: Ambr. Baryt. 

Cham. Coccul. Croc. Graph. Ignat. 

Kali. Lach. Lycop. Magn. mur. 

Nux vom. Petr. Rhus. Sec. corn. 

Sep. Sil. 
SPASMS : Bell. Cuprum. Ipec. Sec. 

corn. 
SPOTS, red: Plat. Rhus. Sulph. 
STIFFNESS : Amm. mur. Caust. 

ftux vom. Oleand. Sassap. Rhus. 
STITCHES : Aeon. Alum. Antim. 

crud. Arn. Asa f. Bell. Bry. Canth. 

Cocc. Con. Dulc. Ferr. Guaj. Kali. 

Laur. Mang. N. mosch. Phosph. 

Phosph. acid. Puis. Rhod. Rhus. 

Sabina. Squill. Stann. Staph. 

Sulph. Tar. Thuj. 
SWEAT: Asar. Ipec. 
SWELLING : Antim. crud. BeU. 

Bry. Hell. Rhus. 
SWELLING OF BONES : Rhus. 

Sil. Sulph. 



104 



UPPER EXTREMITIES. 



TEARING : Agar. Amm. mur. Anac. 

Arn. Aur. Bell. JBryon. Canth. 

Carbo an. Caustic. Chel. China. 

Cin. Con. Digit. Dros. Ferr. Guaj. 

Kali. Led. Lye. Mur. ac. Magnes. 

mur. Nitr. Nux vom. Phosph. 

Plumb. Puis. Rhus. Sabina. Sassap. 

Sil. Stann. Staphys. Sulph. Zinc. 
TENSION : Ant. crud. Asa feet. Bry. 

Dig. Laur. Rhus. 
TREMBLING: Ars. Bry. Capsic. 

Caust. Cicut. Hyosc. M. arct. Op. 

Petr. Phosph. Puis. Rlius. Sabad. 

Sil. Spig. Sulph. Veratrum. 
TUBERCLES : Ant. crud. Arsenic. 

Calc. Cocc. Nitric ac. Staph. 
TUMORS: Ant. crud. Ars. Caust. 

Natr. mur. Nitric ac. 
ULCERS : Lach. Rhus. 

Shoulder-Joint. 

BEATING: Magn. Merc. Thuj. 
BURNING: Brom. Graph. 
CONTUSIYE PAIN: Dros. 
CREAKING: Ant. tart. Bar. Cic. 

Croc. Eerr. Merc. Thuj. 
DISLOCATED, as if: Magn. 
DRAWING: Asa f. Carbo veget. 

Cham. Magn. mur. Staph. 
PEELING OE WEAKNESS : Dros. 
— of heaviness: Puis. 
IN GENERAL: Arn. Asa f. Bry. 

Calc. Carbo veg. Caust. Croc. Dros. 

Ferr. Ign. Kali. Lach. Lye. Led. 

Merc. Natrum mur. Nux vom. 

Pulsat. Rhus. Staph. Sulph. Ve- 
ratrum. Yit. Zinc. 
HEAT, feeling of: Brom. 
INFLAMMATION : Aeon. Bry. Led. 

Puis. Rhus. 
JERKING: Puis. 
JERKS : Colch. Sil. 
LAMENESS : Lye. Puis. Stann. 
PAIN AS IE DISLOCATED : Alu- 

min. Ambr. Arn. Caps. Croc. Ign. 

Natr. mur. Petr. Puis. Rhod. Rhus. 

Sabina. Sep. Spigel. Thuj 



— as if bruised : Eerr. Ign. Kali. Nux 

vom. 
— simple : Aco. Calc. Croc. Ign. Natr. 

mur. Phosph. 
— laming : Euphorb. Nux vom. Puis. 

Staph. 
PRESSURE: Bism. Bryon. Calcar. 

Dros. Kali. Laur. Led. Staph. Yit. 
STIFFNESS: Caust. Euphorbium. 

Staph. 
STITCHES : Asa feet. Bry. Calcar. 

Coccul. Crot. Ferr. Graphit. Hell. 

Ignat. Iod. Laur. Led. Mercur. 

Puis. Staph. Stront. Sulph. ac. 

Thuj. 
SWELLING: Aeon. Bry. Hep. 
TEARING : Ambr. Argent. Bism. 

Bry. Carbo veg. Caust. Ferr. 

Graph. Ign. Led. Merc. Phos. 

Puis. Rhus. Sabin. Sulph. Yit. 
TENSION: Asa f. Bov. Bry. Eu- 
phorb. Laur. Lye. Zinc. 

Arm-Pit. 

BURNING: Carbo veg. Caust. 

CUTTING: Kali. 

ERUPTION : Lye. Merc. Natrum 
mur. Nitric ac. Petr. Sep. 

GLANDULAR SWELLINGS ^el- 
lad. Calc. Hep. Iod. Mercur. Natr. 
mur. Nitric ac. Sulph. Rhus. Staph. 

SORENESS: Carbo veg. 

SORE, as if: Teucr. 

STITCHES : Arn. Canth. Graph. 
Men. Staph. Zinc. 

SWEAT : Hep. Kali. Lach. Merc. 
Nitric ac. Phosph. Rhus. Sep. 

TEARING: Colch. Kali. Natr. mur. 

Lower Arm. 
BLUE SKIN: Samb. 
BORING : Asa f. Natr. Phosph. ac. 

Ran. sc. 
BURNING : Agar. Amm. mur. Asa 

feet. Carb. veget. Euphorb. Graph. 

Merc. Mur. ac. Oleander. Rhus. 

Sulph. Zinc. 



UPPER EXTREMITIES. 



105 



BONE-PATS' : Kali bichr. Nate. mur. 

Spong. 
CHILL: Ign. Puis. Rhus. 
COLDNESS: Biy. Nux vom. Rhus. 
CONTUSIYE PAIN : Dros. 
CRAMP Y : Anac. Cin. Conium. Ole- 

and. Plat. Bhodod. Ruta. Yaler. 
CREEPING : Am. Bell Cocc. Con. 

Merc. Op. Sec. corn.. 
DEADNESS: Nux vom. 
ERUPTION: Amnion, mur. Calad. 

Caust. Lach. Lye. Merc. Nitr. ac. 

Phosph. ac. Sil Staphys. Suljjh. 

Thuj. Zinc. 
FAINTNESS : Nux vom. Rhus. 
IN GENERAL : Aeon. Agar. Alum. 

Amm. mur. Anac. Arg. Am. Asa f. 

Bell. Baryt. Bism. Bry on. Calad. 

Calc. Camph. Canth. Carbo an. 

Caust. Chamom. China. Cic. Cin. 

Colchic. Con. Creos. Croc. Cupr. 

Dulc. Ferr. Graph. Guaj. Hejj. Hy- 

osc. Ign. Kali carb. Laur. Lye. M. 

arct. Mang. Merc. Mezer. Mosch. 

Mur. ac. Natr. Nitr. Nitric ac. Nux 

vom. Oleand. Phosph. Phosph. ac. 

Plumb. Puis. Ran. sc. Bhod. Rhus. 

Buta. Sabin. Sassap. Selen. Sep. 

Sil. Spig. Squill. Stann. Staph. 

Sulph. Tar. Teucr. Thuj. Valer. Vit. 

Zinc. 
HEAT: Bry. 
HEAVINESS : Anac. Aur. Croc. M. 

austr. Phos. ac. Sulph. 
HERPES: Con. Magn. Merc. Nux 

vom. 
INSENSIBILITY: Stront. 
ITCHING • Agar. Amm. mur. Carb. 

an. Caust. Dulc. Hyosc. Laur. Merc. 

Puis. Ran. Rhus. Spig. Sulph. 
JERKS : Dulc. 
LAMENESS: Bellad. Calc. Caust. 

Dulcam. Lach. Lycop. Sil. Sulph. 
PAIN AS IT BRUISED : Con. Croc. 

Mur. ac. Bhus. Ruta. Zinc. 
— as if dislocated : Coccul. Led. 
~aa if sore : Am. Cic. Rhus. 

55 



— simple : Croc. Baryt. Bellad. Calc. 

Graph. Phosph. 
— laming: Baryt. Bism. Cycl. Dulc. 

Mosch. Natr. mur. Nux vom. Ruta. 
J*Sfl. Staph. Stront. Zinc. 
PRESSURE: Anne. Asa f. Baryt. 

Bismuth. Camph. Cocc. M. arct. 

Mang. Oleander. Plat. Prun. Ruta. 

Sabin. Spigel. Staphys. Yerb. 
RASH: Merc. Selen. 
SHOCKS: Oleand. 
SPOTS, blueish: Sulph. ac. Thuj. 
—red: Yit. 
STITCHES: Aconit. Anac. Ant. 

crud. Am. Asa f. Bell. Bov. Bryon. 

Calc. Carbo an. Caustic. Cicut. 

Cycl. Dig. [Hyosc. Lycop. Magn. 

Merc. Mosch. Oleand. Phosphor. 

Phosph. ac. Ran. bulb. Sabin. Sas- 
sap. Spig. Staph. Stram. Tar. Thuj. 
SWELLING : Bry. Calc. Caust. Lye. 

Nux vom. Rhus. 
TEARING: Aeon. Alum. Ammon. 

mur. Anac. Arg. Asa f. Aur. Baryt. 

Bell. Bism. Bry. Canth. Carbo yeg. 

Caust. Cina. Colch. Cupr. Cycl. 

Daph. Dig. Graph. Grat. Guaj. 

Kali. Lach. Lycop. Mur. ac. Magn. 

mur. Natr. mur. Nitric ac. Phosph. 

Puis, Ran. bulb. Rhod. Bhus. Sas- 
sap. Sil. Stannum. Staph. Stront. 

Sulph. Teucr. Thuj. Yaler. Zinc. 
TENSION : Anac. Am. Caustic. Co- 

loc. Dig. Kali. Led. Puis. Stront. 

Sulph. Zinc. 
THROBBING: Sabad. 
TREMBLING : Caustic. Nitric ac. 

Rhus. 
TUBERCLES: Coccul. 
— miliary: Agar. 
WARTS: Calc. Sil. 
WEAKNESS : Dulcam. Nux vom 

Bhus. 

Elbow and Joint. 
BONE-PAIN, nocturnal: Lye 
BORING: Caust. Thuj. 



106 



UPPER EXTREMITIES. 



BURNING : Asa feet. Carbo animal. 

Carbo veg. Calc. phosph. Mercur. 

Mill. Nitr. Phosph. Plat. Rhus. 

Sulph. 
BRUISING PAIN: Caust. Dulcam. 

Puis. Ruta. Sulph. Yeratr. 
CONTRACTION : Canst. Ldur. Sec. 

corn. 
CONTUSIVE PAIN: Caustic. Dros. 

Ruta. 
TEARING: Alum. Ambr. Aur. Bov. 

Canth. China. Colchic. Daph. Iod. 

Kali carb. Kali bicltr. Laur. Lye. 

Merc. Mur. ac. Nitr. Nux mosch. 

Pulsat. Rhus. Ruta. Sassap. Sil. 

Stront. Sulph. Zinc. 
CREAKING: Ant. cruel Conium. 

Merc. M. arct. Sulph. 
DISLOCATION PAIN: Arn.Mang. 

Rhus. 
ERUPTION: Dulc. Hyosc. Merc. 

Sabin. Staph. Sulph. 
FAINT FEELING: Led 
GNAWING: Dulc. 
ITCHING: Agar. Alum. Caustic. 

Laur. Merc. Natr. Phosphor. Rhus. 

Sulph. 
— in the bend of the elbow: Canth. 

Laur. Spig. 
JERKING: Bellad. Caustic. Croc. 

Natr. mur. Nitric ac. Rhus. Veratr. 
LAMENESS : Bell. Graph. 
PAIN, simple: Cupr. Dig. Laur. 

Phosph. Puis. Sulph. ac. 
— laming : Bell. Cham. Coccul. Daph. 

Sabin. Staph. Sfront. 
PARALYSIS: Dulc. Petr. 
PRESSURE: Alum. Argent. Hep. 

Led. Zinc. 
STEATOMA: Hep. 
STIFFNESS: Kali carb. M. arct. 

M. austr. Stann. Thuj. 
STITCHES : Asa f. Bellad. Brijon. 

Coccul. Coloc. Hell. Kali. Laur. 

Merc. Mur. ac. Nux mosch. Phosph. 

Rhod. Sabin. Spig. Spong. Thuj. 



SWELLING: Bryon. Hep. Lach. 

Yeratr. Yit. 
TENSION: Daph. Dros. Mur. ac. 

Puis. Rhus. Stann. Sulph. 
THROBBING : Rhus. Thuj. 
TUBERCLES : Caust Mur. ac. 
WEAKNESS: Staph. Sulph. 

Bend of the Elbow. 

IN GENERAL: Amm. mur. Anac. 
Am. Bell. Canth. Caust. Clem. 
Con. Cupr. Dros. Graph. Iod. Kali. 
Laur. Lye. Men. Petr. Phosph. 
Puis. Sep. Spig. Sulphur. Thuj. 
Yaler. Zinc. 

Tip of the Elbow. 

IN GENERAL : Agar. Alum. Bry. 

Carbo an. Causticum. Graph. Hep. 

Merc. Mur. ac. Oleand. Phosphor. 

ac. Rhus. Sabina. Spong. Stann. 

"Wrist-Joints. 
BORING: Hell, Bhod. 
COLD FEELING: Rhus. 
CREAKING: Con. Merc. Selen. 
DISLOCATION-PAIN: Arn. Bov. 

Bry. Calc. e. Caust. Graph. Ign. 

Lye. Nux vom. Rhodocl. Rhus. 

Buta. Sabin. Stannum. Staph. 

Sulph. 
ERUPTION: Merc. Calc. phosph. 

Rhus. Sulph. 
EXCORIATION: Sulph. 
GANGLIA: Magn. m. Sil 
IN GENERAL: Aeon. Amm. Anac. 

Am. Ars. Asa f. Bism. Bov. Bry. 

Calc. c. Calc. phosph. Carbo veg. 

Caustic. Chel. Colch. Creos. Cycl. 

Dig. Euphrasia. Graph. Hep. 

Hyosc. Iod. Kali. Led. Lye. Mang. 

Merc. Mezer. Nitr. Phosphor. Puis. 

Bhod. Rhus. Ruta. Sabin. Sassap. 

Selen. Sep. Sil. Staphys. Stront. 

Sulphur. Teucr. Thuj. Yerb. Zinc. 
ITCHING: Amm. mur. 
WANT OF MOBILITY: Sep. 



UPPER EXTREMITIES. 



107 



NODES, gouty: Calc. c. Lye. 
NUMBNESS : Boy. Croc. 
SPOTS : Kali. Petr. 
STIFFNESS: Bellad. Caust. Cliel. 

Lack. Led. Lye. Puis. Rhod. Ruta. 

Sabina. Sep. Sulphur. Thuj. 
STITCHES: Alum. Arn. Bryon. 

Calc. c. Caust. Con. Graphit. Hell. 

Kail. Laur. Merc. Natr. mnr. Nux 

vom. Rat. Sep. Sil. Squill. Sulph. 
SWELLING: Bry. Calc. 
TEARING: Baryt. Bov. Calc. c. 

Carbo veg. Chel. Grat. Kali. Lach. 

Mezer. 01. an. Pkosph. Plumb. 

Puis. Rhod. Sabina. Sulph. Teucr. 
TENSION: Amm. carb. Spongia. 

Zinc. 
TREMBLING: Aeon. 
TWITCHING: Bar. Rhus. Sulph. 

Valer. 
PAIN : Aeon. Ammon. Asa feet. 

Hyosc. Merc. Nitr. Sulph. 
— laming: Aconit. Asar. Bism. Eu- 

phorb. Kali. Led. Nux vom. 
— as if sprained : Am. Calc. c. Puis. 

Rhod. 
— as if bruised: Calc. phosphor. 

Caust. Nitric ac. Puis. Ruta. 
PRESSURE: Led. Nitr. ac. Stann. 

Zinc. 
WEAKNESS : Merc. Phosph. 

Hands. 

BEATING: Sabad. 

BLISTERS : Amm. mur. Arg. nitr. 

Bell. Canth. Clem. Hep. Kali. Lach. 

Natr. mur. Rhus. Sep. Squill. 

Sulph. 
BLUENESS: Aco. Camph. Cupr. 

Lac 1 :. Nux vom. Rhus. Samb. Ye- 

ratrum. 
BOILS: Calc. carb. Hep. Lycop. 

Merc. 
BURNING: Aeon. Anac. Aurum. 

Bryon. Calc. Chin. Hell. Kali. 

Lach. Laur. Nux mosch. Nux vom. 



Op. Phosph. Sec. corn. Sep. Squill. 

Stann. Staphys. Sulph. Zinc. 
BRITTLE, skin : Graph. Natr. mur. 
CHILBLAINS : Agar. Nitr. ac. Petr. 

Phosph. Puis. Stann. Sulph. 
CHILLINESS- Ambr. Anac. Merc. 

Nux vom. Petr. 
COLDNESS: Aeon. Agar. Ambr. 

Arn. Aur. Bar. Bell. Calc. c. Camph. 

Cann. Caustic. Cham. Chin. Crot. 

Cuprum. Cycl. Dajjli. Dig. Dros. 

Ferr. Hell. Iod. Ipecac. Kali. M. 

arct. Mang. Nitric ac. Nux vom. 

Phosph. Puis. Ranunc. bulb. Rhus. 

Samb. Sep. Spigelia. Sulph. Thuj. 

Veratr. Vit. 
— feeling of: Rhus. Sec. corn. 
CONTRACTION: Cann. Cin. Merc. 

Nux vom. Prun. Sec. corn. 
CRAMPY FEELING: Aeon. Ambr. 

Anac. Asa f. Aur. Calc. carb. Cann. 

Euphr. Graph. Lycop. Mang. Men. 

Mercur. Mosch. Nitr. Nux vom. 

Plat. Sil. Spig. Spong. Stram. 
CREEPING: Arn. Ars. Bar. Bell 

Caust. Croc. Lach. Laur. Nux vom. 

Phosph. Plat. Rhodod. Ruta. Sec. 

corn. Spig. Sulphur. Veratr. 
— as if gone to sleep : Bry. 
DEADNESS: Calc'. Con. Laches. 

Nux vom. Phosph. Rhus. Sec. corn. 

Sil. Zinc. 
DESQUAMATION OF HANDS: 

Amm. Barr. Ferr. Merc. Phosph. 

ac. Sep. Sulph. 
DISLOCATION-PAIN: Bar. Rhus. 
DRY PALMS OF HANDS : Bism. 
DRYNESS: Lye. Natrum. Sabad 

Sulph. 
EMACIATION: Graph. Gratiola. 

Selen. 
ERUPTION: Alum. Antim. crud. 

Ars. Canth. Carbo reset. Cic. 

Hep. Lye. Merc. Mur. ac. Nitric 

ac Rhus. Secale corn. Selen. Spig. 

Staph. Sulphur. Sulph. ac. Zinc. 
ERYSIPELAS: Ran. bulb. Rh us. 



10S 



UPPER EXTREMITIES. 



IN GENEBAL : Aeon. Agar. Ambr. 

Amm. Anac. Arg. Arn. Ars. Asa 

f. Aur. Bar. Bell. Bism. Bry. Calc. 

Carbo veg. Caustic. Chamom. Chin. 

Coccul. Creos. Cupr. Dig. Dulc. 

Ferr. Graph. Hep. Ipec. Kali. 

Lach. Laur. Led. Lye. M. arct. 

Mang. Men. Mere. Mur. ac. Natrum. 

Natr. mur. Nux vom. Op. Petr. 

Phosph. Phosph. ac. Plumb. Puis. 

Ban. bulb. Khod. Bhus. Buta. 

Samb. Sec. corn. Selen. Sep. Sil. 

Spig. Stann. Staph. Sulph. Yeratr. 

Verb. Zinc. 
HEAVINESS: Bov. Caust. Nitric. 

Phosph. 
HEAT : Aeon. Bry. Carb. veg. Coc- 
cul. Graph. Hell. Hepar. Led. 

Lye. Nitric ac. N. vom. Phosph. 

Sep. Stann. Staph. Zinc. 
HEBPES: Ambr. Bov. Calcarea. 

Clem. Dulc. Merc. Natr. mur. Sas- 

sap. Sep. Sulph. Zinc. 
INSENSIBILITY: Bell. Lye. Natr. 

mur. Rhus. Sec. cornut. Stann. 

Stront. Zinc. 
ITCH: Merc. Sep. Selen. Sulph. 
ITCHING : Aur. Bov. Cann. Caustic. 

Cina. Coccul. Hep. Kali. Nitric ac. 

Phosph. ac. Plat. Plumb. Rhus. 

Sulph. Veratr. 
JEBKS: Valer. 
NODES, arthritic: Calc. carbon. 

Calc. phosph. Led. Lye. Bhod. 

Bhus. Sep. Sulph. 
NUMBNESS : Asa feet. Coccul. Car- 
bo veg. Lach. Lye. Puis. Bhus. 

Buta. 
PAIN : Agar. Daph. Nux vom. Plumb. 
— laming: Bell. Bism. Caustic. Cycl. 

Dig. Nux vom. Sil. Vit. 
PABALYSIS: Ambr. Crot. Cupr. 

Lach. Natr. mur. Nux vom. Phos- 
phor. Plumb. Bhus. Sil. Zinc. 
PABCHED SKIN : Lycop. Phosph. 

acid. 



PBESSUBE: Asa f. Calc. phosph. 

Carbo veg. Cycl. Hep. Kali. Men. 

Nitric ac. Staph. Zinc. 
BEDNESS: Dulc. Fluor, ac. Nux 

vom. Sabad. Sangn. Staph. 

BHAGADES: Cycl. Graphit. Petr. 
Sulph. 

BOUGH: Alum. Kali. Nitric ac. 

Phosph. ac. 
GONE TO SLEEP : Ambra. Baryt. 

Carbo an. Croc. Fluor, acid. Graph. 

Kali. Lach. Lycop. M. austr. Natr. 

mur. N. vom. Phosph. Puis. Sec. 

corn. Sil. Veratr. 
SOBE, pain as if: Calc. c. Nitric ac. 

Rhus. 
BBUISED, pain as if: Carbo veg. 

Dros. Buta. 
SPASM : Bell. Caust. Sec. corn. 
SPASMODIC FEELING: Anac. 

Bell. Caust. Plat. 
— pain : Anac. Caustic. Lycop. Spig. 
SPOTS: Ant. tart. Nitr. ac. Sep. 
— red: Merc. Sep. 
STIFFNESS: Ars. Bellad. Caust. 

Cham. Coloc. Croc. Mer cur. Bhus. 

Zinc. 
STITCHES : Aconit. Ang. Am. Asa 

f. Bellad. Calc. phosphor. Carbo 

an. Caust. Caps. Chel. Cina. Hell. 

Graph. Lach. Led. Lye. Mosch. 

Magn. mur. Par. Plumb. Squill. 

Stann. 
SWEAT : Ant. tart. Calcar. c. Cann. 

Chamom. Coccul. Con. Laur. 

Natr. mur. Nitric acid. Nux vom. 

Phosph. Sulph. Veratr. 
— cold: Caps. Sep. 
— in palm of hands: Aeon. Bar. 

Calc. c. Con. Dulc. Fluor, ac. 

Ignat. Laur. Merc. Nux vom. 

Bheum. 
SWELLING: Aconit. Ars. Bell. 

Bry. Calcar. Caust. China. Coccul. 

Dig. Ferr. Hep. Lach. Lye. Merc, 

Nux vom. Phosph. Rhus. Buta. 

Sec. corn. Stann. Sulph. 
— nocturnal: Dros. 



UPPER EXTREMITIES. 



109 



TEARING AND DRAWING: 

Agaric. Amm. Am. Ars. Aur. Bel- 
lad. Calc. Canth. Carbo ve^et. 

Canst. Chaniom. Chel. China. 

Colch. Cupnun. Digit. Graph. 

Grat. Iod. Kali. Lack. Laur. Led. 

Lye Mang. Mur. acid. Natr. mur. 

Nitr. Petr. PheU. Phos. Plumb. 

Rheum. Rhod. Rhus. Sabin. Selen. 

Sep. Spig. Stann. Sulph. Teucr. 

Verb. Zinc. 
TENSION: BeU. Canth. Caustic. 

Chin. Hyp. Zinc. 
TREMBLING: Agar. Anac. Ant. 

tart. Ars. Bell. Bism. Bryon. 

Calc. c. Caustic. Chin. Cic Coccul. 

Coffea. Crotal. Ferr. magn. Hijos- 

cyam. Iod. Kali. Lach. Led. Nitr. 

ac. Oleand. Op. Phosph. Plat. 

Plumb. Rhus. Sil. Spong. Stan- 

num." Stram. Sulph. Zinc. 
TUBERCLES: Ars. Calc. Coccul. 

Lye. Natrum mur. Nitric ac. Rhus. 
TWITCHING : Anac. Bar. m. Asaf. 

Bell. Cina. Cupr. Graph. Ignat. 

Lach. Laur. Meph. Natr. Op. Plat. 

Ran. bulb. Sep. Stann. Sulph. ac. 

Vit. 
ULCERS : Ars. Lye. Sil. Sulph. 
URTICARL1: Hep. 
VARICOSE VEINS: Alumin. Arn. 

Calc. Chel/Chin. Laur. Men. Nux 

vom. Op. Phosph. Puis. Rheum. 

Rhod. Stront. Sulphur. Thuj. 
CRACKED VEINS: Alum. Calc. 

Creos. Graph. Lach. Magn. c. 

Merc. Natrum mur. Nitric ac. 

Petr. Sil. Sulph. Zinc 
VESICLES : Daph. 
WARTS: Calc. c. Caust. Dulcam. 

Rhus. Sep. Thuj. 
WEAKNESS: Calc. Carb. \eg. 

Caust. Chin. Cupr. Hell. Nitr. Nux 

vom. Phosphor. Sil. Tab. Zinc. 
YELLOWNESS ■ Canth. Ign. Merc. 

Spig. 



Fingers. 

BLOTCHES : Lach. Lye. Staph. 
BURNING: Asa. f. Asar. Calcar. 

Caust. Con. Dig. Kali. Lach. Natr. 

Nitric ac. Nux vomica. Oleand. 

Plat. Sil. Sulph. Sulphur, ac. Ve- 

ratr. 
BONE-PAIN: Fluor, ac. 
CHAPPING: Fluor, ac. Natrum 

mur. Petr. Sil. 
CHAPPING OF SKIN: Petr. 
CHILBLAINS : Agar. Croc. Nitr. 

ac. Nux vom. Petr. Puis. Rhus. 

Sulph. 
COLDNESS : Antim. tart. Calad. 

Cham. Chel. Digit. Hell. Lye. Mur. 

ac. Merc. Rhod. Sulph. Tar. Thuj. 
CONTRACTION: Ambra. Anacard. 

Antim. tart. Arg. Bism. Calc. Caus- 
tic. Cina. Colchic. Coloc. Graph. 

Lye. Merc. Nux vom. Plat. Rhus. 

Ruta. Sec. corn. Sep. Sil. 
CONTRACTION OF TENDONS : 

Caust. 
CRAMPY FEELING : Anacard. 

Arn. Ars. Asa f. Calc. Cin. Coccul. 

Cycl. Euphr. Graphit. Ignat. Lye. 

Mur. ac. Mosch. Nux vom. Oleand. 

Phosph. Plat. Rhus. Stann. Staph. 

Sulphur. Veratr. 
CREAKING: Bar. Caps. Nitr. 
CREEPING : Aeon. Ambr. Amm. 

mur. Ars. Calc. Caust. Cina. Croc. 

Graphit. Kali. M. arct. Magn. Natr. 

mur. Opium. Plat. Ran. bulb. Rhod. 

Rhus. Sec. corn. Sep. Sil. Sulph. 

Thuj. Veratr. Verb. 
— in the tips of the fingers : Aco. 

Ammon. mur. Croc. M. austr. Sec. 

corn. Sep. Thuj. 
— as of ants: Sec. corn. 
— as if gone to sleep: Mur. ac. 
DEADNESS : Agar. Calc. Caust. Cic. 

Con. Hep. Lycop. Merc. Nitric ac. 

Phosph. ac. Puis. RJius. Sec corn. 

Sulphur. Thuj. Veratr. 



110 



UPPER EXTREMITIES. 



— gangrenous: Sec. corn. 

— of tips of fingers : Ant. tart. Chel. 

DESQUAMATION OF THE 

SKIN : Amm. nrar. 
— on the tips of the fingers : Sabadilla. 
DISLOCATION-PAIN : Bell. Cham. 

Ign. Natr. mur. Phosphor. Spig. 

Sulph. 
DRYNESS OF TIPS OE FIN- 
GERS : Ant. tart. 
ERUPTION; Antim. crud. Baryt. 

Canthar. Caust. Clem. Cycl. Daph. 

Graph.Lach. Lyc.Mur. ac. Phos.ac. 

Plumb. Puis. Rhus. Spigel. Squill. 

Veratr. Zinc. 
— between the fingers: Graph. Sulph. 

acid. 
ERYSIPELAS : Lye. Rhod. 
— of the tips of fingers : Thuj. 
EXHAUSTION: Sil. Rhus. 
HEAT: Sabad. Thuj. 
IN GENERAL : Aeon. Alum. Ambr. 

Amm. mur. Anac. Antim. tart. Am. 

Ars. Asa f. Baryt. Bell. Bism. Bor. 

Bry. Calcar. Canth. Carbo vegetab. 

Caust. Cham. Chel. Cic. Cina. Coc- 

cul. Colch. Creos. Croc. Cyclam. 

Dros. Eerr. Graph. Hell. Hep. Ign. 

Kali. Lach. Lye. M. arct. M. austr. 

Magn. Mercur. Mosch. Natr. Natr. 

mur. Nux vom. Oleand. Phosph. 

Puis. Ban. Rhodod. Rhus. Ruta. 

Sabad. Sec. corn. Sep. Sil. Spigel. 

Slann. Staphys. Stront. Sulphur. 

Teucr. Thuj. Yaler. Yeratr. Verb. 

Vit. Zinc. 
HERPES : Ambr. Merc. Nitric ac. 

Ran. bulb. 
INFLAMMATION: Aco. Con. Hep. 

Kali. Lye. Merc. Puis. Ran. Sil. 
INSENSIBILITY: Digit. Ferr. N. 

vom. Phosph. Bhus. Sec. com. 
— of tips of fingers : Ant. tart. Cham. 

Ferr. M. austr. Staph. 
ITCHING: Agar. Alum. Aur. Calc. 

Camph. Caust. Chel. Con. Cycl. 

Lach. Lye. Nux vomica. Oleander. 



Phosph. Plumb.JPuls. Bhod. Sulph. 

ac. Zinc. Veratr. 
ITCHING, between the fingers : Aur. 

Lach. Plumb. Rnod. 
— at the tips of fingers : Ambra. Ant. 

crud. Sulph. ac. Spig. 
LAMENESS: Carbo veg. 
— of the thumb : Kali. 
NODES, arthritic: Graph. Lye. 
NUMBNESS: Ang. Calc. Caust. 

Con. Cina. Euphr. Ferr. Graph. 

Kali. Lach. Lycopod. Phosph. Plat. 

Rhus. Sec. corn. Sil. Staph. Sulph. 
PAIN : Caust. Led. Sassap. Veratr. 
— as if bruised : Amm. carbon. Cina. 

Natr. mur. Nitric ac. 
— laming: Bellad. Cycl. Digit. Kali. 

Mosch. Sabin. Sil. 
PARALYSIS: Calc. Bryon. Kali. 

Lach. Phosph. 
PRESSURE: Asa f. Bell. Con. Cycl. 

Dig. Hell. Hyosc. Ban. Rhod. Ruta. 

Sassap. Staphys. Tar. Teucr. Vit. 

Zinc. 
REDNESS : Agar. Nux vomica. 
RIGIDITY: Ars. Merc. 
GOING TO SLEEP : Aeon. Ambra. 

Amm. mur. Aur. Bar. Calc. Carbo 

an. Cham. Cina. Croc. Dig. Graph. 

Iod. Kali. Lach. Lye. Merc. Magn. 

mur. Natr. mur. Nux vom. Par. 

Petr. Phosph. Plumb. Puis. Bhus. 

Sassap. Sec. corn. Sep. Sil. Staph. 

Sulphur. Thuj. Veratr. 
SORE BETWEEN THE FIN- 
GERS: Graphites. 
SPASM: Bellad. Chamom. Hyper. 

Ign. Nux vom. Rhus. Veratr. 
SPASMODIC FEELING: Anac. 

Bell. Caust. Digit. Nux vom. Plat. 

Rhod. 
SPOTS, yellow : Con. Petr. Sabadilla. 
— dark : Ant. tart. 
— red: Plumb. Zinc. 
STITCHES: Ambr. Ammon. mur. 

Anac. Am. Bryon. Carbo an. Car- 
bo veg. Caust. Colch. Croc. Daph. 



UPPER EXTREMITIES. 



Ill 



Dig. Graph. Kali. Lack. Lye. 

Merc. Mur. ac. Natrum mur. Nux 

vom. Oleand. Petr. Pliosph. Ban. 

sc. Rhod. Phus. Sabad. Sassap. 

Staiin. Staph. Sulj)h. ac. Teucr. 

Thuj. Verb. Zinc. 
SWELLING: Amm. caro. Arsenic. 

Bry. Calc. Hep. Iod. Lack. Lye. 

Magn. Merc. (Nitr. Nux vom. 

Phosph. Ran. seel. Rhus. Sil. 

Sulph. Thuj. 
— feeling as of a : Bell. 
TEARING: Agar. Ambr. Ammon. 

mur. Arsen. Aur. Bell. Bism. 

Canth. Carbo veg. Caust Chel. 

Coleh. Daph. Hell. Ign. Iod. Kali. 

Lach. Laur. Lye. Magn. Merc. Mur. 

ac. Natrum mur. Nitr. 01. an. Par. 

Phos. ac. Plumb. Ran. bulb. Phod. 

Sab in. Sil. Spig. Stann. Staph. 

Sulph. Teucr. Zinc. 
TENSION : Canth. Iod. Phosph. 

Plumb. Puis. Veratr. 
THROBBING: Carbo veget. Crot. 

Sil. Sabad. Teucr. 
THUMB GOES TO SLEEP : Kali. 

Plumb. 
— clenched : Bell. Cham. Hyosc. Ign. 

Phus. 
TREMBLING: Ambr. Bry. Rhus. 

Stront, 

TWITCHING : Alum. Amm. mur. 

Anac. Bry. Caust. Cham. Cic. Cin. 

Crotal. Cupr. Dig. Ign. Lycop. M. 

austr. Merc. 01. an. Phosph. Plumb. 

Rheum. Rhod. Rhus. Sabad. Stann. 

Sulph. Sulph. ac. 
ULCERS: Alum. Ars. Caust. Lye. 

Natrum mur. Ran. bulb. Sil. Sulph. 
URTICARIA: Hep. 
WARTS: Caust. Lach. Lycopod. 

Petr. Sep. Sulph. 
WEAKNESS: Carbo veget. Hell. 

Nitr. Phus. Sil. 
YELLOW, turning: Chel. 



Finger-Joints. 
BORING: Hell. 
CRAMP-PAIN : Euphr. Magan. Plat. 

Sulph. 
CREAKING: Baryt. Caps. Meph. 

Nitr. 
DISLOCATION-PAIN: Natrum 

mur. Phosph. Sulph. 
DRY, as if : Puis. 
IN GENERAL: Ambr. Amm. Aur. 

Bell. Calc. Caps. Carbo veg. Caust. 

Cham. Chin. Colch. Con. Creos. 

Drosera. Graph. Hell. IIcp. Ignat. 

Kali. Led. Lye. Mang. Merc. Natr. 

mur. Nitr. Nitric ac. Nux vomica. 

Oleand. Phosph. Plat. Puis. Rhod. 

Phus. Puta. Sep. Sil. Spng. Spong- 

Staph. Sulph. Sulph. ac. 
NODES, gouty: Calcar. Clem. Hep. 

Lye. Phod. Staph. 
PAIN: Kali. Sil. Sulph 
— laming: Bell. Calc. 
PRESSURE: Led. Merc. Zinc. 
REDNESS : Lye. Spong. 
STIFFNESS: Aur. Ars. Carbo an. 

Caust. Graph. Hep. Lycopod. 

Phus. Sep. Sulph. 
STITCHES : Am. Bar. Bry. Carbo 

veg. Con. Hell. Ign. Men. Nitric 

ac. Phus. Sabin. Sepias. Sulph. ac. 
SWELLING : Euphr. Hep. Lycop. 

Nitric ac. 
TEARING : Agar. Ammon. Anac. 

Aur. Bell. Bryon. Carbo veg. Caust. 

Chel. Colch. Hell. Kali. Led. Lye. 

Phosph. acid. Plat. Puis. Rheum. 

Rhodod. Rhus. Ruta. Sabin. Samb. 

Spig. Staph. Sulph. Teucr. Zinc. 
TENSION : Iod. Nitric ac. Puis. Sep. 
ULCERS: Sep. 

Tips of Fingers. 
IN GENERAL : Ambr. Ammon. mur. 
Ant. tart. Asa f. Bor. Calc. Chel. 
Croc. Hep. Lach. M. austr. Phos. 
Pulsat. Rhus. Sec. corn. Sep. Sil. 
Spig. Staph. Sulphur. Teucr. Thuj. 
Veratr. 



112 



LOWER EXTREMITIES. 



Finger-Nails. 
ALTERED COLOR : Ars. Mur. ac. 
BLUE: Chel. Chin. Chlor. Crotal. 

Big. Nux vom. Petr. 
DISTORTION: Graph. Sep. Sulph. 
EXFOLIATION: Graphit. Mereur. 

Sulph. 
IN GENERAL: Alum. Ant. crud. 

Arsen. Bar. Bism. Bor. Bov. Calc. 

Caust. Chel. Colch. Con. Crotal. 

Digit. Graph. Hep. Kali. Iodine. 

Lach. M. austr. Merc. Natr. mur. 

Nitr. Nitric ac. Nux vom. Phosph. 

Pulsat. Ran. bulb. Sabad. Sep. Sil* 

Sulph. Sulph. ac. Thuj. 
GNAWING: Alum. 
GROWTH, slow: Ant. crud. 
HANG-NAILS: Natr. mur. Rhus. 

Stann. Sulph. 



NAILS, brittle: Graphit. Mercur. 

Thuj. 
— growing in : Sil. Sulph. 
PRESSURE: Calc. Caust. 
TEARING UNDER THE NAILS: 

Sil 
— all round : Arabr. Lye. 
THICKENING: Graph. Sabad. 
ULCERATED: Alum. Arsen. Bar. 

Calcar. Conium. Hep. Kali. Laches. 

Lycopod. Mercur. M. austr. Natr. 

mur. Petr. Phosph. Sepise. Silic. 

Sulph. Thuj. 
ULCERATIVE PAIN: BeUad.Con. 

Graph. Hep. Kali. Merc. Plat. Puis. 

Sil. Sulph. Sulph. acid. Thuj. 
YELLOWNESS: Ambr. Con. Merc. 

Nux vom. 



LO'WJEJJEt EJCTRJSMITIJES. 



Extremities. 

(t. signifies thigh, 1. leg.) 

IN GENERAL : Anac. Arn. Bellad. 
Brxj. Calc. c. Calc. phosph. Carbo 
veg. Caustic. China. Colchic. Crot. 
Dig.- Graphit. Guaj. Ignat. Iod. 
Kali bichr. Kali carb. Lach. Led. 
Lycop. Merc. Mezer. Mosch. Mur. 
ac. Natr. Natr. mur. 3S T . vom. Oleancl. 
01. an. Phosph. acid. Plat. Plumb. 
Puis. Bhodod. Rhus. Ruta. Sabin. 
Sep. Sil. Spigel. Spong. Staph. 
Sulph. Thuj. Yaler. Viol. tr. 

Thighs. 
BLOTCHES: Calc. c. Lach. Merc. 

Staph. 
BOILS : Hep. Sep. Sil. 
BORING : Arn. Rhus. Staph. 
BURNING: Asa f. Carbo animal. 

Carbo veget. Daph. Euphorb. Kali. 

Nux vom. Phos. Plumb. Rhus. Sil. 

Sulph. Zinc. 



CARIES : Asa f. Aur. Calc. c. Hep. 

Merc. Nitric ac. Phos. Sep. Sil* 

Sulph. 
COLDNESS (t. and 1.) : Ars. Bell. 

Calad. Calc. c. Camph. Carbo veg. 

Daph. Led. Lye. Nitric acid. Nux 

vom. Op. Puis. Sec. corn. Sep. 

Sulph. Veratr. 
— feeling of : Helleb. M. austr. Oleand. 
— feeling of (t. and 1.) : Camph. 

Carb. veg. Chin. Merc. Natr. Sec. 

corn. 
CONTUSIYE PAIN (t. and I.): 

Arn. Euphorb. Led. Nux mosch. 

Rhod. Buta. 
CONVULSIONS (t. and 1.) : Cham. 

Caustic. Cuprum. Hyosc. Ign. 

Ipec. Men. Op. Plumbum. Rhus. 

Sec. corn. Strain. 
CRAMPS : Asar. Chin. Colch. 
— (t. and 1.) : Bell. Bism. Cina. Cupr. 

Lach. Nux vom. Rhus. Sec. corn. 

Stram. 



LOWER EXTREMITIES. 



113 



CRAMP Y FEELING: Angust. Arn. 

Calc. c. Cycl. Digit. Graphit. 

Hyosc. Lycopod. Men. Petr. Phos- 
phor. Rhus. Sep. Valer. Veratr. 
CREEPING: Arsenic. BeU. Guaj. 

Mane. Rhus. Sec. corn. 
CUTTING (t. and L): Alum. BeU. 

Bry. Graph. Lycop. Natr. Sil. 

Sulph. ac. 
DISLOCATION-PAIN (t. and 1.) : 

Carbo veg. Caust. Led. Natr. mur. 

Rhus. 
EMACIATION: Arg. nitr. Arsen. 

Calc. c. China. Iod. Lach. Merc. 

Nux vom. Selen. 
ERUPTION: Clem. Euphorb. Gra- 
phit. Kali. Lye. Merc. Natr. mur. 

Rhus. Sil. Sulph. 
EXTERNAL SIDE: Anac. Asa f . 

Bellad. Caustic. Coccul. Euphorb. 

Merc. Mezer. N. vom. Phosph. ac. 

Rhus. Stann. Sulph. Zinc. 
POSTERIOR SIDE : Alum. Antim. 

crud. Calc. c. Canth. Carbo veget. 

Caust. Con. Euphob. Graph. Ign. 

Kali. Led. Lye. Men. Merc. Mezer. 

Phosph. Phosph. ac. hus. Selen. 

Sep. Stann. Staph. Sulph. Yeratr. 

Zinc. 
INTERNAL SIDE : Ant. crud. Asa 

f. Ca!c. c Carbo veg. Caust. Grayh. 

Hep. lo&.Kali. M. austr. Merc. Mur. 

acid. Nitric ac. Oleand. Petroleum. 

Rhod. Sabin. Selen. Stann. Staph. 

Sulph. Tar. Thuj. 
ANTERIOR SIDE : Anac. Ang. Ar- 
gent. Asa foet. Bar. Cann. Chin. 

Digit. Euphorb. Kali. Lye. Men. 

Mur. ac. Natrum mur. Nux vom. 

Olean. Phos. ac. Sabin. Sil Spong. 

Stann. Thuj. Valer. 
FAINT FEELING : Arn. Ars. Bry. 

Chin. Crot. Dig. Guaj. Hell. Kali. 

Laur. Oleand. Phosph. ac. Plat. 

Rhodod. Ruta. Spig. Yeratr. 
— (t. and 1.) : Agar. Alum. Ambra. 
An m . Amm. mur. Arsen. Asar. 



Bell. Bryon. Calc. c. Cann. Caust 

Chiua. Con. Croc. Graph. Hell. Ign. 

Ipec. Lach. Laur. Led. Lye. Nitr. 

ac. Nux mosch. Nux vom. Phosph. 

Ph. ac. Plat. Plumb. Puis. Rhodod. 

Rlius. Huta,. Sec. corn. Sep. Stront. 

Sulph. Zinc. 
FORMICATION: Ast. Bellad. Nux 

vom. Sec. corn. 
IN GENERAL: Agar. Ambr. Anac. 

Ant. tart. Arn. Asa f. Asar. Bell. 

Bry. Calc. c. Caps. Carbo an. Car- 
bo veg. Caust. Chel. Chin. Cocc. 

Colchic. Creos. Crotal. Cycl. Eu- 
phorb. Graph. Guaj. Hell. Hep. 

Ign. Kali. Lach. Led. M. austr. 

Merc. Mezer. Mosch. Mur. ac. Nalr. 

mur. Nitric ac. Nux vom. Oleand. 

Phos. ac. Plat. Puis. Ran. bulb. 

Rhodod. Rhus. Sabin. Selen. Sep. 

Sil. Spigel. Spong. Stann. Staph. 

Sulph. Thuj. Zinc. 
HEAT : Aconit. Bryon. Caustic. 

Sulph. 
HEAVINESS : Alum. Ambr. Bry. 

Calc. c. Cann. Carbo veget. Graph. 

Hell. Ign. Iod. Kali. Lach. Lact. 

M. arct. Natrum mur. Nux voin. 

Puis. Rhus. Ruta. Sep. Spig. Stann. 

Sulphur. Sulph. ac. 
HERPES : Graph. Lye. Merc. Staph. 

Sutyh. Zinc. 
INSENSIBILITY (t. and 1.) : Ambr. 

Ars. Asar. Carbo veg. Lach. Lye. 

Oleand. Op. Rhus. Sec. corn. 
ITCHING: Agar. Ant. crud. Ars. 

Calc. c. Carbo veg. Cic. Dig. Eu- 
phorb. Graph. Lach. Led. M. arct. 

Merc. Natrum mur. Nitric ac. N. 

jugl. Nux vom. Oleand. Rhod. Sec. 

corn. Sil. Spig. Staphys. Sulphur. 

Thuj. Yeratr. Zinc. 
JERKS (t. and 1.) : Antim. tart. Cal- 

car. c. Cic. Creos. Euphr. Merc. 

Phosph. Stram. Sulplt. Sulph. ac. 
LAMENESS : Causticum. Coccul. 

Oleand. 



114 



LOWER EXTREMITIES. 



— (t. and 1.) : Bell. Bry. Caust. Coc- 
cul. Dig. Iod. Lack. Mane. Natr. 

mur, N. Yom. Rhus. Buta. Sec. 

corn. Sep. Sil. Sulph. Zinc. 
MUSCLES BELAXED (t. and I.) : 

Ambr. Calc. c. Carbo veg. Ferr. 

Iod. Merc. Nux vom. Phosph. ac. 
NODES, gouty : Ant. crud. Calc. c. 

Calc. ph. Lycop. Bhus. Staph. 

Sulph. 
NUMBNESS : Carbo veget. Ferr. 

Graph. Spong. 
— (t. and L): Ang. Asa f. Calc. c. 

Carbo veg. Coccul. Iod. Kali. Lach. 

Merc. N. Yom. Plat. Bhus. Sulph. 

Veratr. 
PAIN (t. and 1.) : Arn. Anacard. Aur. 

Calcar. c. Carbo veg. Cupr. Daph. 

Graph. Lycop. Mur. ac. Nitric ac. 

Phosphor. Bhus. Sil. Stann. Sulph. 
— laming : Carbo veg. Caust. Cina. 

Coccul. Ign. Natr. mur. Nux vom. 

Bhus. Sep. 
— as if sore (t. and 1.) : Anac. Am. 

Calcar. c. China. Graph. Kali. Led. 

Lycop. Nux vom. Bhod. Staph. 

Sulph. 
— as if bruised: Bry. Bell. Calc. c. 

Caust. Coccul. Cuprum. Graph. 

Guaj. Hep. Led. Men. Natr. N. 

vom. Phosph. ac. Plat. Puis. Ruta. 

Sepise. Spig. Sulph. Tar. Valer. 

Veratrum. 

(t. and 1.) : Bry. Bell. Canthar. 

Carbo veg. Croc. Graph. Laur. 
Natr. Nux r mosch. Sep. Sil. 
Stann. 
PBESSUBE: Agar. Caps. Digital. 

Guaj. Led. Men. Mosch. Mur. ac. 

Nitric, ac. Oieand. Ph. ac. Sabin. 

Sassap. Sil. Stann. Verb. 
PULSATIONS : Asa feet. Coccul. 

Plat. 
SHUDDEBING: Cann. Chin. Ign. 

Phosph. Puis. 
GONE TO SLEEP: Ambra. Canth. 

Cham. Coccul. Croc. M. arct. 



Mosch. Nux vom. Oleander. Puis. 

Bhus. Sec. corn. Veratr. 
SOBENESS BETWEEN THE 

THIGHS: Graph. Kali. Mercur. 

Bhod. Selen. Sulph. 
SPOTS, red: Graph. Merc. 
STAGGEBING : Asar. Coccul. Hell.' 

Ign. Iod. Nux vom. Oleander. Op. 

Bhus. Sec. corn. Stram. Veratr. 
STIFFNESS: Ars. Graphit. Ignat. 

Natr. mur. Oieand. Bhod. 
— (t. and 1.) : Alum. Ang. Bell. Calc. c 

Caust. Cic. Ferr. Ign. Kali. Led. 

Merc. Natr. mur. Phosph. Rhus. 

Sep. Sulph. . 
STITCHING: Aco. Arn. Asa f oet. 

Bell. Bnj. Calc. c. Caustic. Coccul. 

Con. Euphr. Graph. Guaj. Hyosc. 

Laur. Mangan. Men. Nux vomica. 

Oieand. Phos. Rhus. Sabad. Sas- 
sap. Sep. Sjng. Spong. Stann. 

Staph. Sulph. Tar. Thuj. Viol. tr. 

Zinc. 
STBETCHY FEELING: Bellad. 

Daph. Phosph. ac. 
SWEAT : Carbo an. Merc. N. vom. 

Bhus. Thuj. 
— (t. and 1.) : Asa f . Hep. Phos. Sep. 

Veratr. 
SWELLING (t and 1.): Arsen. Bry. 

Calc. c. Carb. veg. Chin. Colch. 

Dulcam. Hell. Lye. Merc. Phosph. 

Sec. corn. Sep. Sil. Sulph. 
SWELLING OF BONES (t and 1.) : 

Asa f. Aur. Calc. c. Calc. ph. Dulc. 

Iod. Lye. Merc. Phosph. Phosph. 

ac. Bhus. Sil. Staph. SuIjjIi. 
TEABING AND DBA WING: Aga- 
ric. Alum. Amm. mur. Anac. Asa f. 

Aur. Bellad. Bry. Calc. c. Canth. 

Carbo an. Caust. Chamom. China. 

Coccul. Colchic. Daph. Dulc. Eu- 

phorb. Graph. Guaj. Kali. Lycop. 

Merc. Mezer. Natr. mur. Nitr. ac. 

Nux vom. Phos. ac. Plat. Plumb. 

Puis. Rhus. Sepise. Sil. Stann. 

Sulph. Valer. Zinc. 



LOWER EXTREMITIES. 



115 



TENSION: Arn. Calc.c.Carbo veg. 

Creos. Guaj. Lye. Merc. Men. Ni- 
tric ac. Petr. Khod. Kims. Sab In. 
— t. and L: Alum. Carbo anim. 

Caust. Cham. Dulcam. Iod. Kali. 

Lye. Natr, mur. Pulsat. Sep. 

Sulpli. Zinc. 
THROBBING (t. and L): Antim. 

tart. Asaf. Bell. Brom. Bry. Dig. 

Kali. M. austr. Natrum mur. Phos- 
phor. Rhus. Buta. Sulph. 
TREMBLING (t. and 1.) : Ammon. 

mur. Am. Calc. c. Carbo veg. 

Caust. Cic. Con. Digit. Graph. 

Lach. Mercur. Natr. Nux mosch. 

Nux vom. Flat. Plumb. Puis. Rhus. 

Sil. 
TWITCHING: Agn. Am. Asaf. 

Caust. China. Graph. Laches. Lye. 

Mang. Nux vom. Phos. Puis. 

Rheum. Blius. Sep. Sil. Staph. 

Sulph. Valer. Yeratr. 
ULCERS : Calc. Sil. Thuj. 
— t. and 1. : Calc. Carbo veget. Graph. 

Lye. Merc. Natrum. Nitric ac. Petr. 

Rhus. Silic. Sulph. 
UNEASINESS (t. and 1.): Ars. 

Cann. Carbo veg 1 . Caustic. Chin. 

Con. Graph. Kali. Lach. Merc. 

Nux vom. Phosphor. Plat. Ruta. 

Sep. Sulph. 
VARICOSE VEINS (t. and 1.): 

Ambra. Arn. Ars. Calc. c. Carbo 

veg. Ferr. Graph. Lye. M. austr. 

Puis. Sulph. Zinc. 

Legs. 
BOILS: Hep. Merc. Magn. carb. 

Nux vom. Sil. Sulph. 
BORING: Anacard. Aur. Mercur. 

Staph. 
BURNING: Agar. Arsen. Asa f. 

Carbo veg. Caust. Crot. Kali. Lye. 

Nux vom. Phosph. ac. Rhus. Sep. 

Tar. Teucr. Zinc. 
COLD FEELING: Ambra. Mosch. 

Puis. Valer. 



CONTRACTION : Ars. Canth. Cocc. 

Lye. Nux vom. 
CRAMP (in calves): Alum. Ambra. 

Aug. Ars. Cale. carb. Camph. Carb. 

veg. Chamoni. Cin. Coloc. Cupr. 

Dulc. Ferr. Graph. Hep. Hyosc. 

Ign. Laches. Led. Lye. M. austr. 

Men. Natr. Natr. mur. Nitric ac. 

N. jug I. N. vom. Petr. Rhodod. 

Rhus. Samb. Sec. corn. Sep. Sil. 

Stram. Sulphur. Yeratr. Zinc. 
CREEPING: BeU. Cic. Ipec. Nux 

vom. Rhus. Sec. corn. 
CUTTING: Calc. c. Phos. ac. Thuj. 

(compt. t.) 
DIGGING: Spig. 
EMACIATION : Phos. ac. Samb. 
ERYSIPELAS : Arn. Rhus. Sulph. 
FAINTNESS: Natr. mur. Oleand. 

Plat. Stann. 
FLESH LOOSE, as if: Nux vom. 

Rhus. 
IN GENERAL : Aco. Ambr. Amm. 

mur. Anac. Ant. cruel. Antim. tart. 

Ars. Asa f. Bell. Brijon. Calc. c. 

Carbo veg. Canth. Caust. Cham. 

Chel. Conium. Creos. Cupr. Cycl. 

Dig. Euphorb. Ferr. Graph. Hyosc. 

Ign. Ipec. Kali. Lach. Led. Lye. 

M. austr. Men. Mercur. Mezer. 

Natr. N. vom. Oleand. Phosph. 

Phosph. ac. Plumb. Puis. Rhod. 

Rhus. Sabin. Sec. corn. Sep. Sil. 

Spigel. Spongia. Staph. Sulph. 

Tar. Valer. Veratr. Vit. 
HEAT : Aeon. BeU. Bry. Guaj. Hyosc. 
HEAVINESS: Ars. Bell. Camph. 

Ferr. Ign. Ipec. Laur. Lye. Rhus. 

Veratr. (comp. t.) 
HERPES : Lye. Plumb. Staph. Sulph. 

Zinc. 
ITCHING: Agar. Asa f. Aurum. 

Calc. c. Chel. Dulcam. Daph. Kali. 

Lach. Laur. Lye. Natr. Op. Sabin. 

Sil. Staph. Sulph. 
LAMENESS : Agar. Ars. Carb. veg. 
NODES, gouty: Antim. crud. Rhus. 

Sulph. Staph. 



116 



LOWER EXTREMITIES. 



NUMBNESS: Alum. Graph. Kali. 

Sil. (comp. t.) 
PAIN AS IF SOEE: See t. 
— as if bruised: Alumina. Asar. 

Calc. c. Caust. Croc. Digital. Ferr. 

Phosph. Plumb. Sepice. (comp. t.) 
PRESSURE: Agar. Arn. Ays. Asa f. 

Bell. Camph. Cupr. Cylc. Ign. Led. 

Mang. Nux mosch. Nux vom. Phos. 

ac. Rhus. Ruta. Sep. Stann. Tar. 

Valer. Zinc. 
PULSATIONS: Asa foetida. Plat 

Stann. 
RIGIDITY, feeling of (t. and L): 

Cham. Coccul. 
SHUDDERING: Kali. 
GONE TO SLEEP : Asa f. Cicuta. 

Ign. Laur. Nux vom. Plumb. Samb. 
SPOTS, blue: Arn. Lach. 
— yellow: Stann. 
— red: Aeon. Calc. c. Conium. Merc. 

Sulph. ac. 
STIFFNESS: Ferr. Ipec. Petr. 

(comp. t.) 
STITCHING: Amm. mur. Anac. 

Ant. cruel. Arn. Asa f. Bell. Bry. 

Calc. c. Carbo an. Caustic. Chin- 
Graph. Hell. Ign. Kali. M. arct. 

Men. Mur. ac. Natr. mur. Nux vom. 

Plumb. Phosphor. Plat. Ehus. 

Ruta. Spig. Staph. Sulph. Valer. 
SWEAT: Euphorb. Hyosc. Mercur. 

(comp. t.) 
SWELLING: Aconit. Asa f. Ferr. 

Led. Puis. 
TEARING AND DRAWING : Agar. 

Alum. Ambr. Ant. tart. Arn. Ars. 

Bell. Bryon. Calc. c. Carbo an. 

Carbo veg. Caust. Cham. Colch. 

Croc. Dulcam. Euphorb. Ferr. 

Graph. Ignat. Kali. Lach. Lye. M. 

austr. Mezer. Magn. mur. Natrum. 

Nux vom. Phosph. Puis. Rhod. 

Rhus. Sassap. Sep. Silicea. Spong. 

Staph. Sulph. Valer. Zinc. 
TENSION: Asa f. Bry. Calc. c. 

Chamom. Cocc. Graph. Ign. Kali. 



N. vom. Puis. Rhus. Spig. Valer. 

(comp. t.) 
TICKLING: Laur. 
TREMBLING: See t. 
TWITCHING: Anac. Arsen. Asar. 

Bellad. Cina. Cupr. Graph. Hyosc. 

Lycop. M. austr. Men. Op. Petr. 

Plumb. 
ULCERS: Ars. Calc. c. Graphit. 

Lach. Lye. Euta. Staph. 
ULCERATIVE PAIN: Puis. 
UNEASINESS : See t. 

Heels. 
IN GENERAL : Amnion, mur. Ant. 
cruel. Arg. Arn. Calc. c. Caust. 
Coloc. Cycl. Graphit. Ign. Kali. 
Led. Lycop. M. arct. Merc. Natr. 
Nitric ac. Petr. Pulsat. Bhodod. 
Rhus. Sabin. Sec. corn. Selen. Sep. 
Sil. Spongia. Stann. Stront. Sulph. 
Valer. Viola, trie. 

Feet. 

BENT INWARDS; Sol. n. 
BOILS: Calc. c. Merc. 
BURNING : Arn. Ars. Calc. c. Coc- 
cul. Crotal. Graph. Hep. Lye. 

Merc. Natr. Natrum mur. Phos. ac. 

Puis. Rhus. Sec. corn. Sep. Sil. 

Stann. Tar. 
CHILBLAINS: Ant. crud. Cham. 

Nitr. ac. Nux vom. Petr. Phosph. 

Puis. Rhus. Sulph. 
COLD, liable to take : Con. Sil. 
COLDNESS: Ambra. Amm. mur. 

Ant. crud. Ant. tart. Arn. Bell. 

Calad. Calc. c. Caustic. Chel. Chin. 

Coff. Con. Daph. Digit. Graph. Ign. 

Ipec. Kali. Lach. Lye. Men. Mur. 

ac. Natr. Nux vom. Oleand. Petr. 

Phosph. Puis. Rhodod. Rhus. 

Sabin. Samb. Sepiae. Sil. Squilla. 

Stann. Sulph. Veratr. 
CORNS: Ant. crud. Arn. Calc. c. 

Caust. Ign. Lye. Nux vom. Puis. 

Ran. sc. Rhus. Sep. Sil. Sulph. 



LOWER EXTREMITIES. 



117 



CRAMPY FEELING : Calc. c. Cal- 

ad. Caust. Graph. Hep. Laches. 

Lye. Natr. mur. Petr. Sil. Sulph. 
— in the soles : Calc. c. Chelid. Ferr. 

Eupliorb. Natr. c. Selen. Sil. 

Sulph. , 
CREEPING: Arn. Bell. Caustic. 

Dulc. Graph. Ign. Natr. Nuxvom. 

Phosph. Rhodod. Rhus. Sec. corn. 

Sep. Staim. 
DEADNESS: Ant. crud. Arsenic. 

Calc. c. N. vom. Rhus. Sec. corn. Sil. 
DESQUAMATION: Dulc. 
DRY SOLES OF FEET: Bism. 
EXHAUSTION, feeling of: Bellad. 

Bov. Cham/Croc. Ferr. Lye. Phos. 

Plat. Rhus. Zinc. 
ERUPTION: Graph. Petr. Sulph. 
ERYSIPELAS : Nux vom. Dulc. 
FETOS: Plumb. Sil. 
IN GENERAL: Aeon. Anac. Am. 

Ars. Asa f. Aur. Baryt. Bell. Bry. 

Calc. c. Camph. Car^o vej. Caust. 

Cham. Conium. Creos. Cuprum. 

Ferr. Graph. Hep. Ign. Kali. Led. 

Lye. Merc. Natr. Natr. mur. Nux 

vom. Petr. Phosph. Plumb. Puis. 

PJwd. Rhus. Ruta. Samb. Secale 

corn. Sep. Sil. Stann. Stront. Sulph. 

Verat. Zinc. 
GOUT: Arn. Bryon. Graph. Lach. 

Led. Lye. Nux vom. Oleand. Rhus. 

But a. Sabin. Yeratr. 
HEAT: Aeon. Arn. Bryon. Calc. c. 

Carbo anim. Led. Nux vom. Puis. 

Phosph. Sep. Sulph. 
— of the soles : Anac. Nux vomica. 

Sangn. 
ITCHING: Agar. Asa f. BeL Calc.c. 

Coccul. Lach. Lycop. Puis. Selen. 

Stann. 
LAMENESS: Oleander. Phosphor. 

Plumb. 
NUMBNESS: Bryon. Carbo veget. 

Con. Op. Phosph. ac. 
PAIN AS IF BRUISED : Bry. Laur. 

Magn. c. 



—as if sprained : Arn. Carbo veg. 
PRESSURE : Asa f. Bellad. Bryon. 

Graph. Led. Nuxvom. Plat. Stann. 

Sulph. ac. 
PULSATIONS : Ran. bulb. 
RIGID FEELING: Asa feet. 
GONE TO SLEEP: Alum.Ammon. 

mur. Ant. tart. Bar. Cocc. Eupliorb. 

Graph. Kali. Lach. Laur. Lycop. 

Nux vom. Oleand. Plumb. Bhod. 

Sep. Sil. 
STIFFNESS : Ambr. Ars. Led. 
SPASM : Bar. Bell. Nux vom. Rhus. 

Secale corn. 
STITCHES: Alum. Arn. Asa feet. 

Bellad. Bryon. Calc. c. Carbo veg. 

Chin. Graph. Ign. Kali. Meph. 

Mur. ac. Natr. Natrum mur. Nitr. 

acid. Phosph. Ban. sc. Sep. Sil. 

Sulph. 
SWEAT: Bar. Calc. c. Cann. Carbo 

veg. Cupr. Graph. Ipec. Kali. Led. 

Lycop. Magn. mur. Merc. Nitr. ac. 

N. jugl. Ph. ac. Pulsat. Sep. Sil. 

Squill. Sulph. 
— of the soles of feet: Arn. Chin. 

Plumb. 
SWELLING: Amm. c. Arn. Ars. 

Asa f. Bell. Bry. Calc. carb. Caps. 

Caust. Cham. China. Cocc. Crotal. 

Digit. FeiT. Graph. Kali. Lach. 

Led. Lye. Merc. Natr. Natr. mur. 

Petr. Phosph. Puis. Rhod. Rhus. 

Sec. corn. Sep. Sil. Stann. Staph. 

Sulph. 
TEARING AND DRAWING: Al- 
um. Ant. crud. Arn. Bellad. Bism. 

Bov. Carbo veg. Caustic. Chin. 

Colch. Ferr. Graphit. Hep. Lach. 

Lycop. Merc. Natr. Natr. mur. Ni- 
tric acid. Phosph. ac Rhodod. Si 1 . 

Spig. Stann. Stram. Sulph. 
TENSION: Bry. Led. Rhus. Sulph. 
TICKLING : Laur. Rhod. Sil 
TREMBLING: Arn. Ars. Coffea. 

Stram. Veratr. Zinc. 



118 



.LOWER EXTREMITIES. 



TWITCHING: Arn. Chin. Cupr. 

Grapliit. Ign. Ipec. Laur. Phosph. 

Sep. Veratr. 
ULCERS: Ars. Ipec. Lach. Merc. 

Ruta. Sec. corn. Sulpli. 
ULCERATIVE PAIN: Bry. Graph. 
UNEASINESS: Arn. Bar. Carbo 

veg. Rhus. 

Tarsal Joints. 

BEATING : Arg. Ruta. * 

BEND, liable to: Carbo an. Na- 

irum . Natrum mur. Nitric ac. Nux 

vom. Rhus. 
BORING: Spig. 

BURNING: Calc. Euphorb. Sul- 
phur. 
CREAKING: Camph. Kali bichr. 

Petr. 
IN GENERAL : Ambr. Arn. Arsen. 

Bry. Calc. c. Carbo animal. Canst. 

Creos. Cycl. Dros. Graph. Hep. 

Ign. Kali. Led. Lycop. Mang. Merc. 

Mezer. Natr. mur. Nitric ac. Petr. 

Phos. Puis. Rhus. Ruta. Sep. Sil. 

Spig. Staph. Stront. Sulph. Zinc. 
ITCHING : Daph. Kali. Oleancl 

Selen. 
LAMENESS: Natr. mur. Oleand. 
PAIN AS IE SPRAINED: Arn. 

Bry. Carbo veg. Caust. Dros. Led. 

Men. Natr. Nux vom. Prun. Rhus. 

Sulph. Valer. 
— as if bruised : Calcarea. Hep. Valer. 
— as from weariness : Croc. Nux vom. 
PRESSURE : Camph. Daph. Led. 

Natr. Spig. 
PULLING: Caust. Spig. 
SPASM: Ars. loci. 
STIEENESS : Capsic. Caust. Chel. 

Ignat. Kali. Led. Lye. Petr. Rhus. 

Buta. Sep. Sulph. 
STITCHES : Arn. Ars. Asa f. Bov. 

Bry. Caustic. Kali. Oleand. Rhus. 

Spig. Sulph. 
SWELLING : Arsen. Asa f. Bry on. 

Calc. c. Led. Lye. Merc. Rhod. 

Rhus. Sulph. 



TEARING AND DRAWING: Agar. 

Arn. Arsen. Colch. Euphorb. Kali. 

Merc. Puis. Ran. bulb. Rhod. 

Rhus. Spong. Zinc. 
TENSION: Bry. Lye. Sep. Zinc. 
WEAK FEELING: Calc. c. Carbo 

an. Merc. 

Dorsum of Feet. 
IN GENERAL: Asa f. Bry. Cam- 
phor. Caust. Hep. Lycop. Mercur. 
Mur. ac. Natr. Par. Puis. Rhus. 
Spig. Sulphur. Tar. Thuj. Zinc. 

Soles of Feet. 
IN GENERAL: Ambr. Anac. Arn. 
Ars. Bell. Bry. Calcar. c. Carbo 
veg. Caust. Creos. Cuprum. Graph. 
Lye. Mercur. Mur. ac. Natr. Petr. 
Phosph. Phosph. ac. Phell. Plum b. 
Pulsat. Rhus. Sil. Stront. Sulph. 
Tar. 

Hip and Joint. 

BORING: Arn. Cin. Merc. 
BURNING: Bell. Carbo veg. Hell. 

Rhus. Ruta. Sep. Valer. 
CREAKING: Anac. Camph. 
CRAMPY FEELING: Bellad. Plat. 

Sulph. 
CUTTING: Alum. Cacl. c. 
IN GENERAL : Aeon. Amm. Ant. 

crud. Ant. tart. Arn. Bellad. Bry. 

Calc. c. Carbo veget. Caust. Coc- 

cul. Coloc. Creos. Ferr. Hell. Ign. 

Ipec. Kali. Led. Lye. M. austr. 

Mercur. Natr. mur. Nitric ac. N. 

vom. Phosph. Phosph. ac. Pulsat. 

Rhus. Ruta. Sep. Silicea. Stront. 

Sulph. Teucr. Veratr. 
HIP-DISEASE : Bry. Calcar. c. 

Caust. Coloc. Hepar. Merc. Nitric 

ac. Phosph. ac. Rhus. Ruta. Sil. 

Sulph. (See Limping, spont.) 
IS CHI AS : Aconit. Bell. Bry on. 

Caust. Chamom. Coloc. Led,. Merc. 

Nux vom. Puis. Rhus. Buta. Sa- 

bin. Sep. Sulph. 



LOWER EXTREMITIES. 



119 



ITCHING : Caustic. Led. Natrum. 
■ Sep. 

LAMENESS: Cham. Lye. Veratr. 
LIMPING, spontaneous : Aconit. 

Bell. Calc. c. Caust. Coloc Lye. 

Merc. Rhus. Ruta. Staph. Sulph. 

Zinc. (See Hip-disease.) 
NUMBNESS: Lach. Staph. 
PAIN, simple : Aco. Bell. Cham. 

Led. Nux vom. Rhod. Rhus. Ruta. 
— laming: Bell. Cina. Coccul. Lach. 

Natr. mur. 
— as if sprained: Amm. m. Am. Bry. 

Caust. Cham. Euphorb. Ipec. Na- 
trum mur. Nux vom. Rhus. 
— as if sore : Cic. 
— as if bruised: Alum. Am. Bry. 

Caust. Croc. Ferr. Lach. Natr. 

Natr. mur. Phos. ac. Ruta. Sep. 

Zinc. 
PRESSURE : Am. Asar. Caustic. 

Coccul. Euphorb. Led. Nux vom. 

Ruta. Sabadilla. Sep. Stann. 
PULLING : Natr. mur. 
STIFFNESS : Bell. Caust. Chamom. 

Ign. Led. Sep. Staph. 
STITCHES: Alum. Bellacl. Bryon. 

Calc. c. Caust. Coccul. Ferr. 

Graph. Ign. Led. Natr. mur. Nux 

vom. Bhus. Sil. Zinc. 
SWELLING : Bry. Sep. 
TEARING AND DRAWING: 

Alum. Ant. crud. Bry. Carbo veg. 

Caust. Con. Dulc. Euphorb. Kali. 

Lye. Merc. Natr. Natr. mur. Rhod. 

Bhus. Sep. Zinc. 
TENSION : Bell. Lye, Natr. mur. 

Nitr. ac. Puis. Rhus. 
TWITCHING: Calc. carb. Coccul. 

Mezer. N. vom. Sep. Sil. Sulph. 
WEARINESS, feeling of: Thuj. 

Knee and Joint. 
ANEURYSM IN BEND OF 

KNEE : Carbo veg. 
BORING: Caust. Canth. 
BURNING : Asa feet. Tabac. Carbo 

veg. Lye. Mur. ac. Phosph. Sulph. 



COLDNESS : Aeon. Arsen. Chin. 

Daph. Puis. Sep. Sulph. 
— feeling of : Dig. Veratr. 
CONTRACTION: Carbo an. Lycop. 

Merc. Rhus. Sil. Sulph. 
CONTRACTIVE FEELING IN 

HAM-STRINGS : Con. Nitric ac. 

Bhus. Buta. Sulph. Veratr. 
CREAKING : Camph. Caust. Coc- 
cul. Led. Nitric ac. Nux vom. Petr. 

Rhus. Selen. Sulph. 
CRAMPY : Bellad. Bryon. CausU 

Oleand. 
CREEPING: Rhus. 
CUTTING : Graphit. Tax. Thuj. 

Veratr. 
ERUPTION: Hep. Kali. Lye. Nux 

vom. Phosph. ac. Thuj. 
FUNGUS OF THE KNEE: Ant. 

crud. Ars. Bell. Bry. Calc. c. Iod. 

Kali hydr. Led. Lycop. Merc. 

Phosph. Puis. Rhodod. Rhus. Sep. 

Sil. Sulph. 
IN GENERAL : Aco. Ambr. Amm. 

Amm. mur. Anac. Ant. crud. Arg. 

Arn. Ars. Asa f. Asar. Bry. Calc. c 

Calc. phosph. Caps. Carbo veg-. 

Caustic. Chin. Colch. Con. Ferr. 

Cycl. Graph. Hep. Iod. Kali. 

Lachesis. Led. Lye. Mane. M. austr. 

Merc. Natr. Natrum mur. Nitric 

ac. Nux mosch. Nux vom. Petr. 

Phos. Plumb. Puis. Rheum. Rhod. 

Rhus. Ruta. Sabad. Sep. Sil. 

Spigel. Stann. Staph. Sulph. Tar. 

Valer. Veratr. Vit. Zinc. 
GIVING WAY, liable to: Arnica. 

Bell. Camph. Caust. Chin. N. vom. 

Rhod. Rhus. Ruta. Sulphur. 
HEAT, feeling of: Aur. m. Calc. c. 

Ign. 
HEAVINESS: Chin. Rhus. Verat. 
HERPES : Calc. c. Natr. Natr. mur. 

Petr. Sulph. 
— in the bend of the knee : Calc. c. 

Graph. Natr. Natrum mur. Psor. 

Sulph. 



120 



LOWER EXTREMITIES. 



ITCHING: Asa tot. Caust. Kali. 
Lye. Mur. ac. Nitric ac. 

— in bend of the knee : Natr. Nux 
vom. Sassap. 

JEEKS : M. austr. Spig. Sulph. ac. 
PAIN AS IF DISLOCATED : Agar. 

Arn. Caust. Ipec. Men. Nitric ac. 

Phos. Bhus. Spig. Staph. 

— as if sore : Carbo an. Caustic. Nux 
vom. Sulph. 

— as if bruised: Amm. carbon. Ars. 
Aurum. Caniph. Graph. Hep. Jatr. 
Led. Nux vom. Bhus. Buta. Stann. 
Veratr. Zinc. 

PEESSUEE: Alum. Asa f . Bellad. 

Calc. c. Chel. Cycl. Led. Magn. 

mur. M. austr. Eheum. Stann. 

Sulph. Thuj. 
PEICKLING: Aur. m. 
PULLING : Caust. Natr. mur. 
SHOCK IN THE BEND OF THE 

KNEE: Veratr. 
GONE TO SLEEP : Carbo veg. 
SPASM: Euta. Sulph. 
SPOTS, red: Lye. Petr. Bhus. 
SPBAIN, liable to : Nux vom. Ehus. 
STIFFNESS : Ambr. TAmmon. mur. 

Ars. Bell. Bry. Calc. Caps. Caust. 

Coloc. Graph. Hell. Ignat. Kali. 

Lach. Led. Lye. Natr. mur. Nux 

vom. Petr. Phosph. Pulsat. Ehus. 

Sassap. Sep. Stann. Sulph. 
STITCHES : Alumina. Ant. crud. 

Arn. Asa f. Bell. Bry. Calc. Carbo 

an. Caust. Chel. Cocc. Con. Graph. 

Hell. Kali. Lach. Laur. Led. Natr. 

mur. Nitric ac. Petr. Phos. Puis. 

Ehus. Sassap. Sep. Sil. Stann. 

Staphysag. Tab. Thuj .Valer. Veratr. 
SWEAT: Calc. Led. 
SWELLING: Ars. Bryon. Calc. c. 

Calc. phosph. Chin. Coccul. Ferr. 

Graph. Hep. Kali hydr. Iod. Lach. 

Led. Lye. Mur. ac. Nitric ac. Nux 

vom. Phos. Puis. Ehod. Ehus. Sep. 

Sil. Sulph. 



TEAEING AND DEAWING: 

Aconit. Agar. Alum. Anac. Arn. 

Bell. Benz. ac. Bryon. Calc. carb. 

Calc. phosph. Canth. Carbo an. 

Caust. Cham. China. Clem. Colch. 

Crot. Euphorb. Iod. Kali. Kali 

bichr. Lach. Laur. Led. Lycop. M. 

austr. Merc. Mur. ac. Natrum. Nitr. 

Phos. Puis. Bhod. Ehus. Sep. Sil. 

Spig. Stront. Sulphur. Zinc. 
TENSION: Am. Bryon. Caustic. 

Graph. Kali. Laches. Led. Nitric 

ac. Nux vom. Phosph. Puis. Ehus. 

Sep. Sulph. 
THEOBBING: Calc. c. Euta. 
TUBEECLES : Calc. c. Chin. Led- 

Lye. Nux vom. 
TWITCHING: Bell. Caps. Caust. 

Chin. Laur. Plumb. Sulphur. 

Veratr. 
UNSTEADINESS: Aconit. Arnica. 

Carbo veg. Nux vom. Ehus. 
WANT OF MOBILITY: Graph. 
WEAK FEELING: Aconit. Arnica. 

Asar. Bryon. Caust. Chin. Con. 

Cupr. Ferr. Ign. Lach. Led. Lye. 

Merc. Natrum mur. Nitric ac. 

Plat. Puis. Stann. Staph. Sulph. 

Veratr. 
WEAEINESS : Asar. Cocc. Couium. 

Nux mosch. Pulsat. Buta. 

ISTails. 
IN GENEEAL: Alum. Ars. Caust. 
Graph. Hep. Hell. Mercur. Natr. 
Natrum mur. Nux vom. Phosph. ac. 
Sabad. Sep. Sil. Sulph. 

Tibia. 
IN GENEEAL: Agar. Anac. Arn. 
Ars. Asa f. Bell. Calc. Caustic. 
Coloc. Con. Creos. Dulc. Graph. 
Kali. Lach. Lycopod. Mang. Merc 
Mezer. Mur. ac. Phos. Puis. Bhod. 
Rhus. Sabin. Sep. Sil. Spong. Tar. 
Zinc. 



LOWER EXTREMITIES. 



121 



Calves. 

IN GENERAL : Alum. Ambr. Ant. 
crud. Ars. Asa f. Bry. Calc. Caps. 
Caustic. Cham. Coloc. Croc. Cupr. 
Ferr. Graph. Hyosc. Ign. Led. Lye. 
M. austr. Mang. Merc. Natr. Natr. 
mur. >"itr. ac. Nux vom. Petr. Puis. 
Rhus. Sabina. Sec. corn. Sep. Sil. 
Spig. Stann. Staph. Sulphur. Tar. 
Valer. Veratr. 

Toes. 
BOEING: Merc. Ban. sc. 
BURNING: Am. Dulc. Nitric ac. 

Nux vom. Staph. 
— in the toe-balls : Bry. 
CHILBLAINS, blisters: Axe. Nitric 

ac. Petr. 
CHILBLAINS: Agar. Amm. Ant- 

crud. Caust. Nitr. ac. Nux vom. 

Petr. Phosph. Puis. Rhus. Sulph. 
COLDNESS: Calad. Sulph. 
CONTRACTION: Cham. Eerrum. 

Hyosc. Nitr. Nux vom. Lye. Merc. 

Plat. 
CRAMPY : Amm. Arn. carb. Bar. c. 

Calc. Caust. Ferr. Hyosc. Ign. Lye. 

Mosch. Nux vom. Plat. Sulph. 
CREEPING: Alum. Asa f. Caust. 

Hep. Lach. Plat. Plumbum. Rhod. 

Sec. corn. 
DEADNESS: Cycl. Sec. com. 
IN GENERAL: Agar. Amm. Arn. 

Aur. Calcar. Carbo an. Carlo veg. 

Caust. Colch. Graph. Kali. Magn. 

carb. Merc. Mezer. Natrum mur. 

Nitric ac. Petr. Phosph. Phos. ac. 

Plat. Ran. seel. Sabin. Sec. corn. 

Sil. Sulph. 
ITCHING: Ambr. Cycl. Daph. Hep. 

Nux vom. Paeon. Pulsat. Stront. 

Staph. 
JERKS : Anac. Arn. 
NUMBNESS: Arn. Crot. Phosph. 
56 



— of toe-balls: Puis. 

PAIN AS IF BRUISED : Aur. 

Sulph. 
PRESSURE: Asa f. Cycl. Graph. 

Nux vom. 

PRICKLING: Aeon. Ant. tart. 

REDNESS: Carbo veg. 

GONE TO SLEEP: Cham. Nux 

vom. Rhus. 
SORENESS: Graph. Natr. Ban. 

bulb. Sil. 
SPASMS : Bar. m. Cham. Nux vom. 

01. an. 
STIEENESS : Sec. corn. Sil. Sulph. 

STITCHES : Arn. Asa feet. Calcar. 

Carbo veget. Caustic. Cocc. Graph. 

Lycopod. Natr. mur. Oleand. Puis. 

Ran. bulb. Ban. sc. Sil. Yeratr. 

Zinc. 
SWEAT : Arn. Sit 
SWELLING : Arn. Carbo veg. Graph. 

Merc. Nitric acid. Phosph. Sabin. 

Sulph. 
— of toe-balls : Daph. Led. 
TEARING AND DRAWING : Agar. 

Amm. mur. Arn. Ars. Asar. Camph. 

Caust. Chin. Cicuta. Cycl. Hep. 

Kali. Lach. Led. Lye. Par. Phos. 

Puis. Bhus. Sil. Sulph. Stront. Vik 

Zinc. Valer. 
TICKLING: Ambr. 

TWITCHING: Asa f. Chin. Cupr. 
Merc. Ran. sc. 

ULCERS : Ars. Caustic; Graph. 
Petr. Sep. 

Toe-Joints. 

IN GENERAL: Am. Aur. Bism. 
Calc. Caust. Cham. China. Conium. 
Cycl. Graph. Hep. Kali. Led. Lye. 
Merc. Phos. Puis. Rhod. Bhus. 
Buta. Sabin. Sep. Sil. Staple 
Sulph. Teucr. Valer. Zinc. 



122 



XXVIII. SKIN AND EXTERNAL SYMPTOMS. 



ABSCESSES, acute: Ars.BeTl. Hep. 

Lach. Merc. Phosph. Pulsat. Sil. 

Sulph. 
— chronic: Calc. c. Calc. ph. Con. 

Hep. Lach. Iod. Lycop. Merc. Ni- 
tric ac. Phosph. Sil. Staph. Sulph. 

Thuj. 
BED-SORES: Agar. Arn. Baryt. 

Calc. c. Carbo veg. Caustic. Chin. 

Cic. Creos. Ferr. Graphit. Hepar. 

Ign. Lach. Lycop. Mercur. Kitric 

ac. Petr. Puis. Bhus. Ruta. Sep. 

Silic. Sulph. Sulph. ac. 
BITING IN THE SKIN: Ant.crud. 

Bar. Canth. Cham. Dig. Graphit. 

Kali. Led. Lye. Nux vom. Oieand. 

Plat. Pulsat. Ban. sc. Bhus. Buta. 

Spong. Staph. Veratr. Vit. 
BLOATING: Ant. crud. Ars. BeU. 

Bryon. Calc. c. Caps. Cupr. Dulc. 

Ferr. Graph. Kali. Lycop. Merc. 

Mosch. Oieand. Op. Pulsat. Bhus. 

Spig. Staph. Sulph. 
BLOODY-TUMORS : Bryon. Merc. 

Sec. corn. 
— blisters : Ars. Canth. Secale corn. 

Sulph. 
BLOTCHES: Apis. Creos. Dulc. 

Natr. mur. Bhus. Sulph. 
BOILS: Ant. crud. Arn. Bellad. 

Calc. c. Carbo anim. Euphorb. 

Hep. Lach. Led. Lye. Merc. Mur. 

ac. Nitr. ac. Phosph. Phosph. ac. 

Sec. corn. Sep. Sil. Staph. Sulph. 

Sulph. ac. Thuj. 
BLOTCHES: Agar. Ant. crudum. 

Ars. Bell. Bry. Calc. c. Carbo anim. 

Caust. Con. Daph. Dulc. Graphit. 

Hep. Iod. Lach. Led. Lye. Magn. 

Mang. Mezer. Natrum mur. Oieand. 

Petr. Phosphor. Puis. Bhus. Buta. 

Sec. corn. Sep. Sil. Staph. Sulph. 

Thuj. Verat. 
BURNING OF SKIN: Aconit.Arn. 

Ars. Asa f. Aur. Aur. mur. Bell. 



Bryon. Calc. Camph. Caps. C<ak . 
veg. Caust. Cic. Coccul. Creos. 
Cupr. Dig. Euphorb. Ferr. Hep. 
Lgn. Kali. Lach. Lye. Merc. Nitr. 
ac. Nux vom. Op. Phosph. Puis. 
Bhus. Secale corn. Sep. Sil. Spig. 
Staph. Sulph. Sulph. ac. Veratr. 
Viola, tr. 
COLOR OF THE SKIN, blue: 
Arsen. Bell. Cina. Con. Cupr. Dig. 
Hydr. ac. Lach. Merc. Op. Phosph. 
ac. Sec. corn. Veratr. 

pale : Bellad. Calc. Chin. Coccul. 

Ferr. Graph. Kali. Lycop. 
Nitric ac. Nux vom. Plat. Pulsat. 
Sep. Spigel. Sulph. • 

yellow: Ambr. Ars. Bell. Bryon. 

Canth. Carbo vegetab. Cham. 
China. Con. Ferr. Ign. Lye. 
Merc. N. vom. Op. Plumb. Puis. 
Bhus. Sep. Spig. Sulph. Veratr. 

red: Aconit. Arn. Bell. Bry. 

Canth. Dulc. Graph. Lye. Merc. 

N. vom. Op. Phos. ac. Rhus. 

Buta. Secale corn. Strain. Vit. 

— sallow: Calc. Ferr. Iod. Laches. 

Merc. Natr. c. Phos. Sec. corn. Sep. 

COMEDONES: Calcar. c. Natr. 

Natrum mur. Nitric ac. Selen. 

Sulph. 

CONTUSIVE PAIN: Arn. Rhus. 

Sulph. ac. . 
CRACKING OF THE SKIN: 
Alumin. Arn. Calc. c. Cham. 
Creos. Hep. Kali. Lach. Lye. Natr. 
Natr. mur. Nitric ac. Petrol. Puis. 
Bhus. Sep. Sil. Sulphur. Zinc. 
CRTTSTA LACTEA: Calc. Carbo 
veg. Dulc. Graph. Lye. Merc. Rhus. 
Sassap. Staph. 
DAMP SKIN: Alum. Ars. Calc 
Carbo veget. Cic. Clem. Dulc. 
Graph. Lye. Merc. Nitric ac. Petr. 
Bhus. Sepise. Sil. Sulph, 



SKIN AND EXTERNAL SYMPTOMS. 



123 



DESQUAMATION: Aeon. Amm. 
Amm. mur. Arsen. Aur. Bell. Bov. 
Caustic. Clem. Dulc. Graph. Hell. 
Iod. Mercur. Mezer. Oleand. Phos. 
Phos. ac. Puis. Rhus. Secale corn. 
Sep. Sil. Staph. Veratr. 

Eruption. 
IN GENERAL : Aeon. Amm. carb. 

Ant. crud. Arn. Ars. Aurum. Bar. 

Bov. Bry. Calc. carb. Canth. Carb. 

an. Carbo veget. Canst. Cic. Clem. 

Con. Cuprum. Cycl. Dulc. Ferr. 

Graphit Hell. Hep. Ipec. Kali. 

Lack. Lye. Magn. c. Magn. m. 

Merc. Natr. Natr. mur. Nitric ac. 

Nux vom. Oleander. Petr. Phosph. 

ac. Puis. Ehod. Rhus. Sassap. 

Selen. Sejjice. Sil. Spigelia. Stapli. 

Stront. Sulphur. Sulph. ac. Thuj. 

Viola, tr. Zinc. 
ERUPTION, peeling off: Ammon. 

Bell. Clem. Hell. Led. Merc. Mezer. 

Phosph. Sepiae. Sil. Staph. 
— smarting: Bry. Cale. Calc. canst 

Caust. Eupliorb. Lach. Led. Mezer. 

Natr. mur. Puis. Sil. Spong. 

Sulph. 
— vesicular: Ant. crud. Ars. Bry. 

Canth. Carbo an. Caustic. Clem. 

Dulc. Graphit. Hell. Hep. Kali. 

Lach. Natr. Natr. mur. Nitr. ac. 

Phosph. Ran. bulb. Rhus. Secale 

corn. Sep. Sulph. 

gangrenous : Arsen. Carbo veg. 

Camph. Sec. corn. 
— purulent: Ant. tart. Ars. Asa feet. 

Calc. Clem. Dulc. Hep. Kali bichr. 

Lye. Merc. Natr. Natr. mur. Nitric 

ac. Puis. Rhus. Sec. corn. Sep. Sil. 

Staph. Sulph. Zinc. 
— humid: Alum. Ars. Bovista. Carbo 

an. Carbo veg. Caust. Clem. Dulc. 

Graph. Hep. Kali. Lach. Lye. Nitr. 

ac Petr. Rhus. Selen. Sep. Sil. 

Staph. Sulph. Sulph. ac. 
- flat : Ars. Asa f. Bell. Lach. Lye. 



Natr. Nitric ac. Phosph. ac. Selen. 

Sep. Sil. 
— corrosive : Ars. Baryt. Borax. Calc. 

Cham. Con. Graphit. Hep. Kali. 

Lach. Mercur. Natr. Nitric ac. Pe- 
trol. Ehus. Sep. Sil. Staph. 
— yellowish: Creos. Eupliorb. Merc. 

Nitr. ac. 
— miliary: Agar. Ars. Carbo veget. 

Graph. Hep. Led. Natr. mur. Nux 

vom. Zinc, 
—itching : Aco. Ant. crud. Ant. tart. 

Ars. Bry. Canth. Caustic. Cham. 

Clem. Graphit. Ignat. Kali. Lach. 

Mercur. Mezer. Nitric ac. Oleand. 

Ran. bulb. Rhus. Sep. Sil. Staph. 

Sulph. Veratr. 
— coppery: Arsen. Carbo an. Creos. 

Lach. Merc. Rhus. Veratr. 
— nettle-rash : Aco. Apis. Ars. Bell. 

Bry. Calc. c. Caustic. Cepa. Cop. 

Dulc. Hep. Ipec. Lye. Natr. mur. 

Puis. Rhus. Secale corn. Petr. Sep. 

Sulph. Veratr. 
— scurfy: Alum. Ant. crudum. Bell. 

Calc. c. Carbo anim. Carbo veg. 

Cic. Con. Dulcam. Graph. Hep. 

Lye. Mercur. Puis. Rhus. Sassap. 

Sepia?. Sil. Sulph. 
— scaly : Amm. mur. Ars. Aur. Bell. 

Bry. Calc. c. Clem. Dulc. Graph. 

Led. Lycopod. Mercur. Oleand. 

Phosphor. Phosph. ac. Puis. Rhus. 

Sep. Sulph. 
— dry : Bar. Calc. c. Carbo veg. Cupr. 

Dulc. Graph. Led. Lycop. Magn. c. 

Mercur. Phosph. Sep. Sil. Staph. 

Veratr. . 
— richly : Bor. Calc. c. Cham. Graph. 

Hep. Merc. Natrum. Nitr. ac. Petr. 

Rhus. Sil. 
HERPES, generally: Alumin. Ambr. 

Arsen. Bov. Bry on. Calc. c. Carbo 

veget. Caustic. Chel. Clem. Chlor. 

Conium. Creos. Dulc. Fluor, ac. 

Graphit. Hep. Kali. Lach. Led. I^yc. 

Merc Natr. Natr. mur. Nitric acid. 



124: 



SKIN AND EXTERNAL SYMPTOMS. 



Oleander. Petr. Rhus. Phosph. Sep. 

Silic. Spig. Staph. Snlph. 
— suppurating: Dulc. Lycop. Merc. 

Rhus. Sep. Sil. Sulph. 
— humid : Bov. Calcar. c. Clem. Con. 

Graphit. Hep. Lach. Lye. Natr. 

Nitric ac. Rhus. Sep. Sil. Sulph. 
— spreading: Ars. Calc. Graph. Lye. 

Merc. Nitr. Petr. Rhus. Sil. Sulph. 
— furfuraceous : Ars. Calcar. Dulc. 

Graphit. Sep. Sil. Sulphur. 
— crusty: Bar. Bov. Calc. c. Clem. 

Con. Dulc. Graphit. Lach. Lye 

Merc. Rhus. Sep. Sulph. 
— pustulous : Creos. Mercur. Sulph. 
— ring-shaped: Natr. Natrum mur. 

Sep. 
— scaly: Ars. Clem. Dulcam. Merc. 

Phosph. Bhus. Sulph. 
—syphilitic: Aur. Merc. Nitric ac. 

Thuj. 
— grape-shaped: Calc. c. 
— dry: Ars. Bov. Calc. carb. -Dulc. 

Graph. Led. Lye. Merc. Bhus. 

Sepiae. Sil. Sulphur. Veratr. 
MEASLES: Aeon. Ars. Bell. Bry. 

Coff. Dulcam. Iod. Ipec. Mercur. 

Phosph. Puis. Rhus. Sulph. 
MILIABIA, white : Ars. Bryon. Ipec. 

Nux vom. Sulph. Valer. 
— of lying-in women : Bry. Ipec. 
PIMPLES: Ant. crud. Ars. Bry. 

Calc. c. Canth. Caustic. Chamom. 

Con. Dulc. Graph. Kali. Merc. 

Natr. Natrum mur. Nitric ac. 

Phosph. Puis. Rhus. Sep. Sil. 

Spong. Staph. Sulphur. Sulph. ac. 

Thuj. Zinc. 
PUBPLE-BASH: Aco. Bell. Coff. 

Sulph. 
PUSTULES : Ant. crud. Ant. tart. 

Arn. Ars. Bell. Bryon. Caust. Cic. 

Clem. Dulcam. Hyosc. Merc. 

Nitr. ac. Petr. Pulsat. Rhus. Sil 

Staphys. Sulph. 



BASH : Aeon. Ant. crud. Ant. tart. 
Arn. Ars. Bell. Bry. Canth. Carbo 
veg. Causticum. Cham. Coffea. 
Graph. Ipec. Lach. Merc. Phos- 
phor, ac. Puis. Rhus. Selen. Staph. 
Sulphur. Yeratr. 

BUBEOLA : Aeon. Bell. Bry. Coff. 
Merc. Puis. Bhus. 

SCABLET-BASH: Aconit. Bell. 
Bry. Coff. Dulc. Ipecac. Merc. 
Phosph. Sulph. 

— suppressed: Apis. Bry. Phos. Sul- 
phur. 

SMALL-POX: Ant. crud. Antim. 
Tart. Arn. Ars. Bell. Canthar. 
Mercur. Puis. Rhus. Sil. Sulph. 

— spurious : Bell. Merc. Pulsat. 
Rhus. 

— black: Ars. Bhus. Sec. corn. Sep. 
Sil. 

SPOTS, blue: Arn. Ars. Bry. Con. 
Crot. Lach. Nitric ac. Nux mosch. 
Nux vom. Op. Phosph. Bhus. Sec. 
corn. Sulphur, ac. 

— bloody (Petechia) : Arnica. Ars. 
Bell. Bry. Calc. Conium. Crot. 
Ferr. Hyosc. Laches. Led. Nitric 
ac. Nux vomica. Phosph. Puis. 
Rhus. Buta. Sec. corn. Sep. Sil. 
Sulphur. Sulph. ac. 

— brown red: Cann. Nitr. ac. 

— raised : Merc. 

— yellow : Arn. Ars. Conium. Ferr. 
Iod. Lach. Lycop. Petr. Phosph. 
Sep. Sulph. 

greenish: Arn. Con. Crot. Buta. 
Sep. 

— liver-colored : Ant. crud. Arn. 
Calc. Carbo veg. Con. Dulc. Ferr. 
Lye. .Merc. Natrum. Nitric ac. 
Nux vom. Phosph. Sep. Sulph. 

— mottled : Crot. Thuj. 

— dark-red : Natr. mur. Thuj. 

— red: Amm. Arn. Bell, Bry. Calc, 
Carbo veg. Coccul. Cycl. Dulc. 
Graph. Kali. Lach. Lye. Magn. 
Merc. Nitr. ac. Phos. Rhus. Sabad, 



SKIN AND EXTERNAL SYMPTOMS. 



125 



Sep. Sil. Sulphur. Sulph. ac 
— scarlet-red: Amm. Bell. 
— black : Crot. Lack. Sec. corn. 
— violet: Veratr. 
— white: Alum. Ars. Phospn. Sep. 

Sil. Sulph. 
VARICELLA : ^.nt. crua. Ant. tart. 

Bryon. Carbo veg. Ipec. Led. Merc. 

Pulsat. Rhus. Sep. Sil 
ZONA: Ars. Graph. Mercur. Rhus. 

SIL Sulph. 

Excrescences. 
CHILBLAINS: Agar. Ant. cruel. 

Am. Carbo au. Cham. Lycop. Nitr. 

Petr. Phosph. Puis. Bhus. Sulph. 

Sulph. ac Thuj. 
— blistered: Cepa. Nitric ac. Rhus. 
— blue-red: Am. Puis. 
— inflamed: Cham. Nitric ac. Puis, 

Sulph. 
— itching: Nitric acid. Nux vom. 

Sulph- 
FUNGUS NEMATODES: Arsen. 

Calc. Carbo an. Carbo veg. Lack. 

Lycop. Merc. Nitric acid. Phospli. 

Sil. Sulph. Thuj. 
FUNGUS MEDULLABIS: Carbo 

an. Phosph. Sil. 
FUNGUS ABTICULABIS : Antiin. 

<_tuu. Ars. Creos. Iod. Lach. Bhus. 

Sil. Staph. Suljjh. 
GANGLIA : Amm. c. Calc. c. Phos. 

Sil. Zinc. 
MOLES : Calc. Carbo veg. Merc. 

Phosph. Sep. Sil. Sulph. Sulph. ac. 

Thuj. 
NOMA : Aur. mur. Creos. Fluor, ac. 

Iod. Sec. corn. 
POLYPI: Aur. Calc. Con. Hep. Lye. 

Merc. Nitric ac. Phospli. Puis. Sil. 

Staph. Sulphur. Teucr. Thuj. 
STEATOMA: Antim. crud. Baryt. 

Calc. c. Graph. Hep. Nitric ac. 

Sabin. Sil. Sulph. 
SYCOSIC WABTS: Calcar. Lycop. 

Nitric ac. Phosph. ac. Sabina. Thuj. 
- — horny: Ant. crud. 



WABTS : Ars. Bar. Bell. Bor. Calc. 
Caust. Cepa. Dulc. Hep. Kali blcltr. 
Lach. Lye. Natr. Nitr. ac. Petr. 

Phos. ac. PJius. Buta. Sangn. Sep. 

Sil. Staph. Sulph. Thuj. 
— bleeding : Natr. c. Nitric ac. Sulph. 

ac. Thuj. 
— burning: Arsen. Petr. Bhus. Thuj. 
— suppurating: Caust. Hep. Sil. 
— inflamed: Calc. Natr. c. Nitr. acid. 

Bhus. Sil. 
— flat : Calc. c. Dulc. 
— pedunculated : Dulc. Lye. Sabin. 

Thuj. 
— horny : Ant. crud. Natr. carb. 

Sulpli. Thuj. 
— small : Calc. Bhus. Sulph. 
— painful : Calc. c. Nitric acid. Sulph. 

Thuj. 
— split: Lye. Nitric ac. Phosph. ac. 

Thuj. 
EBYSIPELAS: Aeon. Arn. Arsen. 

Bell. Pry. Calc. c. Camyh. Canth. 

Carbo an. Graph. Hey. Iod. Lach. 

Merc. Nitric ac. Phos. Puis. Rhus. 

Sabad. Sep. Sulyh. 
— vesicular: Ars.\Bel\. Canth. Graph. 

Lach. Phosphor. Puis. Rhus. Sey. 

Sulph. 
—flying: Bell. Puis. Rhus. 
— smooth: Aeon. Amm. Bell. Merc. 
— with swelling: Amm. Apis. Ars. 

Bar. Bell. Bryon. Calc. Graph. Hep. 

Lycop. Merc. Nitric acid. Phosph. 

Bhus. Sulph. 
FORMICATION: Arn. Bar. Carbo 

veg. Bell. Kali. Laur. Lycop. Mur. 

ac. Natrum. Nux vom. Oleand. Plios. 

ac. Plat. Puis. Rhod. Rhus. Secale 

com. Sep. Spig. Staph. Sulph. 
FRECKLES: Alum. Antim crud. 

Calc c. Graph. Lye. Merc. Natr. 

Puis. Sep. Sulph. 
GANGRENE, humid: Ars. China. 

Hell. Phospli. Sec. com. 
—hot : Ars. Carbo veg. Sec. corn. 
— cold : Ars. Asa f . Carbo an. Fluor. 



126 



SKIN AND EXTERNAL SYMPTOMS. 



ac. Plumb. Secale corn. Sil. Squill. 

Sulph. 
HANG-NAILS: Cole. Merc. Natr. 

mux. Rhus. Stann. Sulphur, 
ITCH : Ant. crud. Ars. Calc. Carbo 

veg. Caust. Dulcam. Graph. Lacli. 

Mang. Merc. Phosph. ac.Psor. Se- 

len. Sep. Sulph. Yeratr. 
— greasy: Caust. Merc. 
ITCHING: Aeon. Alum. Ambra. 

Ant. crud. Arg. Asa f. Bar. Calad. 

Calc. c. Cantli. Carbo veg. Caust. 

Chel. Cic. Clem. Con. Cycl Eu- 

pliorb. Ferr. Graph. Hep. Ign.Kali. 

Lack. Led. Lye. Magn. mur. Mere. 

Mur. ac. Natr. mur. Nuxvom. Ole- 
ander. Op. Phos. Plat. Puis. Eliod. 

Kims. Kuta. Sangn. Selen. Sep. 

Spig. Spong. Staph. Sulph. Sul- 
phur, ac. Thuj. Vit. 
NUMBNESS : Ambr. Anac. Cham. 

Lacli. Lycop. Nunc vom. Oleand. 

Phosph. Phospli. ac. Plat. Puis. 

Rhus. Secale corn. Sulph. 
PAIN, as if sore: Alum. Arnica. 

Bryon. Cantli. Caust. Cic. Colch. 

Graph. Hep. Ign. KaU. Merc. Natr. 

mur. Petr. Phosph. Puis. Ehus. 

Sep. Sulph. Sulph. ac. Zinc. 
PITYRIASIS : Ars. Merc. Oleander. 

Sabad. Sulph. 
PORES, black: Graph. Natr. Nitric 

ac. Sulph. 
PRICKLING: Agar. Bellad. Croc. 

Mezer. Plat. Sabacl. Sulph. Zinc. 
PUS, bloody: Ars. Asa f. Carbo veg. 
Hep. K&li.Lach. Lye. Merc. Nitr. 
ac. Puis. SU. Sulph. Sulph. ac. 

broAvnish : Carb. veg. Con. Rhus. 

Sil. 

thick : Hep. Merc. Sil. 

thin : Asa foet. Carbo veg. Caust. 

Merc. Puis. Sil Sulph. 

yellow: Ars. Bryon. Calc. Carbo 

veget. Caust. Cic. Hep. Lycop. 
Merc. Phosphor. Puis. Sep. Sil. 
Staple. Sulph. 



yellow-green : Sil. 

gray : Caust. Lye. Sil. 

greenish : Asa f. Caustic. Merc. 

Puis. Rhus. Sil 

ichorous : Ars. Asa foet. Carbo 

veg. Chin. Graph. Merc. Nitric 
ac. Phos. Ehus. Sangn. Sil. 

with mites : Sabad. Sil. 

copious : Arsen. Asa ftet. Canth. 

Calc. Merc. Puis. Rhus. Sep. Sil 

sour-smelling : Hep. 

acrid: Ars. Caustic. Clem. Merc. 

Nitric ac. Ehus. Sep. SO. 

fetid : Ars. Asa feet. Carbo veg. 

Chin. Graph. Hep. Lacli. Lye. 
Merc. Nitric ac. Sil. Sulph. Sec. 
corn. 

watery : Ars. Asa foet. Caustic. 

Merc. Nitric ac. Ran. sc. PJius. 
Sil. Sulph. 

white like milk : Calc. Hell 

Lye. Puis. Sulph. 

- too little : Calc. Dulcam. Hep. 

Lacli. Merc. Phos. Plumb. Sil. 

viscous : Arsen. Con. Mercur. 

Yiola tr. 
SKIN, dry : Aconit. Amm. Arn. Ars. 
Bell. Bry. Calc. carb. Cham. China. 
Colch. Dulc. Graphit. Hep. Hyose. 
Iod. Kali. Led. Lye. Merc. Natrum. 
Nitric ac. Nux mosch. Op. Phosph. 
Phosph. ac. Puis. Rhus. Sec. corn. 
Seneg. Squill. Sil. Staph. Sulph. 
Verb. 
— hard: Ant. crud. Arsen. Dulcam. 
Graph. Lacli. Phosph. Rhus. Sep. 
Sil. 
— rough : Apis. Bellad. Calc. c. Lod. 

Merc. Natr. Rhus. Sep. Sulph. 
— wrinkled : Am br. Ant. crud. Calc. c. 
Camphor. Cupr. Hell. led. Lye. 
Phosph. ac. Rhus. Sec. corn. Sep. 
Spig. Veratr. 
— relaxed: Calc. carb. Caps. Chin. 
Coccul. Cuprum. Ferr. Graphit. 
Hell. Iod. Lach. Lye. Merc. Natr. 
Sec. corn. Sulphur. Veratr. 



SKIN AND EXTERNAL SYMPTOMS. 



127 



—sensitive: Agar. Ars. Asa f. Bell. 

Calc. Carbo an. Carbo veg. Caust. 

Chin. Ferr. Hep. Ign. Lach. Led. 

Lye. Natr. rnur. Nitric ac. Nux vom. 

Petr. Phosph. ac. Puis. Kan. bulb. 

Rhus. Sil. Spig. Thuj. Veratr. 

to contact : Bell. Bryon. Camph. 

Colch. Nux vom. Puis. Spig. 

humid air: Alum. carb. Calc. c. 

Carbo veg. Dulcam. N. mosch. 
Puis. Rhod. Rhus. 

to cold air: Amm. c. Calc. c. 

Carbo veg. Caust. Lye. Nux 
vom. Rhod. Sec. corn. Sep. 

to warm air : Calcar. Puis. Sep. 

STITCHES : Aeon. Aril. Arsen. Bar. 

Bell. Bry. Calc. Canth. Caust. Coc- 

cul. Con. Dulcam. Graph. Hell." Ign. 

Lycopod. Merc. Nitric ac. Nux 

vom. Oleand. Puis. Ran. sc. Rhus. 

Sabad. Sep. Spong. Staphys. Sulph. 

Tar. Thuj. viola tr. 
SWELLING IN GENERAL: Ant. 

cruel. Apis. Arn. Ars. Aur. mur. 

Bell. Bry. Calc. c. Calc. ph. Canth. 

Chin. Colchic. Con. Dig. Dulc. 

Ferr. Hell. Iodine. Kali. Lach. Led. 

Lye. Merc. Nitric ac. Op. Phos. 

Plumb. Puis. Rhodod. Rhus. Ruta. 

Samb. Sep. Sil. Sulph. 
—pale : Arn. Bry. Calc. Chin. Ferr. 

Lach. Lye. Merc. Puis. Rhus. Sep. 
— inflamed: Aeon. Ars. Asa f. Bell. 

Bry. Caustic. Hep. Lach. Merc. 

Nitr. ac. Puis. Rhus. Ruta. SIL 

Sulph. 
— hard: Arn. Ars. Asa f. Bell. Bry. 

Carbo an. Caustic. Con. Hep. 

Lach. Phosph. Puis. Rhus. Sabin. 

Stront. Sulph. 
— cold : Ars. Chin. Con. Lach. Puis. 

Sec. corn. 
— erysipelatous: Apis. Bell. Merc. 

Rhus. 
— dropsical: Ant. cruel. Apis. Ars. 

Aurum mur. Bell. Bry. Canth. 

Cepa. China. Con. Dig. Dulc. Ferr. 



Hell. Iod. Kali. Led. Lye. Mercur. 

Nitric ac. Phosph. Puis. Rhod. 

Rhus. Samb. Squill. Seneg. Sep. 

Sulph. 

Ulcers. 
IN GENERAL : Ant. crud. Arsen. 

Asa fret. Aur. Bell. Bryon. Cale. c. 

Calc. pli. Carbo an. Carbo veg. 

Caust. Cham. Con. Creos. Hep. Iod. 

Kali. Lach. Lye. Merc. Natr. Nitr. 

ac. Nux vom. Petr. Phosph. Ph. ac. 

Puis. Rhus. Ruta. Sangn. Sec. 

corn. Sassap. Sep. Sil. Staph. 

Sulph. Thuj. 
ULCERS, blueish: Ars. Aur. Con. 

Hep. Lach. Merc. Sec. corn. 
— bleed, liable to : Ars. Asa f . Carbo 

veg. Con. Hep. Lach. Lye. Merc. 

Nitric ac. Phosph. Puis. Sil. Sulph. 

Sulph. ac. 
— burning : Ars. Asa f. Bell. Carbo 

veg. Caust. Clem. Hep. Lye. Merc. 

Mur. acid. Nux vom. Nitric acid. 

Phosph. Puis. Rhus. Sil. Sulph. 
— fistulous : Antim. crud. Apis. Asaf. 

Bell. Calc. c. Caust. Con. Lye. Merc. 

Nitric acid. Phosph. Puis. Sil. 

Sulph. 
—flat : Ars. Lach. Sil. 
— with swelling : Ars. Bell. Bry. Hep. 

Kali. Merc. Nitric ac. Puis. Rhus. 

Sep. Sil. Sulph. 
— hard swelling : Ars. Asa feet. Bell. 

Calc. Con. Hep. Laeh. Lye. Merc. 

Puis. Sangn. Sil. 
— margins evested: Ars. Asaf. Hep. 

Merc. Petr. Rhus. Sil. Sulph. 
— itching : Ant. tart. Ars. Caustic. 

Chin. Hep. Lye. Nitric ac. Phosph. 

ac. Puis. Rhus. Sil. Sulph. 
— cancerous : Ars. Ast. Carl), an. Car- 
bo veg. Con. Creos. Graph. Hep. 

Lach. Mercur. Rhus. Sil. Sulph. 
— mercurial: Alum. Asa foet. Carb. 

veg. Fluor, ac. Hepar. Lach. Lycop. 

Mezer. Nitric ac Sassap. Sulph. 

Thuj. 



128 



SLEEP, DREAMS. 



-salt-rheum, like : Ars. Graph. Lye. 

Sep. Sil. Sulph. 
-painful : Arn. Ars. Asa feet. Carbo 

veg". Caust. Cham. Con. Creos. 

Graph. Sep. Lach. Lycop. Merc. 

Nitric ac. Petr. Phosph. Phos. ac. 

Puis. Sabin. Sep. Sil. Sulph. 

Veratr. 
-painless : Ars. Bellad. Carbo an. 

Carbo veg. Cic. Con. Hyosc. Lach. 

Lye. Oleand. Phosph. Phosph. ac. 

Puis. Sec. corn. Sulph. 
-with ash-colored base: Mercur. 

Nitric ac. Thuj. 
-spongy: Ars. Carbo an. Carbo veg. 

Clem. Lach. Merc. Petr. Phosph. 

Sep. Sil. Sulphur. Thuj. 
-lardaceous : Hep. Mercur. Nitric ac. 
-stitches in ulcers: Ars. Bell. Bry. 

Carbo veg. Graph. Hep. Lye. Mer- 
cur. Nitric acid. Petr. Pulsat. Sil. 

Sulph. 
-syphilitic : Aur.lCaxbo veg. Fluor. 

acid. Kali bichr. Nitric acid. Merc. 

Phos. ac. Sangn. Thuj. 
-deep : Asa f. Calc. c. Con. Hep. 

Lach. Lye. Merc. Nitric ac. Puis. 

Sii. Sulph. 
-insensible: Ars. Calc. carb. Carbo 

veg". Con. Iodine. Lach. Laur. Lye. 

Phosph. ac. Sec. corn. Sil. 
-unhealthy: Calc. c. Cham. Chel. 

Hep. Lach. Mercur. Petr. Rhus. 

Sil. StaiJh. 
-ulcerative pain : Asaf. Calc. Graph. 

Phos. Puis. Rhus. Sil. Sulph. Zinc. 



— suppurating : Arsen. Asa feet. Calc. 

c. Canthar. Carbo veg. Caustic. 

Con. Creos. Graph. Hep. Lye. 

Merc. Mur. ac. Nitric ac. Puis. 

Rli us. Kuta. Sec. corn. Sep. Sil. 

Staphys. Sulph. Sulph. ac. 
— with proud flesh: Ars. Carbo an. 

Cham. Creos. Graph. Hep. Lach. 

Merc. Petr. Sep. Sil. Sulph. 
— painfully sore: Ars. Bell. Calcar. 

Graph. Hep. Merc. Nux vom. Puis. 

Sep. Sulph. 
— shaggy: Lach. Merc. Phosph. ac. 

Thuj. 
VAKICES : Ant. tart. Arn. Ars. 

Carbo veg*. Caust. Ferrum. Graph. 

Lach. Lye. Natrum mur. Pulsat. 

Spig. Sulxjh. Thuj. 
VEINS, swelling of : Arn. Bell. Chin. 

Croc. Ferr. Graph. Hyosc. Phos. 

Pulsat. Sulph. Thuj. 
WOUNDS: Arn. Carbo veget. Hep. 

Lach. Merc. Phosphor. Puis. Rhus. 

Staph. Sulphur. Sulph. ac. Zinc. 
— bleeding: Arn. Laches. Phosph. 

Sulph. Sulph. ac. 
—cut: Am. Staph. Sulph. ac. 
— contused : Arn. Con. Hepar. Rhus. 

Ruta. Sulph. ac. 
— punctured : Carbo veget. Cic. Con. 

Hep. Nitric ac. 

by insects: Aconit. Apis. Arn. 

Bell. Calad. Lach. Merc. Seneg. 
— burns: Aco. Arn. Ars. Canthar. 

Carbo veg. Caustic. Creos. Sulph. 

ac. Urtic. ur. 



XXIX. SLEEP, DREAMS. 



CLAIRVOYANT STATE: Aconit. 

Op.Phoxph. Sil. Sulph. 
DRO WSINESS, in the evening: Ant. 

tart. Ars. Asa f. Bar. Bell. Bov. 

Calc. c. China. Cin. Cou. Croc. 

Crotal. Ign. Kali. Lach. Laur. Natr. 



mur. N. vom. Phosph. Ph. ac. Puis. 

Rhus. Selen. Sil. Valer. 
— in the morning: Ant. crudum. Arn. 
Asa f. Calc. c. Caust. Con. Graph. 
Kali. Merc. Natr. Natr. mur. JVux 
\om. Phosphor. Phosph. ac. Puis. 



SLEEP, DREAMS. 



129 



Rhus. Sep. Sil. Spig. Stram. Sulph. 
— in the afternoon: Agar. Canthar. 

Canst. Chin. Coff. Croc. Graphit. 

Guaj. Ignat. Kali. Lavh. Lam. 

Lycop. Mm. ac. Natr. Natr. mur. 

JY". vom. 01. an. Pliosph. Pulsat. 

Ehus. Sep. Sil. Staph. Sulph. Thuj. 

Yeratr. Viol. tr. Zinc 
- — in the day-time : Agar. Arabr. Am m. 

carb. Anac. Ant. crud. Ant. tart. 

Ars. Asa f. Am. Bell. Bry. Calc. c. 

Canthar. Carbo veg. Canst. Cham. 

China. Coccnl. Con. Croc. Dulc. 

Ferr. Gent. Graph. Hell. Ign. Kali. 

Lact. Laur. Led. Lye. Mercur. 

Mosch. Katr. JVafe". mur. Nitr. ac. 

JV. mosch. X. vom. Op. Phosph. 

Phosphor, ac. Pulsat. Ran. bulb. 

Rheum. Rhus. Sabacl. Selen. Sep. 

Sil. Stram. Sulph. Tart. Yeratrum. 

Viola tr. 
— in the forenoon: Agar. Ant. erud. 

Ant. tart. Cannabis. Carbo veget. 

Fluor, ac. Graphit. Kali. Laches. 

Mosch. Matruin. Sabad. SassajD. 

Sepia? . Sulph. 
— excessive- Ant. tart. Coff. Croc. 

N. mosch. Op. Phosph. ac. 
FALLING ASLEEP TOO LATE: 

Alum. Anac. Ant. tart. Ars. Bellad. 

Bry. Calad. Cale. e. Carbo an Car- 
bo veg. Caust. Chin. Creos. 

Graphit. Guaj. Ignat. Lach. Led. 

Lye. Mere. Xatruin carb. Nate. 

mur. N. vom. Petr. Phosphor. Puis. 

PJius. Selen. Sep. Sil. SjAg. Stann. 

Sulph. 

Positions in Sleep. 

ARMSABOYE THE HEAD : 
Calc. c. N. vom. Plat. Puis. Ye- 
ratr. 

ON THE STOMACH: Bell. Coc- 
cul. Ign. Stram. 

LEGS STRETCHED : Bellad. 
Cham. Puis. 

—drawn up: Carbo veg. Cham. Plat. 
Puis. 



only one : Stann. 

HAND UNDER THE OCCIPUT: 

Ign. 
— under the head: Antim. tart. Ars. 

N. vom. Pulsat. Spigel. Viol. od. 
BOTH HANDS UNDER THE OC- 
CIPUT: Ambr. 
KNEES SPREAD : Cham. M. arct. 

Plat. Viol. od. 
HEAD DRAWN BACK : Bell. Cina. 

Hell. Hyosc. Ign. 
— inclined forward : Cic. Puis. Staph. 

Viol. od. 
— stooping: Arn. Spong. 
— toward the back : Ambr. Ant. tart. 

Ars. Bry. Calc. c. China. Cic. Ferr. 

Ign. Lye. Nux vom. Phosph. Puis. 

Rhus. Stram. Sulph. 
— on one side: Par. Merc. Natr. 

Nux vom. Phosph. Spigel. Sulph. 
— to left side: Lye. Natr. carb. 

Phosph. 
— to right side : Merc. Phosph. 
SITTING: Aeon. Ars. Lye. Puis. 

Sulph. 



SLEEP, with nightmare : Calcar. 

Caust. Puis. Sulph. 
—with starting up : Ars. Bell. Cham. 

Cina. Coff. Graphit. Ign. Ipecac. 

Kali. Lyeop. Op. Samb. Sulph. 
— with screaming : Antim. tart. Bell. 

Cham. Rheum. Zinc. 
— with eyes half open : Cin. Ipec. Op. 
— stupid: Ant. tart. Bell. Calad. 

Calc. c. Camphor. Cic. Con. Croc. 

Graph. Ign. Led. N. moseh. Nux 

vom. Op. Phosph. Puis. See. corn. 

Spig. Valer. 
— with throwing off the cover: Cham. 

Con. Puis. 
— sound : Ant. crud. Antim. tart. Ars. 

Bell. Camph. Cic. Croc. Ign. Led. 

Mosch. N. mosch. Op. Phosphor. 

ac. Puis. Sec. corn. Selen. Stram. 

Yeratr. 
— with grasping at flocks : Ant. tart. 

Ars. Hyosc. 



130 



SLEEP, DREAMS. 



-early : Anac. Ant. tart. Asa f . Calc. 

Canst. Con. Croc. Graph. Ignat. 

Kali. Laur. Lye. Mere. Natr. N. 

Yom. Phosphor. Phosph. ac.Puls. 

Sep. Sil. Sulph. Veratr. 
-settling down in bed : Muriat. acid, 
-tossing abont : Arsen. Bell. Cham. 

Cin. Hep. Ladies. Rheum. Ehus. 
-too long : Am. Bellad. Calc. Carbo 

veget. Coccnl. Hyosc. Kali. Ign. 

Merc. N. vom. Phos. Phosph. ac. 

Plat. Sep. Verat. 

-too light: Anac. Ars. Bry. Carbo 

veg. Chin. Ferr. Ignat. Merc. N. 

vom. 01. an. Selen. Sil. 
-with openmouth : Cin. Merc. Ehus. 
-with somnambulism : Bryon. Phos. 

Sulph. 
-with talking: Alum. Arnica. Bell. 

Carbo an. Cham. Magn. c. Nux 

vom. Puis. Rhus. Sil. Sulph. 
-slumber-like : Graph. 
-with snoring: Camph. Cham. Chin. 

Dulc. Fluor, ac. Graph. Hep. Op. 

Sil. Sulph. Stram. 
-loud talking : N. vom. 
-with moaning : Alum. Cham. Ign. 

Merc. Op. 

-with involuntary stool : Arnic. 
-unrefreshing : Aeon. Alum. Ambr. 

Ant. tart. Bellad. Bry. Calc. Cann. 

Carbo veg. Caust. Chel. Chin. Cic. 

Con. Croc. Ferr. Graph. Hep. Ign. 

Kali. Lach. Lye. Magn. mur. Merc. 

Natr. Natr. mur. Nitric ac. N. vom. 

Op. Petr. Phosph. Phosph. acid. 

Puis. Ehus. Secale corn. Selen. Sil. 

Spigel. Staphys. Sulph. Viola trie, 
-restless: Agn. Alum. Antim. tart. 

Ars. Asa f . Aur Bar. Bell. Bor. Bry. 

Calc. Cane. Cann. Caustic. Cina. 

Cham. China. Coccul. Coff. Coloc. 

Creos. Daph. Dig. Dulcani. Ferr. 

Graph. Hep. Ign. Kali. Lach. Lye. 

Mang. Merc. Mosch. Mur. ac. Natr. 

Nitric ac. Nux vom. Petr. Phosph. 

Puis. Eat. Eheum. Ehod. Rhus. Sa- 



bad. Sec. corn. Sep. Sil. Sulphur. 

Tereb. Thuj. Veratr. Yiola tr. 
— interrupted : Ars. Gina. Cocc. Ign. 

Kali. Merc. Pulsat. PJius. Sulph. 
SLEEPLESSNESS: Aeon. Ambra. 

Anac. Ars. Bar. Bell. Bry. Calc. c 

Camph. Cann. Caust. Cham. Chin. 

Cin. Coff. Con. Creos. Daph. Dig. 

Dulc. Ferr. Fluor, ac. Graph. Hep. 

Hydr. ac. Hyosc. Ign. Kali. Lach. 

Led. Lycop. Merc. Mosch. Natr. 

Nux vom. Op. Oleancl. Phosphor. 

Puis. Ehod. Rhus. Sangn. Selen. 

Sep. Sil. Squill. SuljjJt. Sulph. ac. 

Thuj. Yaler. Verat. Vine. 
— before midnight : Ars. Bellad. Bry. 

Calc. c. Carbo anim. Carbo veget. 

Chin. Con. Cycl. Graphit. Ign. 

Kali. Laches. Lye. Merc. Natr. Ni- 
tric acid. Phosphor. Pulsat. Rhus. 

Selen. Sep. Sil. Spig. Staph. Sulph. 

Voter. 
— after midnight : Ars. Asa feet. Aur. 

Capsic. Coffea. Hep. Hyosc. Kali. 

Lach. Lye. Merc. Natrum. Nitric 

ac. Nux vom. Plat. Pulsat. Bhodod. 

Rhus. Samb. Sep. Sil. Sulph. ac.Thuj. 
SOPOE: Agn. Ant. crud. Ant. tart. 

Am. BsbT.Bell. Brom. Camph. Cic. 

Con. Croc. Graphit. Hell. Ign. Kali. 

Lact.Laur. Merc. Mosch. N. mosch. 

Op. Phosph. ac. Plumb. Puis. Sec. 

corn. Veratr. Vit. 
WAKING, too early: Ars. Asa feet. 

Bryon. Calc. c. Coff. Croc. Dulc. 

Hep. Ign. Kali. Lye. Magn. Mur. 

ac. Natr. carbon. N. vom. Phosph. 

ac. Ban. bulb. Ehod. Sep. Sil. 
— frequent: Ambra. Ant. crud. Arn. 

Ars. Bell. Bism. Calc. c. Cann. Car- 
bo anim. Caust. Cham. Chin. Cic. 

Coff. Dig. Fluor, ac. Graph. Hep. 

Kali. Lye. Mang. Merc. Nitric ac. 

Nux vom. Phell. Phosph. Pulsat. 

Bhus. Euta. Samb. Selen. Sep. Sil. 

Staph. Sulphur. Sulph. ac. Tereb, 

Teucrium. Zinc. 



SLEEP, DREAMS. 



131 



— difficult: Antim. tart. Con, Nitric 

ac. Op. Khus. 
— too late : Am. Calc. Caustic. China. 

Con. Graph. Kali. Lack. Laur. 

Merc. Natr. carb. Nux vom. Olean. 

Phosph. Phosph. ac. JPulsat. Sep. 

Sil. Sulph. 
YAWNING: Ant. tart. Ars. Bellad. 

Br} . Calc. c. Caust. Chamom. Cin. 

Coccul. Creos. Croc. Ferr. Hell. 

Ign. Kali. Laur. Lye. Mur. ac. 

Natr. Natr. mur. N. vom. Op. Phos. 

Pus, Rhus. Sep. Sil. Stann. Staph. 

Sulph. Veratr. 
— with stretching: Ars. Calc.c. Caust. 

Cham. Ign. Ipec. Nux vom. Puis. 

Rhus. Spongia. Staph. Valer. 
— spasmodic : Ign. Plat. Rhus. 

Dreams. 
IN GENERAL: Aeon. Alum. Am- 

bra. Ant. tart. Arn. Bellad. Brij. 

Calc. Caps. Carbo veget. Cham. 

Chin. Cic. Con. Croc. Graph. Hell. 

Hep. Tgnat. Kali. Lach. Laur. Lye. 

M. arct. Magn. Mang. Merc. Na- 

trnm. Natr. mur. Nitric ac. N. vom. 

Op. Par. Phosphor. Phos. ac. Puis. 

Ran. sc. Rlius. Sabad. Sec. corn. 

Sep. Sil. Stann. Staph. Stram. 

Sulph. Thuj. Valer. Vit. 
ANXIOUS : Aeon. Ambr. Anac. Arn. 

Ars. Aur. Bar. Bellad. Calc. c. 

Cann. Carbo veg. Caust. Chamom. 

Chin. Con. Creos. Fluor, acid. 

Graphit. Hep. Iod. Ign. Kali. Lye. 

Mann. carb. Merc. Natr. Natrum 

mur. N. vom. Op. Phosph. Psor. 

Puis. Ehus. Sassap. Sep. Strain. 

Sulphur. Teucr. Thuj. Veratr. 
DREAMS, of thieves: Aur. Magn. m. 

M re. Veratr. 
— of falling: Bell. Digit. Ignat. Merc. 

Phosph. ac. Thuj. 

into water: Ferr. Magn. c. 

— of fire: Alum. Anac. Antim. tart. 



Calc. carb. Hep. Plagn. Magn. mur. 

Phos. Rhus. Spiff. 
— of war: Hyosc. Magn. carb. Thuj. 
— of animals : Arn. Hyosc. Nux vom. 
— of wild animals : Nux vom. 
— of death: Coccul. Kali carb. Nux 

vom. Plat. 
— of dead bodies: Anac. Ars. Aur. 

Brom. Calc. c. Graphit. Iod. Kali. 

Magn. carb. Phos. ac. Sulph. ac. 

Thuj. 
— of ijoisoning: Natr. mur. 
— of imprisonment : Clem. 
— of dead persons : Natr. carb. Sulph. 

acid. 
— of water : Amm. mur. Arsen. Ferr. 

Graphit. Ign. Magn. carb. Merc. 

Natr. Nitr. Sil. 
— of quarreling: A rn. Calcar. Cham. 

Magn. carb. N. vom. Phosph. Puis. 

Selen. Stann. 
— vexing: Ambra. Ars. Asar. Caust. 

Cham. Con. Hep. Ign. Natr. Nux 

vom. Phell. Phosph. Rhus. Staph. 

Sulph. 
— pleasant : Agar. Alum. Ant. crud. 

Calc. c. Carbo veget. Coccul. Cojf. 

Croc. Graphit. Ignat. Kali. Lach. 

Mercur. .Natr. Natr. mur. Nux vom. 

Op. Phosph. Puis. Sep. Sil. Staph. 

Sulph. Viol. tr. 
— of flowers : Natr. c. 
— of fine country : Ol. an. 
— of gold : Cycl. Magn. c. 
— of journeys: Crot. Lach. Magn. 

carb. Op. 
— of dancing: Magn. carb. 
— continued : Calc. carb. Ign. Natr. c. 

Puis. 
— nauseous: Amm. carb. Natr. mur. 

Zinc. 
— that can be remembered: Bellad. 

Natr. mur. Phosph. 
—frightful : Calcar. c. China. Graph. 

Kali. Lye. Nux vom. Op. Phosph. 

Puis. 
— lascivious : Antim. crud. Calc. c. 

Canih. Chel. Con. Graphit. Ignat. 



132 



GENERAL SYMPTOMS. 



Kali. Lack. Lye. Merc. Natr. Natr. 
mur. Nux vom. Oleand. Op. Plat. 
Plumbum. Puis. Sep. Staph. Thuj. 
Vine. Viol. tr. 

-indifferent: Chin. Ign. Nux vom. 
Puis. Stront. Sulph. 
-half-awake: Op. 

-vivid : Anac. Arn. Ars. r Bell. Calc. c 
Canthar. Cham. Cic. Coffea. Con. 
Fluor, ac. Ignat. Lach. Lye. Magn. 
carb. Mang. Merc. Natr. Natrum 
mur. Petr. Phosphor. Pulsat. Ehus. 
Buta. Sil. Squill. Sulph. 
-merry : Caust. Laur. Op. 
-fanciful : Calc. c. Kali. Lach. Natr. 
Nitric ac. 



— wandering : Calc. c. Kali. Lye. Natr. 
Natr. mur. Nux vom. Sulph. 

— sad: Ign. Laur. Natr. c. Op. Phos. 

Zinc. 
— that cannot be remembered: Aur. 

Bellad. Cic. Hell. Ign. Iod. Lach. 

Lye. Merc. Natr. Natr. mur. 01. an. 

Plat. Bhus. Samb. Selen. Spig. 

Sulph. Tar. Veratr. 
— confused: Bar. Calc. c. Chin. Cic. 

Crot. Hell. Led. M. austr. Natr. 

Petr. Phos. Puis. Spig. Stann. 
— wakeful: Aeon. Am. Bell. Cham. 

Lach. Merc. Nux vom. Op. Phos. 

ac. Stram. 



XXI GENERAL SYMPTOMS. 

(All the pains which belong exclusively or mor 3 particularly to a certain part should be looked 

for under that head.) 



AGGBAVATION, in the afternoon: 

Agar. Alum. Ant. crud. Asaf. Bell. 

Bism. Calc. Canth. Carbo veget. 

Caustic. Cic. Coccul. Coloc. Con. 

Creos. Ferr. Hell. Ign. Lach. Laur. 

Lye. Mosch. Nitr. Nitric ac. Nux 

vom. Op. Phosph. Puis. Kuta. 

Selen. Seneg. Sil. Spig. Staph. 

Teucr. Thuj. Veratr. Zinc. 
— in the open air: Agar. Ambr. Arn. 

Bar. Calc. Camph. Carb. an. Cham. 

Chin. Coccul. Coff. Ferr. Guaj. 

Ign. Lach. Lye. M. austr. Mur. ac. 

Natr. Nitric ac. N. mosch. N. vom. 

Op. Phosph. ac. Bhus. Selen. Sil. 

Spig. Staph. Stram. Sulph. ac. 

Thuj. Viol. tr. 
— when alone : Ars. Kali. Lye. Stram. 
— before breakfast : Amm. mur. Bar. 

Calc. Cann. Caustic. Croc. Ferr. 

Ign. Iod. Kali. Laches. Lye. Nux 

vom. Plat. Plumb. Bhus. Sabad. 

Spig el. Staph. Valer. Verb. 
— by changing one's position : Caps. 



Carbo veg. Ferr. Lach. Lycopod. 

Phosph. Puis. Bhus. 
— when chewing : Alum. Amm. Amm. 

mur. Bell. Bry. Calc. China. Euphr. 

Hep. Ignat. Mang. Men. Natr mur. 

Nitric ac. Oleand. Phosph. Phosph. 

ac. Puis. Rhus. Sabin. Sep. Staph. 

Sulph. ac. Thuj. Zinc. 
— in the cold : Aco. Amm. Arn. Arg. 

Ars. Aur. Bar. Bellad. Camph. 

Carbo veg. Caust. Cic. Con. Dulc. 

Graph. Hell. Hep. Hyoscyam. Ign. 

Kali. Magn. Magn. muriat. Mosch. 

Nux vom. Petr. Phos. Bhod. Bhus. 

Sabad. Sep. Sil. Spong. Squill. 

Stront. Sulphur, ac. Veratr. 
—in company : Bar. Hell. Lye. Natr. 

Phospji. Plumbum. Sep. Stann. 
— by contact: Aeon. Aug. Arn. Ars. 

Bell. Bov. Bry. Cann. Carbo veg. 

Cham. Chel. Cin. Coccul. Colch. 

Cupr. Ferrum. Graph. Hell. Hep. 

Hyosc. Led. Lye. Magn. mur. Merc. 

Mezer. Nitric ac. Nux vom. Oleand. 



GENERAL SYMPTOMS. 



133 



Phosph. acid. Pulsat. Kan. bulb. 
Bhodod. Rhus. Sabin. Sec. corn. 
Sep. Sil. Spig. Staph. Stram. Sulph. 
Tart. emet. Yeratr. 
— gentle contact: Bell. China. Nux 

VOIU. 

— by crying: Am. Bell. Cham. Cupr. 

Lach. Puis. Yeratr. 
— by a draught of air : Bellad. Calc. 
Cham. Chin. Hep. Ign. Kali. Led. 
Natr. Nux vom. Puis. Rhus. Selen. 
Sep. Silic. Sulph. 
— drinking coffee : Canth. Caustic. 
Cham. Coccul. Ign. Lye. Merc. Nux 
VOm. Pulsat. Rhus. Sulph. 

cold liquids: Ant. crud. Ars. 

Caustic. Con. Graph. Ign. Lye. 

Mang. Merc. Nux mosch. Nux 

Yom. Rhod. Rhus. Sulph.Jera.tr. 

— after chinking: Ars. Bry. Cham. 

China. Coccul. Coloc. Con. Croc. 

Dros. Ferr. Hep. Ign. Merc. Mezer. 

Natr. Natr. mur. Nux vom. Pu's. 

Rhus. Ruta. Squill/Sep. Sil. Sulph. 

Tart. emet. Yeratr. 

— while drinking: Anac. Arsen. Bell. 

Bry. Canth. Colch. Hijosc. Ign. 

Iod. Lach. Mercur. Phosph. Rhus. 

Sep. Sulph. Stram. 

— drinking beer: Ferr. Lye. N. vom. 

Puis. Bhus. Stram. Sulph. Yerat. 
— drinking tea : Ferr. Selen. 

warm liquids : Ambr. Anac. Bell. 

Bryon. Carbo vcg. Cham. Hell. 
Kali. Mezer. Phosphor. Pulsat. 
Spig. Sulph. ac. 

cold water : Arsen. Bell. Canth. 

Croc. Ign. Lye. Natrum. N. vom. 
Phos. ac. Rhod. Bhus. Sulph. 
Sulph. ac. Yeratrum. 

wine : Ant. crud. Ars. Calc. Coff. 

Lach. Lye. Natr. Natr. mur. Nux 
yom. Op. Ban. bulb. Selen. Sil. 
Zinc. 

vinegar: Ant. crud. Ars. Ferr. 

Lach. Nux vom. Sulph. 
— before eating: Ambr. Calc. Chel. 



Croc. Ferr. Graph. Ign. Iod. Kali. 
Lach. Laur. Natr. Phosph. Plumb. 
Puis. Rhus. Sabad. Sulph. 
while eating : Amm. Ars. Bar. Bry. 
Calc. Carbo an. Carbo veg. Cham. 
Coccul. Graph. Hep. Kali. Lach. 
Lycop. M. arct. Natr. Natr. mur. 
Nitric ac. Phosph. Puis. Rhod. Sep. 
Thuj. Yeratr. 
— after eating : Amnion, mur. Anac. 
Ars. Asa f. Bryon. Calc. Carb. veg. 
Caust. Cham. China. Con. Graph. 
Hyosc. Iod. Kali. Lycopod. Merc. 
Mur. ac. Natr. Natrum mur. Ni- 
tric acid. Nux vom. Posph. Pulsat. 
Rhus. Sep. Sil. Sulph. Sulph. ac. 
Yeratrum. Zinc. 
— by eating bread: Bry. China. Kali. 
Natrum mur. Nux vom. Puis. Rhus.- 
Sep. Staphysag. Sulph. Zinc. 

eggs : Ferr. 

fat : Ars. Carbo veget. Cycl. 

Ferr. Hell. Magn. mur. Nitric 
ac. N. vom. Pulsat. Sep. Sulph. 
Tar. Thuj. 

fish : Kali. Plumb. 

smoked meat : Calc. Sil. 

— ■ — vegetables : Ars. Bryon. Hell. 
Lye. Natr. Puis. Yerat. 

honey: Natr. 

peas and beans : Bry. Calc. Lye. 

Natr. mur. Petr. Puis. 

meat : Carb. an. Ferr. Puis. 

Staph. Sulph. 

oysters : Lye. 

pastry : Carbo veg. Puis. 

roots : Calc. Lye. Puis. 

onions : Natr. Thuj. 

potatoes : Yeratr. 

farinaceous food : Sulph. 

milk: Ambr. Arsen. Bryon. 

Calc Cham. China. Con. Ign. 
Kali. Lye Natr. Natr. mur. Nilr. 
ac. N. vom. Samb. Sep. Spong. 
Sulph. 

fruit : Arsen. Bry. Carbo veg 

Chin. Magn. mur. Puis. Rhod. 
Selen. Veratr. 



134 



6SSNERAL SYMPTOMS. 



— — turnips: Puis. 

salt food : Carbo veg. Lye. 

sour food: Ant. crad. Ars. Ferr. 

Natr. Nux vom. Sep. Sulph. 

sweet : Cham. Ignat. Natr. Merc. 

— by eructations: Cann. Chamom. 

Coccul. Kali. Laches. Phosph. 

Plumb. Rhus. Sabin. Sep. 
— in the evening: Ambr. Amm. Ant. 

crud. Arn. Ars. Asa f. Bell. Bry. 

Calad. Calcar. Caps. Carbo veg. 

Caust. Coff. Colch. Croc. Dulcam. 

Euphr. Ferr. Hell. Hyosc. Ignat. 

Iod. Lacli. Lycop. M. austr. Magn. 

Men. Merc. Nitr. ac. "Petr. Phosph. 

Plat. Puis. Ran. sc. Khod. Rhus. 

Selen. Sep. Sil. Sulphur. Sulph. ac. 

Tart. emet. Tlruj. Zinc. 
— during expirations: Bry. Caustic. 

Colonic. Dig. Ign. Iod. Oleancl. 

Puis. Sep. Spigel. Veratr. Viol. od. 
— in the fall : Chin. Colchicum. Rhus. 

Veratr. 

— in a feather-bed : Aur. Coloc. 
Lycopod. Mang. Merc. Pulsat. 
Rims. Sulph. 

— in the forenoon: Alum. Ambra. 

Ant. cruel. Argent. Bar. Calc. 

Cann. Carb. vegetab. Caust. Coc- 
cul. Con. Euphorb. Ferr. Graph. 

Guaj. Hep. Ign. Kali. Laur. Lye. 

Magn. mur. Mang. Nux mosch. 

Nux vom. Phosph. Phosph. ac. 

Puis. Rhus. Sabacl. Selen. Sepiae. 

Sil. Spig. Staph. Sulphur. Sulph. 

ac. Viol. tr. 
— when hungry: Aur. Graphit. Iod. 

Kali. 

inspiration : Aconit. Anac. Arn. 

Bry. Calc. Chamon. Croc. Guaj. 
Hyosc. Ipec. Lye. Merc. Mosch. 
Oleand. Rhus. Sabad. Sabina. 
Selen. Squill. Spong. Sulph. 
— by laughing : Ars. Bell. Bor. Carbo 

veg. Chin. Con. Nux vom. Phosph. 

Stann. 



— in bright light : Ant. crudum. Bell, 
Calc. Cham. China. Coffea. Con. 
Croc. Euphr. Graph. Hep. Ign. 
Lye. Magn. mur. Merc. Natr. Nux 
vom. Phosphor. Phosph. ac. Pul- 
sat. Rhus. Sep. Sil. Spig. Strain. 
Sulph. 

-when looking in the bright light : 
Bry. Bell. Calc. Kali. Merc. Phosph. 
Zinc. 

down : Calc. Spig. 

up: Calc. Graphit. Puis. Selen. 

Sil. Thuj. 

sidewise : Bell. 

lying down : Ambra. Amm. mur. 

Ars. Asa f . Aur. Aur. mur. Bry. 

Canth. Caps. Chamom. Coloc. 

Conium. Croc. Dros. Dulc. Ferr. 

Ig-n. Kali. Lye. Magn. mur. Men. 

Mur. ac. Natr. Op. Phos. ac. 

Plat. Puis. Rhod. Rhus. Samb. 

Selen. Sepise. Stann. Stront. 

Sulph. Tar. Tart. emet. Teucr. 
in bed : Alum. Ambr. Ant. crud. 

Ars. Aur. Bellad. Bor. Calc. 

Carbo veg. Cham. Chin. Cina. 

Coff. Coloc. Dros. Ferr. Graph. 

Ign. Iod. Kali. Led. Lycop. 

Magn. Mang. Merc. Mur. ac. 

Nitric ac. Nux vom. Phosph. 

Plat. Puis. Rhod. Rhus. Samb. 

Sec. corn. Selen. Sep. Sil. Spig. 

Sulphur. Tart. emet. Veratr. 

Viol. od. 
on the back : Ars. Canth. Caust. 

Cham. Chin. Cuprum. Ign. Iod. 

Kali. Lach. Mercur. N. vom. 

Phos. Puis. Rhus. Sep. Sulph. 

Thuj. 
on the side : Aeon. Anac. Arn. 

Bry. Calad. Calc. Carbo an. 

Con. Ferr. Ign. Kali. Lye. Merc. 

N. vom. Puis. Seneg. Stann. 

Sulph. Viol.tr. 
on the painful side : Aeon. Arn. 

Ars. Bar. Calad. Caustic. Chin. 

Graph. Hep. Iod. Kali. Lye. 



GENERAL STilPTOMS. 



135 



Magn. Nitr. ac. N. mosch. N. 

vom. Phosphor. PJiosph. ac. 

Rata. Selen. SiL Spong. Thuj. 
- — on the painless side: Ambr. 

Ara. Bry. Calcar. Caustic. 

Cham. Coloc. Ignat. Kali. M. 

austr. Puis. Elms. Stann. 
-after lying down in the evening : 
Ambr. Amm. Ars. Aur. Caustic. 
Cham. Coff. Dros. Bale. Ferr. 
Hyosc. Ign. Kali. Lye. Magn. 
Magn. mur. Nitric ac. Plat. Plumb. 
Puis. Rhus. Samb. Seneg. Sepice. 
Stront. Sulph. Tar. einet. Veratr. 
Tiol. od. 

-at new-moon : Calc. Caustic. Cupr. 
Lye. Sep. SiL 

-at full-moon: Calc. Graph. Natr. 
Sil. Sulph. 

-in the morning: Aeon. Ambr. 
Amm. mur. Ant. crud. Aur. Calad. 
Calc. Carb. an. Carb. veg. Chel. Cic. 
Coccul. Coffea. Con. Croc. Dulcam, 
Euphr. Graph. Hep. Hyosc. Ign. 
Iod. Kali. Lye. M. austr. Natr. 
Natr. mur. Nitr. Nitric ac. N. vom. 
Op. Petr. Phospli. Phosph. ac. 
Rheum. Bhodod. Rhus. Selen. Sep. 
Squill. Staph. Sulphur. Tar. Tart. 
emet. Veratr. 

-during motion: Anac. Am. Asar. 
Bell. Bry. Camphor. Carb. veg. 
Chel. Coccul Colchic. Croc. Graph. 
Hell. Hep. Iod. Led. M. austr. 
Mercur. Natr. Natr. mur. Nitric 
ac. N. vom. Petr. Phosphor. Bhod. 
Ehus. Sabad. Sec. corn. Selen. 
Squill. Spng. Spongia. Staph. 
Sulph. ac. 

-at the beginning of motion: taps. 
Caust. Con. Ferrum. Lye. Phospli. 
Puis. Rhus. Samb. 
at night: Aeon. Ambr. Ang. Ant. 
crud. Am. Arsen. Aur. Bell. Bry. 
Calc. Camph. Canth. Caps. Carbo 
an. Caust. Cham. Chin. Coff. Colch. 
Con. Croc. Cupr. Dulcam. Ferr. 



Graph. Hell. Hep. Ign. Iod. Kali. 

Lach. Lycop. Magn. Magn. mur. 

Mang. Merc. Mezer. Natr. mur. Ni- 
tric ac. Nux vom. Op. Phosphor. 

Plumb. Samb. Secale corn. Selen. 

Sil. Staphys. Stront. Sulph. Tar. 

emet. Thuj. 
—when nursing : Aeon. Bell. Bryon. 

Calcar. Cham. China. Con. Dale. 

Kali. Merc. Phos. ac. Pulsat. Ehus. 

Sep. Sil. Staph. Sulph. 
—by suppressed perspiration : Bell. 

Bryon. Calc. Cham. Chin. Dulc. 

Kali. Lye. Merc. Nux vom. Oleand. 

Phosphor. Phosph. ac. Bhus. Sec. 

corn. Sep. Sil. Sulph. 
— by external pressure : Agar. Ang. 

Ant. crud. Bar. Bry. Cann. Carbo 

veg. Cina. Cupr. Hepar. Ign. Iod. 

Lach. Lye. Mosch. Natrum mur. 

Oleand. Plat. Buta. Sabin. Selen. 

S2p. Sil. Spong. Staph. Stramon. 

Sulph. Verb. 
— raising the trunk : Aeon. Am. Ars. 

Bell. Bry. Cham. China, t ic. Con. 

Ferr. Ignat. Mur. ac. N. vom. Op. 

Phosph. Puis. Rhus. Squill. Spong. 

Sulph. Sulph. ac. 
— by reading : Asa f . Bar. Bell. Calc. 

Chin. Coff. Con. Croc. Graph. Ign. 

Kali. Lye. Natr. Natr. mur. Nux 

vom. Phos. Sil. Sulph. Sulph. ac. 

Vit. 
—during rest : Arsen. Asa feet. Aur. 

Calc. Caps. Chin. Coloc. Con. Dul- 
cam. Euphorb. Ferr. Ignat. Kali. 

Lach. Lye. Mosch. Natrum. Nitr. 

Oleand. Op. Phosphor, ac. Plat. 

Puis. Rhod. Rhus. Sabad. Samb. 

Selen. Sep. Stannum. Stront. Tar. 

Thuj. Valer. Yeratrum. Viol. tr. 
—when rising from a seat : Bell. Bry. 

Calcar. Caps. Carbo veget. Cham. 

Coccul. Con. Ferr. Graph. Ign. 

Laches. Laur. Lye. Natr. mur. 

Nux vom. Phos. Pulsat. Rhus. 

Selen. Spig. Tart. emet. Thuj. 



136 



GENERAL SYMPTOMS. 



-in the room: Aeon. Alumina. 
Anac. Ant. crud. Asa feet. Asar. 
Calc. Carbo veget. Cic. Con. Croc. 
Graph. Hell. Iod. Lye. Magn. 
Mezer. Natrum mur. Phosph. 
Plumb. Puis. Ban. sc. Lhodod. 
Sabina. Selen. Spong. Stann. Ve- 
ratr. Vit. 

-by running : Arn. Ars. Bell. Bry. 
Canst. Ign. Led. Natr. mur. N. 
vom. Oleand. Sil. Sulph. 
-by sexual intercourse : Calad. Kali. 
Selen. 

-after sexual intercourse : Agar. 
Calad. Calc. Chin. Kali. Natr. Petr. 
Phos. ac. Selen. Sep. Staph, 
-when sitting: Agar. Ambr. Ant. 
erud. Asa f. Aur. Bar. Calc. Caps. 
Chin. Cina. Con*. Con. Cuprum. 
Cycl. Dulc. Euphorb. Graph. 
Ignat. Iod. Lach. Lye. M. arct. 
Magn. mur. Muriat. ac. Natr. Ni- 
tric ac. Oleand. Phosph. ac. Pla- 
tina. Puis. Ehod. Rhus. Sabad. 
Seneg. Sep. Spong. Sulph. ac. 
Tar. Thuj. Veratrum. Verb. 
Viol. tr. 

-smoking tobacco : Ant. crud. Calc. 
China. Euphr. Ignat. Lach. Nux 
vom. Puis. Ehus. Euta. Selen. 
Spong. Staph. 

-in the spring : Ambr. Bellad. Calc. 
Carbo veg. Lye. Natr. mur. Puis. 
Ehus. Sulph. Yeratrum. 
-when standing: Alum. Aur. Cal- 
car. Cann. Caustic. Coloc. Con. 
Cycl. Euphr. Ferrum. Graph. Ign. 
Laur. Lye. Magn. mur. Mosch. 
Natr. Oleander. Op. Phosph. ac. 
Puis. Ehod. Rhus. Samb. Sep. 
Staphys. Sulph. Tar. Valer. Ye- 
rati'. 

-when stooping: Aco. Amm. Arn. 
Bar. Bry. Calc. Caps. Cham. Coc- 
cul. Croc. Graph. Hep. Ipec. Kali. 
Mang. Mercur. Nitr. Oleander. 
Petr. Plumb. Ehod. Seneg. Sep. 



Sil. Spigel, Stront. Teucr. Thuj. 

Valer. 
— in the summer : Antim. crud. Bell. 

Bry. Carbo yeget. Lach. Lye. Natr. 

Natr. mur. Puis. Selen. Yeratr. 
— in the sun : Antim. erud. Camphor. 

Euphr. Graphit. Ipecac. Lach. 

Natr. Pulsat. Selen. 
— after suppressed catarrh: Bry. 

Calc. Carbo veg. Chin. Con. Dulc. 

Graph. Ipec. Lye. Merc. Natr. mur. 

Nitric ac. Nux yom. Phosph. Puis. 

Ehod. Sep. Sil. Sulph. Sulph. ac. 
— when swallowing : Aeon. Ars. Bar. 

Bell. Bry. Camph. Chin. Coccul. 

CofFea. Croc. Hep. Hyosc. Kali. 

Magn. Merc. Nitric acid. Nux vom. 

Petr. Phos. Puis. Ehus. Sassap. 

Sep. Spig. Staph. Thuj. Yeratrum. 
—after swallowing : Ambr. Bry. 

Cham. Hep. Ign. Iod. Nitric ac. 

N. vom. Phos. Pulsat. Ehus. Zinc. 
— between the acts of swallowing: 

Ambra. Arn. Graphit. Ign. Lach. 

Laur. Merc. Nux vom. Phosph. ac. 

Sabin. Spong. Stann. Staph. 
— when sweating: Aeon. Arsen. Bry. 

Caust. Cham. Cocc. Dig. Ferr. Ign. 

Ipec. Lycop. Merc. Natr. Nux vom. 

Op. Phosph. Pulsat. Rhus. Selen. 

Sep. Stram. Sulph. Tart. em. Thuj. 

Yeratr. 
— when talking: Ambr. Arnica. Bell. 

Calc. Cann. Cham. Chin. Coccul. 

Dig. Dulc. Graph. Ign. Iod. Lye. 

Mang. Merc. Natrum. Natr. mur. 

Phosph. Phosph. ac. Rhus. Selen. 

Sep. Sulph. 
— during a thunder-storm : Lach. Na- 
trum. Phosph. Ehod. Sil. 
— after uncovering one's self: Ant. 

crud. Ars. Aur. Bell. Cham. China. 

Cic. Clem. Colchic. Graph. Hep. 

Hyosc. Ign. Lach. Natr. Natr. mur. 

Nux mosch. Nux vom. Puis. Ehod. 

Rhus. Samb. Sil. Stram. Stront. 



GENERAL SYMPTOMS. 



137 



— from vomiting: Ars. Asar. Bryon. 

Cupr. Ipec. Nux vom. Plumb. Puis. 

Sep. Sil. Sulphur. Veratr. 
— on waking: Ambra. Amm. mur. 

Am. Ars. Bryon. Calad. Calc. Car- 
bo veg. Caust. Chin. Coccul. Digit. 

(iraphtt. Ilepar. Ign. Kali. Magn. 

mur. Merc. Natr. Natr. mur. Nitric 

acid. Nux vom. Phosphor. Pulsat. 

Rhus. Sabin. Samb. Sep ice. Staph. 

Stront. Sulph. 
—walking fast : Am. Ars. Bell." Bry. 

Caust. Cupr. Led. Lye. Nux vom. 

Oleander. Khus. Silic. Spig. Squill 

Sulph. 
— when walking out into the cold air : 

Ars. Caust. Mosch. Xux vom. Ban. 

bulb. Sabad. 
— in warmth : Ambr. Ant. crud.TSell. 

Calad. Garb. veg. Cham. Coc. Dros. 

Graph. Ign. Iod. Ipec. Lach. Led. 

Lye. Merc. Natr. mur. Nux mosch. 

Op. Phosph. ac. Pulsat. Bhus. Sec. 

corn. Selen. Senega. Sep. Staph. 

Tart. emet. Thuj. 
—by watching : Ambra. Coccul. Merc. 

N. vom. Puis. Selen. Sep. 
— after getting wet : Ars. Bell. Bry. 

Calc. Colch. Dulcam. Ipec. Lye. 

N. mosch. Pulsat. Rhus. Sec. corn. 

Sep. Sulph. 
— by a change of weather : Amnion. 

Bry. Calc. Dulc. Graphit. Mang. 

Nux mosch. Phosph. Puis. Bhod. 

Rhus. Sep. Sil. Sulph. 
— damp weather: Amnion. Aur. Calc. 

Carbo veg. Chin. Dulc. Ferr. Lach. 

Laur. I/tfC. Merc. Muriat. ac. Nitric 

ac. Nux mosch. Puis. Bhod. Rhus. 

Rata. Seneg. Spig. Sta.ph.ys. Sulph. 

Veratr. 
— in stormy weather : Arsenic. Cham. 

Lach. Lye. Mur. ac. Natr. N. mosch. 

Xux vom. Phos. Puis. Rhod. Bhus. 

Spig. Sulph. 
— in dry weather : Asar. Bellad. Bry. 

Carbo veg. Caustic. Cham. Hep. 

57 



Ipec. Mur. ac. Nitric ac. Nux vom. 

Phosph. Sabad. Sil. Spong. 
— by wet : Amm. Ant. crud. Bellad. 

Calc. Canth. Carbo veg. Clem. Dulc. 

Lye. Merc. Nitric ac. Nux vom. 

Phosph. Puis. Rhus. Sep. Sil. Spig. 

Staph. Stront. Sulph. 
— in winter: Aeon. Ars. Aur. Bar. 

Bell. Bry. Caust. Cham. Coccul. 

Con. Dulcam. Hell. Hep. Ign. Kali. 

Lye. Merc. Nux mosch. Nux vom. 

Puis. Khod. Rhus. Sep. Sulphur. 

Veratr. 
— when writing : Anac. Asa f. Calc. 

Carbo veget. Coccul. Grajm. Ign. 

Kali. Lye. Natr. Xatr. mur. Xux 

vom. Phosph. Kuta. Sil. Spong. 

Zinc. 

Amelioration of the 

Pains. 

IN THE OPEN AIB: Alum. Anac. 

Asa f. Aur. Bar. Cann. Carbo veg. 

Con. Croc. Graph. Hell. Ign. Lod. 

Kali. Lycop. Magn. Mezer. Natr. 

Phosph. Plat. Puis. Sabin. Selen. 

Sepise. Spong. Stront. Sulph. Ve- 
ratr. Yit. 
BY BORING INTO THE EAR 

OR NOSE: Lach. Xatr. Phosph. 

Thuj. 
BEFORE BREAKFAST : Caust. 

Cham. Chin. Con. Kali. Lye. Natr. 

mur. N. mosch. Phosph. Phosph. 

ac. Sabin. Selen. Sil. Sulph. ac. 

Zinc. 
BY DEEP BREATHING: Igiu 

Lach. Oleand. Spig. 
WHEN CHEWING : Bryon. Chin. 

Spig. 
IN THE COLD: Ambra. Ant. tart. 

Asar. Cin. Croc. Dros. Graph- Iod. 

Kali. Led. Lye. Merc. Natr. Natr. 

mur. Plat. Puis. Rhus. Sec. coi*n. 

Sep. Sulph. Thuj. Veratr. 
BY CONTACT: Anac. Asa f. Calc. 

carb. Cycl. Drosera. Lycop. Mang. 



138 



GENEKAL SYMPTOMS. 



Mur. acid. Natr. Phosph. Sulph. 

Thuj. 
IN THE DARK : Bar. Bell. Calc. 

cart). China. Con. Croc. Euphr. 

Graph. Ignat. Kali. Lye. Mercur. 

Natr. Phosph. Phosph. ac. Puis. 

Sepise. Sil. Sulph. 
AFTEE DRINKING: Bry. Graph. 

Phosph. Ehus. Sil. 
AFTEE EATING: Calc. c. Cann. 

Chel. Ferr. Graph. Ign. lod. Kali. 

Lach. Merc. Natruin. Phos. Squill. 

Stront. Veratr. 
WHEN EATING: Ambr. Anacard. 

China. Croc. Ferr. Graphit. Ign. 

lod. Lach. Merc. Nux vom. Puis. 

Spig. Staph. Tar. Zinc. 
BY EEUCTATIONS : Ant. tart. Bar. 

Carbo veg. Coccul. Graphit. Ign. 

Kali. Lach. Lye. Natr. Nux vom. 

Sil. Sulph. 
BY FOOD AND DEINK, bread : 

Caust. Natr. 
— vinegar: Puis. 
— meat: Veratr. 
— coffee : Ars. Cham. 
— cold food : Bell. Bry. Cham. Ferr. 

Kali. Laches. M. austr. Merc. 

Phosph. Phosphor, ac. Puis. 
— warm food: Ars. Con. Graph. Ign. 

Lye. Mur. ac. N. mosch. Nux vom. 

Ehus. Sulph. Veratrum. 
— cold water : Bry. Caustic. Phosph. 

Puis. Sep. 
— warm water : Nux vom. Ehus. 
— wine : Con. Lach. Op. 
BY IMPOSING ONE'S HAND: 

Bell. Croc. Natr. 
BY MENTAL LABOE: Croc. Ferr. 

Natr. 
BY BODILY LABOE: Ign. Natr. 

Ehus. Sep. 
BY LEANING AGAINST : Carbo 

veg. Ferr. Kali. Staph. 
IN THE LIGHT: Calc. c. Carbo 

an. Carbo veg. Con. Plat. Stront. 
WHEN LYING DOWN : Alum. 



Ambra. Am. Bell. Bry. Calc. c 
Canth. Caust. Coccul. Colch. Croc. 
Dig. Graph. Hep. lod. Merc. Natr. 
Natr. mur. N. vom. Oleand. Phos. 
ac. Sassap. Squill. Sec. corn. Stan- 
num. Straph. Stram. 

-in bed : Bell. Bry. Canth. Canst. 

Cic. Cin. Con. Dig. Ferr. Lach. 
Lye. Natrum mur. Nitric ac. Nux 
vom. Phosphor. Ehus. Sabad. 
Squill. Selen. Sii. Staph. Stram. 
Veratr. 

on the back : Aeon. Bry. Calc. c. 

Carbo an. Con. Creos. Ferr. Ign. 
Kali. Lye. Natr. mur. Nux vom. 
Plat. Sepiae. Stann. Sulph. 

on the side : Am. Ars. Bry. 

Cham. Cupr. lod. Lach. Natr. 
N. vom. Phosjjh. Rhus. Sep. 

on the affected side : Bry. 

Cham. Ign. Kali. Puis. Ehus. 

on the painless side : Aeon. Ars. 

Bar. Bell. Graph. Hep. lod. Nux 
vom. Phos. Euta. Sil. Sulph. 
Thuj. 
- — with the head high : Ant. tart. 
Ars. Cann. China. Hep. Nux 
vom. Puis. Spig. 

bent double: Coloc. Pulsat. 

Rheum. 
IN THE EVENING, after lying 
down: Bar. Bell. Bry. Calc. c. 
Carbo veg. Cic. Cin. Croc. Graph. 
Hell. Hep. lod. Natr. mur. Nux 
vomica. Oleand. Eheum. Ehodod. 
Secalecorn. Squill. Staph. 
BY MOTION: Ambr. Asa f. Aur. 
Caps. Chamom. Con. Cycl. Bute. 
Ferr. Fluor, ac. Lach. Lye. Merc. 
Mosch. Nitr. Op. Phosphor, ac. 
Puis. Ehodod. Khus. Sabad. Samb. 
Sepice. Sulph. Tar. Valer. Verb. 
BY CONTINUED MOTION: Con. 
Ferr. Kali. Lye. Puis. Sil. Valer. 
Veratr. 
BY EXTEENAL PEESSUEE: 
Amm. mur. Anac. Ars. Aur. Bry. 



GENERAL SYMPTOMS. 



139 



Cantli. Chel. Con. Dulcam. Graph. 

Ign. Kali. Magn. mur. Men. Mur. 

ac. Natr. Nux vom. Phosphor, ac. 

Plumb. Rhus. Sulphur. Sulph. ac. 

Veratr. Vi t. 
BY RAISING ONE'S SELF : Ant. 

tart. Arsen. Calc. c. Cham. China. 

Dig. Ign. Kali Lye. Oleand. Puis. 

Samb. Sep. Sil. Sulph. 
WHEN BEADING : Natr. 
IN REST: Agar. Anac. Ant. tart. 

Asar. Am. Bell. Bry. Calad. Carbo 

an. Carbo veg. Caustic. Chel. Coff. 

Colch. Croc. Ferr. Graph. Hell. 

loci. Ipec. Led. Mang. Merc. Natr. 

mur. Nux mosch. N. vom. Phosph. 

Plat. Rheum. Rhod. Selen. Spigel. 

Squill. Staph. Sulph. ac. 
WHEN RIDING IN A CAR- 
RIAGE : Graph. Nitric ac. 
IN THE MORNING AFTER RIS- 
ING : Ambr. Ant. tart. Ars. Bell. 

Calad. Carbo* anim. Cycl. Fuphorb. 

Ferr. Graph. Ign. Iod. Kali. Led. 

Lye. Mang. Mercur. Merzer. Natr. 

Nux vom. Phosph. Pulsat. Rhus. 

Selen. Sep. Sulphur. Veratr. Viola 

od. 
IN THE ROOM: Agar. Amm. mur. 

Ars. Bell. Calc. carb. Camph. Cann. 

Carbo an. Carbo veg. Cham. Chin. 

CoccoL Con. Creos. Ferr. Guaj. 

Ign. Lach. M. austr. Natr. Nitr. ac. 

N. mosch. Nux vom. Oleand. Petr. 

Rheum. Ruta. Selen. Sil. Spig. 

Strain. Sulph. ac. Teucr. Valer. 
BY SCRATCHING: Asa fa?t. Bry. 

Calc. c. Caust. Cic. Cycl. Ign. Led. 

Mur. ac. Natr. Oleand. Phosphor. 

Ruta. Sulph. Sulph. ac. Thuj. 
BY SLEEP : Ars. Ipec. N^v vom. 

Piiogph. Puis. 
WHEN SITTING: Bryon. Calad. 

Camph. Cann. Chamom. Cic. 

Coffea. Colch. Croc. Hell. Hyosc. 

Iod. Merc. Mezer. N. mosch. Nux 



vom. Phosph. Rheum. Rhus. 

Squill. Secale corn. Staph. 
WHEN STANDING: Antim. tart. 

Asar. Bell. Calad. Calcar. c. Coccul. 

Colchic. Croc. Hell. Hep. Iod. Ipec. 

Led. Mercur. Mur. ac. N. vom. 

Phos. Ruta. Squill. Selen. Spig. 

Vit. 
IN SOCIETY: Arsen. Kali. Lye. 

Stram. 
IN SWALLOWING: Ambr. Graph. 

Ign. Lach. Led. Merc. Nux vom. 

Pulsat. Squill. Spongia. Staph. 
IN SWEATING: Calad. Cham. 

Clem. Graph. Hep. Lye. Nitr. ac. 

Nux vom. Oleand. Rhus. Selen. 

Stram. Thuj. Veratr. 
BY UNCOVERING ONE'S SELF: 

Calc. c. Chamom. Ferr. Ignat. Iod. 

Lye. Phosph. Puis. Secale corn. 

Spig. Veratr. 
ON WAKING: Ars. Calad. Hell. 

Nux vom. Phosph. Pulsat. Sep. 

Thuj. 
WHEN WALKING FAST: Ignat. 

Natr. mur. Sep. 
BY THE WARM STOVE: Ars. 

Aur. Caust. Con. Hep. Ign. Kali. 

Magn. N. vom. Rhod. Rhus. Stront. 

Sulph. 
BY WASHING : Amm. mur. Ars. 

Asar. Caust. Chel. Pulsat. Rhod. 

Spig. 

the face: Asar. Mezer. Saba- 

dilla. 
BY WEEPING: Anac. Ign. Lye. 
IN DAMP WEATHER : Aeon. Asar. 

Caust. Hep. Ipec. N. vom. Sil. 

Spong. 
IN DRY WEATHER: Ant. crudum. 

Calc carb. Chin. Dulcam. Ferr. 

Lach. Lye. Merc. Natr. N. mosch. 

Pulsat. Rhus. Sulph. Veratr. 
BY WIPING WITH THE HAND: 

Asa foet. Calc. c. Cina. Cycl. Ign. 

Natr. Phosph. Plumb. Puis. Thuj. 



140 



GENERAL SYMPTOMS. 



IN WABMTH: Aeon. Amm. Arn. 

Ars. Aur. Bar. Bell. Camph. Carbo 

veget. Caust. China. Cic. Coccul. 

Diik. Ferrum. Graph. Hell. Hep. 

Hyoscyam. Igii. Kali. Lach M. 

austr. Magn. Merc. Mosch. Natr. 

N. moscli. Nux vomica. Petr. Phos. 

Bhod. Rhus. Sabad. Samb. Squill. 

SO. Stapliys. Stront. Sulph. ac. 

Verat. Zinc. 
ANiEMIA: Arn. Ars. Bell. Bry. 

Calc.c. Carbo veg. Chamom. Chin. 

Con. FeiT. Ign. loci. Kali. Lach. 

Lye. Merc. Natr. Natr. mur. Nitric. 

ac. JV. vom. Phosph. ac. Puis. Ehus. 

Sep. Sil. Squill. Staph. Sulphur. 

Sulph. ac. Veratr. 

ANEUEYSMS: Carbo veg. Ferr. 

Graph. Kali. Lach. Lye. Puis. 

Sulph. 
APPAEENT DEATH : Arn.Bellad. 

Carbo veg. Cham. Chin. Lach. 

Nux vom. Op. Tart. emet. 
APOPLEXY: Aeon. Am. Baryt. 

Bell. Calc. Camph. Caust. Chin. 

Coccul. Coff. Dig. Ferr. Hyosc. 

Ipec. Lach. Lycop. Merc. N. vom. 

Puis. Rhus. Sil. Stram. Tart. emet. 

Veratr. 
ATEOPHY: Ars. Baryt. Bellad. 

Calc. c. China. Cina. Iod. Ipec. 

Lach. Merc. Nux vom. Ehus. Sil. 

Sulph. 
BONES, affections of, in general: 

Arn. Ars. Asa fost. Aur. Bell. Calc. 

carb. Calc. phosph. Carbo veget. 

China. Con. Dulc. Graphit. Hep. 

Iod. Kali bichr. Lach. Lycop. Merc. 

Mezer. Nitric ac. Phosph. Pulsat. 

Ehus. Ruta. Sabin. Sec. corn. Sil. 

Spong. Staphysag. Sulph. Sulph. 

ac. Thuj. 
— swelling: Asa f. Aur. Calc. Dulc. 

Guaj. Hep. Lye. Merc. Nitric acid. 

Phosphor. Puis. Rhus. Euta. Sil. 

Staph. Sulphur. 



— fractures : Am. Asa f . Calc. Lycop. 

Rhus. Ruta. Sil. Symphyt. Sulph. 
— inflammation: Asa feet. Aur. Bell. 

Calc. Chin. Hep. Lycop. Merc. Ni- 
tric ac. Phosph. Sil. Sulph. 
— pains: Ars. Asa f. Aur. Bar. Calcar. 

China. Cic. Daph. Fluor, ac. Lach. 

Lye. Merc. Nitric ac. Phos. Phos- 
phor, ac. Plumb. Euta. Sil. Staph. 

Sulph. 
— curvature: Asa feet. Bellad. Calc. 

Calc. phosph. Hep. Tod. Lye. Merc. 

Phosph. Plumb. Ehus. Sil. Sulph. 
— caries : Arsen. Asa foet. Aur. Calc. 

Fluor, ac. Hep. Lye. Merc. Nitric 

ac. Phosph. Phosph. ac. Euta. Sep. 

Sil. Spong. Sulph. 
BLUE DISEASE : Aco. Arn. Ars. 

Aur. Bellad. Camph. Carbo veget. 

Chin. Con. Cuprum. Digit. Ferr. 

Ipecac. Lach. Merc. Nux vom. Op. 

Phosph. Pulsat. Ehus. Sec corn. 

Teratr. 
BOUNDING, as of something: Croc. 
BUENS : Ant. crud. Am. Ars. Carb. 

veg. Caust. Creos. Laches. Secale 

com. Stram. 
CHAGEIN, consequences of: Aco. 

Ars. Bry. Cham. Chin. Coff. Coloc. 

N vom. Phosph. Ph. ac. Plat. 

Staph. 
— suppressed: Ign. Phosph. ac. 
— with wrath : Coloc. Staph. N. vom. 
CHAMOMILE, excessive use of: 

Aeon. Coff. Ign. Puis. Nux vom. 
CHILDEEN, diseases of: Aeon. Bar. 

Bell. Bryon. Ca!car. Cham. Cin. 

Coff. Drosera. Hep. Hell. Ign. Iod. 

Ipec. Merc. Nux mosch. Nux vom. 

Puis. Rheum. Silic. Spongia. 

Sulph. 
CHINA, aliments from abuse of: 

Arn. Ars. Bell. Calc. c. Canthar. 

Carbo veg. Ferr. Ipec. Lach. Lye. 

Merc. Natr. mur. N. vom. Sep. 

Puis. Sulphur. Veratr. 



GENERAL SYMPTOMS. 



141 



CHOLEEA: Ant. tart. Ars. Asar. 

Campli. Carbo veget. Cupr. Dulc. 

Hydr. ac. J air. Ipecac. Lach. Nux 

vom. Phosph. Ph. ac. Sec. corn. 

Veratr. 
CHOLERINE : Bry. Puis. Rhus. 
CHOLERIC TEMPERAMENT : 

Aeon. Anac. Bry. Caust. Cham. 

Cin. Cupr. Hyosc. Kali. Lach. 

Natrum. Nitric ac. Nux vom. Op. 

Phosphor. 
CHLOROSIS: Bell. Calc. carb. 

Camph. Chin. Coccul. Conium. 

Crot. Ferr. Graphlt. Hell. Ign. 

Kali. Lach. Lye. Natr. mur. Nitric 

ac. Nux vom. Flat Plumb. Puis, 

Sep. Staph. Sulph. Yaler. 
COLD, taking: Aeon. Ant. crud. 

Ars. Bell. Bry. Cale. Caust. Cham. 

CofT. Dulcam. Hep. Ipec. Merc. N. 

vom. Phosph. Puis. Rhus. Sil. 

Sulph. 
— liable to take: Aconit. Bell. Bry. 

Calc. Carbo veg. Caust. Cham. 

China. Bros. Dulc. Hep. Lye. Merc. 

Natrum. Nitric ac. Nux vom. Puis. 

Rhus. Sep. Sil. Sulph. 
COMPLAINTS, periodical: Arnic. 

Ars. Bell. Bry. Carbo veget. Chin. 

Iirn. Ipec. Natrum mur. N. vom. 

Puis. Rhus. Spig. Sulph. 
CONCUSSION: Am. Bell. Bry. 

Cic. Con. Nux vomica. Rhus. 

Veratr. 
AILMENTS INCIDENT TO CON- 
FINEMENT: Aconit. Agn. Ar- 
nica. Bell. Bry. Calc. Cham. China. 

Coff. Hep. Hyosc. Ignat. Lye. 

Merc. N. vom. Op. Phosph. ac. 

Plat. Pu!s. Rhus. Sec. corn. Sil. 

Sulph. Yeratr. 
CONGESTIONS OF BLOOD: 

Acoa, Amm. Am. Asa f. Aur. 

Bell. Bry. Calc. c. Carbo vegetab. 

Chin. Croc. Cupr. Dig. Ferr. 

Graph. Hyosc. Kali. Lycop. Merc. 

Natr. mur. Nitric ac. N. \ouu Op. 



Phosph. Puis. Rhus. Seneg. Sep. 

Sil. Stram. Sulph. Sulph. ac. 

Veratrum. Viola tr. 
CONTUSIONS: Aeon. Arg. Arn. 

Cic. Con. Led. Oleand. Petr. Puis. 

Rhodod. Rhus. Ruta. Sulph. 

SuIjjJl ac. 
CRAWLING: Bell. Calcar. Sep. 

Sulph. 
DEBILITY, nervous: Arn. Baryt. 

Bell. Calc. Carbo veget. Cham. 

Chin. Coff. Cuprum. Graph. Hyosc. 

Ign. Lod. Ipec. Lach. Lye. M. arct. 

Mercur. Natr. Natr. mur. Nitric ac. 

Nux mosch. N. vom. Phos. Phosph. 

ac. Plat. Pulsat. Rhus. Sec. corn. 

Selen. Sil. Stann. Stram. Yaler. 

Veratr. 
DRUNKARDS, ailments of: Aeon. 

Ars. Bell. Calc. Carbo veget. Hy- 
osc. Ign. Lach. Natrum. Natr. 

mur. Nux vom. Op. Puis. Rhus. Sil. 

Stram. S-ulph. 
DRYNESS OF INNER PARTS: 

Aeon. Ambr. Ars. Asa f. Bellad. 

Bry. Calad. Calc. Carbo veg. Cham. 

Cic. Con. Croc. Dulc. Graph. Hy- 
osc. Ign. Lye. Magn. mur. Mang. 

Merc. Natrum. Natr. mur. Nitric 

acid. Nux mosch. Nux vom. Par. 

Phosph. Puis. RJlus. Samb. Sec. 

corn. Seneg. Sepia). Sil. Sjjong. 

Stram. Sulph. Veratr. Zinc. 
EMACIATION: Ambra. Anacard. 

Ars. Bar. Bry. Calc. carl). Canthar. 

Carbo veg. Chamom. Chin. Chlor. 

Clna. Coccul. Cupr. Dulc. Ferr. 

GrapML Hep. Lgn. Iod. Ipec. 

Laches. Lye. Merc. Natr. Natr. 

mur. Nitric ac. N. vom. Phosph. 

Phos. ac. Plumb. Puis. Sec. corn. 

Selen. Sil. Stann. Staphys. 

Sulph, Veratr. 
EXCESSES, consequences of: Ana- 
card. Ars. Bar. Calc. carb. Carbo 

veg. Chin. Conium. Kali. Lach. 

Mercur. Natr. Natr. mur. N. vom. 



142 



GENERAL SYMPTOMS. 



Phosph. Phosph. ac. Puis. Rhus. 

Sec. corn. Sep. Sil. Staph. Sulph. 

Thuj. Veratr. 
FAINTING: Aeon. Am. Arsenic. 

Bell. Bryon. Cede. Camphor. Cairn. 

Carbo veget. Chamom. China. Coc- 

cul. Cojf. Creos. Dig. Ferr. Hep. 

Hyosc. Ign. Ipec. Lack. Laur. 

Moscli. N. mosch. N. voni. Op. Petr. 

Phosph. Phosph. ac. Pulsat. Ran. 

sc. Rhus. Sangn. Secale corn. Sep. 

Sil. Spig. Stramon. Tart, eniet. 

Veratr. Yiola od. 
PAT, tendency to get : Antim. crud. 

Ars. Calcar. Caps' Croc. Cupr. 

Ferr.JGraphit. Lach. Lye. 'Merc/Op. 

Pulsat. Spong. Sulph. Veratr. 
PEAR, consequences of : Aeon. Bell. 

Hyosc. Ign. Lach. Op. Puis. Yerat. 
FEMALES, diseases of : Aeon. Agar. 

Alum. Ambra. Arnica. Bell. Bor. 

Calcar. Caps. Caustic. Cham. Chin. 

Cic. Coccul. Con. Croc. Ferrnm. 

Graph. Hyoscyam. Ign. Ipec. Kali. 

Lach. Magn. mur. Merc. Mosch. 

Nux mosch. Nux vom. Plat. Puis. 

Rhus. Sal)in. Sec. corn. Selen. Sep. 

Spongia. Stann. Sulph. Valer. 

Veratr. 

Fever, General Charac- 
ter of. 
FEVER, bilious: Aeon. Ant. crud. 

Ant. tart. Ars. Bry. Bellad. Cham. 

Coccul. Coloc. Creos. Ign. Ipec. 

Merc. Natrum mur. N. vom. Puis. 

Sulph. Verat. 
— catarrhal: Aeon. Ars. Bry. Bellad. 

Canst. Chamom. Con. Dulc. Ipec. 

Lach. Magn. mur. Merc. N. vom. 

Puis. Rhus. Sulph. 
— gastric: Ant. crud. Antim. tart. 

Ars. Aur. Bell. Bry. Cham. Coccul. 

Coloc. Hepar. Ignat. Ipec. Mercur. 

Magn. c. 1*7. vom. Phosph. ac. Puis. 

Rhus. Sulph. Veratr. 



— yellow: Aeon. Ars. Bell. Pry. Crot 

Ipec. Mercur. Nux vom. Puis. 

Rhus. Sulph. 
—puerperal: Aeon. Bell. Bry. Cham. 

Nux vom. Puis. Rhus. 
—milk : Aeon. Bell. Calc. Coff. Puis, 
—nervous: Aeon. Am. Arsen. Bell. 

Bry. Camph. Chamom. Hyosc. Ign. 

Lye. Mercur. Mur. acid. Is. vom. Op. 

Phosphor, ac. Rhus. Strain. Veratr. 
— rheumatic: Aeon. Am. Ars. Bell. 

Bry. Caustic. Cham. Colch. Dul- 

cam. Ipecac. Mercur. W. vom. Puis. 

Rhus. Sil. Sulph. 
— wound : Aeon. Am. Bry. 
— dentition: Aeon. Bell. Calc. Cha- 
mom. Merc. Nux vom. Sulph. 
— hectic: Arsen. Calc. China. Coc" 

cul. Cupr. Big. Ign. lod. Ipec. 

Kali. Laches. Lye. Nux vom. 

Phosph. Phosph. ac. Puis. Sil. 

Staph. Sulph. 
— typhus, abdominal: Aconit. Ars. 

Bell. Bry. Merc. Kux vom. Phosph. 

ac. Rhus. 
— typhus, cerebral: Aeon. Arn. Ars. 

Bell. Bry. Carbo veget. Chin. Crot. 

Hyosc. Lach. Mercur. Mur. ac. N. 

vom. Op. Phosph. Phosph. ac. 

Pulsat. Rhus. Sulph. Veratr. 
— typhus, putrid: Ars. Asa f. Bry. 

Carbo veget. Chin. Ferr. Graph. 

Hep. Ipec. Lach. Merc. Mur. ac. 

Nux vom. Op. Phos. ac. Rhus. 
FLUIDS, ill effects of loss of: Calc. 

Carbo veg. Cliin. Cin. Con. Lach. 

Lye. Natr. Natr. mur. Nitric ac. 

Nux vom. Phosph. ac. Sulph. 

Sulph. ac. Thuj. Veratr. 
FREEZING, consequences of : Aco. 

Ars. Bry. Carbo veg. Laches. Ni- 
tric ac. Sulph. ac. 

Fever, According to Par- 
ticular Symptoms. 
BURNING : Arsen. Bry. Rhus. Ve- 
ratr. 



GENERAL SYMPTOMS. 



143 



CHILLINESS IN GENERAL: 

Ainbra. Ant. tart. Arn. Ars. Bryon. 

Calc. Canth. Cham. China. Cm. 

Colch. Cupr. Ferr. Graph. Hep. 

Ign. Ipec. Lach. Lye. Merc. Mezer. 

Natr. mur. Nux vom. Phosph. 

Phosph. ac. Puis. Rhus. Sabad. 

Sassap. Sep. Sil Spig. Sulph. Thuj. 

Yeratr. 
— external: Arn. Chin. Lijcop. Merc. 

Nux vom. Phos. Bhus. Yeratr. 
— semi-lateral : Ant. tart. Bry. Caust. 

Ignat. Lye. Nux vom. Puis. Rhus. 

Spig. 
— internal: Anac. Ars. Bellad. Bry. 

Cale. Chainom. China. Hell. Ignat. 

Ipec. Lach. Laur. Lycop. N. vom. 

Phosph. Pulsat. SquilL Sep. Thuj. 

Vera tr. 
— -with shaking: Aeon. Bryon. Caps. 

Cham. Chin. Ign. Ipec. Nux yoiu. 

Rhus. Yeratr. 
HEAT IN GENERAL : Aco. Amm. 

mur. Anac. Antim tart. Arn. Ars. 

Bell. Bry. Calc. Canth. Carb. veg. 

Caust. Cham. Chin. Cin. Coffea. 

Con. Cycl. Ferr. Graph. Hell. Hep. 

Ign. Ipec. Kali. Lach. Magn. mur. 

Mere. Mosch. Mur. ac. Nitr. ac. 

Nux vom. Op. Phosph. Phosph. ac. 

Puis. Rhus. Sabad. Sil. Squill. 

Stannum. Staph. Strain. Sulphur. 

Sulph. ac. Yeratr. 
— external : Aeon. Ars. Bell. Bry. Calc. 

Camphor. Carbo veg. Cham. Cic. 

Coccul. Coff. Coloc. Digit. Dulc. 

Euphorb. Hell. Hyosc. Ign. Kali. 

Lach. Lye. Mang. Merc. Mur. ac. 

Nux vom. Op. Phosph. Puis. Rhus. 

Sep. Sil. SquilL Stram. Sulph. 

Zinc. 
— flashes of: Am. Calc. caro. Chin. 

Graph. Iod. Kali. Lycop. Natrum. 

Nux vom. Phosph. Plat. Puis. 

Rhus. Ruta. Sep. Stann. Sulph. 

Thuj. 



— semi-lateral: Arn. Bell. Bry. Croc. 

Ignatia Lye. Nux vom. Phosph. 

Puis. Rhus. Sulph. 
— internal : Aeon. Arn. Ars. Bell. 

Bry. Calc. Canth. Carbo veg. Caust. 

Cham. Cic. China. Coloc. Con. 

Graphit. HeV. Ipec. Lye. Magn. 

mur. Nitric ac. Nux vom. Phosph. 

Phosphor, ac. Puis. Rhus. Sabad. 

Samb. Sec. corn. Spig. Spong. 

Stann. Yeratr. Zinc. 
LOSS OF CONSCIOUSNESS: 

Bell. Bry. Carbo veg. Hell. Hyosc. 

Lach. Op. PI -OS. ac. Rhus. Stram. 
LOSS OP THIRST: Ant. tart. Ars. 

Canth. Carbo veg. Caust. Chin. 

Hell. Ipec. Merc. Puis. 
PULSE, intermittent: Aeon. Ars. 

Bry. Dig. Kali. Lach. Natr. mur. 

Op. Phosph. ac. Sec. corn. Stram. 

Sulph. 
— filiform: Colch. Lach. Yeratr. 
— large : Aeon. Bell. Bry. Cupr. Dig. 

Ferr. Hyosc. Ign. Merc. Nitr. Nux 

vom. Phosph. Spig. Stram. Veratr. 
— hard: Aeon. Arn. Bar. Bell. Bry. 

Canth. Chin. Digit. Ferr. Hyosc. 

Ign. Merc. Nux vom. Phosph. ac. 

Sabin. Samb. Sil. Stram. Veratr. 
— small: Aeon. Ant. tart. Ars. Bar. 

Bell. Calc. carb. Cam/ph. Carbo 

veg. China. Cina. Cocc. Cupr. Iod. 

Ipec. Kali. Lach. Laur. Merc. Natr. 

mur. Op Phosph. acid. Plat. Puis. 

Sec. corn.. Sil.- Strain. Sulphur. 

Sulph. ac. Veratr. 
— slow : Ambr. Ant. crud. Ant. tart. 

Ars. Bell. Cam/ph. Canthar. Cic. 

Con. Dig. Hell. Ign. Kali. Laur. 

Mosch. Op. Puis. Rhodod. Sec. 

corn. Sep. Stram. Veratr. 
— slower than the beats of the 

heart : Cann. Dig. Hell. Sec. corn. 

Yeratr. 
— quick: Aeo. Ant. tart. Arn. Ars. 

Asa f. Bell. Bism. Bry. Carbo veg. 

Coloc. Croc. Dig. Hyosc. Ignat. 



tu 



GENERAL SYMPTOMS. 



Iod. Lach. M. austr. Merc. Nitric 

acid. Nux vom. Phosph. Phosph. 

ac. Pulsat. Rhus. Samb. Sil. 

Spong. Stann. Strain. Sulphur. 

Yeratr. Zinc. 
— imperceptible: Aconit. Ars. Car- 
bo veg. Coccul. Cupr. Ferr. Ipec. 

Lach. Merc. Op. Sec. corn. Sil. 

Stann. Veratr. 
— irregular: Agar. Antim. cruel. 

Ars. Caps. Chin. Digital. Hyosc. 

Kali. Lach. Natr. mur. Op. 

Phosph. ac. Plumb. Sec. corn. 

Stram. Sulphur. Veratr. 
—soft: Ant. tart. Ars. Baryt. Bel- 
lad. Carbo veg. China. Coccul. 

Cuprum. Iodine. Kali. Laur. Merc. 

Op. Phosphor. Plat. Sec. corn. 

Veratr. 
— tremulous: Arsen. Calc. Cic. Kali. 

Phosph. Rhus. Sangn. Spig. 
SHIVERING: Aeon. Ars. Asa feet. 

Aurum. Bell. Calad. Canih. Caps. 

Cham. China. Coccul. Croc. Cycl. 

Ferr. Graph. Hep. Ign. Kali. 

Mercur. Mezer. Natr. Nitr. Nux 

vom. Puis. Rheum. Rhus. Sabad. 

Sec. corn. Sep. Staph. Valer. Ye- 
ratr. 
STRETCHING : Ars. Ipec. N. vom. 

Rhus. 
SWEAT, in general: Aco. Ambr. 

Amm. mur. Ant. tarfc. Ars. Bar. 

Bell. Brij. Calc. Canth. Caps. 

Carbo an. Carbo veget Caust. 

Cham. Chlor. Chin. Cojf. Con. Dig. 

Dros. Ferr. Graph. Guaj. Hep. 

Hyosc. Ignat. Kali. Lye. M. austr. 

Magn. mur. Merc. Natrum. Natr. 

mur. Nitric ac. Nux vom. Phosph. 

Phosphor, ac. Puis. Rheum. Rhod. 

Rhus. Sabad. Sam!). Selen. Sepise. 

Sil. Staph. Stram. Sulph. Tar. 

Thui. Yeratr. 
IRRITABILITY, bodily: Aeon. 

Am. Asar. Aur. Bell. Bry. Canthar. 
Cham. Chin. Coffea. Cupr. Ferr. 



Hyosc. Ign. Lach. M. arct. Merc. 

Natr. Nux vom. Phosph. Pulsat. 

Rhus. Selen. Sil. Spong. Staphys. 

Veratr. 
— want of: Anac. Ars. Bism. Calc. 

Camph. Carb. veget. Cic. Con. Croc. 

Dulc. Ferr. Graph. Hyosc. Ign. 

Iod. Ipec. Kali. Lach. Laur. Lycop. 

Magn. Merc. Nitric ac. Nux mosch. 

Oleand. Op. Phos. ac. Rhod. Sec. 

corn. Sep. Staph. Stram. Sulph. 
JAUNDICE : Aeon. Ambr. Ant. crud. 

Ars. Aur. Aurum mur. [Bellad. Bry. 

Canth. Carbo veget. Cham. Chin. 

Con. Croc. Dig. Ferr. Hep. Ignat. 

Lach. Lycop. Merc. Nitric ac. Nux 

vom. Op. Pulsat. Rhus. Sulph. Sep. 

Yeratr. 
JEALOUSY, ailments from : Hyos- 

cyam. Ignat. Lach. N. vom. Phos. 

ac. Puis. Staph. 
JOY, consequences of excessive 

Aeon. Coffea. Op. 
LANGUOR: Antim. crud. Calc. c. 

Carbo veget. Coccul. Ignat. Iodine. 

Kali. Lach. Lye. Mercur. Mosch. 

Natr, Natr. mur. Op. Phosphor. 

Phosph. ac. Plat. Puisat. Selen. 

Seneg. Sulph. Teucr. Thuj. Valer. 
LAZINESS: Alum. Arsen. Baryt. 

Bell. Bryon. China. Coccul. Guaj. 

Iod. Kali. Lach. Merc. Mur. ac. 

Natr. Natrum mur. N. vom. Ole- 
ander. Phos. ac. Puis. Sec. corn, Se- 
len. Sep. Zinc. 
LIMPING: Bell. Calc. Caust. Coloc. 

Merc. Pulsat. Rhodod. Rhus. Sep. 

Sulphur. 
LOCHIA, morbidly altered: Bellad. 

Calcar. Con. Nux vom. Plat. Puis. 

Sec. corn. 
MARASMUS OF OLD PEOPLE: 

Ant. tart. Bar. Calc. c. Con. Oiean. 

Op. Phosph. Phosph. ac. Rhus. Se- 

cale corn. 
MELANCHOLY TEMPERA- 
MENTS : Ars. Aur. Bellad. Calc. 



GENERAL SYMPTOMS. 



145 



China. Graph. Ignat. Lach. Lycop. 

Merc. Natr. Nux voni. Phosph. ac. 

Puis. Sep. Sil. Veratr. 
MOTION, dread of: Ant. tart. Ars. 

Bar. Bell. Calad. Caps. Chm.Dulc. 

Hell. Ig 7i. Lach. Lye. Merc. Natr. 

Natr. mur. Nux vom. Sulpli. Thuj. 
MUCOUS MEMBEANES, diseases 

of the: Alum. Apis. Arsenic. Bell. 

Brij. Calc. Caps. Caustic. Cham. 

China. Chlor. Dulc. Euphr. Fluor. 

ac. Hep. Ign. Lye. Merc. Mur. ac. 

Natr. mur. Nitric acid. Nuxvom. 

Phosph. Pulsat. Bhus. Sangn. Sep. 

Sil. Stann. Sulph. Sulph. ac. 
MUSCULAB TWITCHINGS : Arn- 

bra. Asa f.Ro'A. Clem. Coloc. Croc. 

Cuprum. Graph. Loci. Kali. Lach. 

Mezer. Natr. Natr. mur. Plat. Bhus. 

Secale com. Sil. Spong. Sulphur. 

Sulph. ac. Yiola tr. Zinc. 

GLAND ULAE AFFECTIONS: 

Ammon. mur. Apis. Arsenic. Aur. 

Baryt. Bell. Calc. earl). Carbo an. 

Carbo veget. Cham. Coccul. Con. 

Dulc. Graph. Hep. Iod. Kali. Lye. 

Merc. Natr. Natr. mur. Nitric ac. 

Nux vom. Phosph. Phos. ac. Plumb. 

Ran. bulb. Rhus. Sep. Sil. Spong. 

Staph. Sulph. Sulph. ac. Thuj. 
GOUT: Aeon. Ant. crud. Arg. Am. 

Ars. Asa f. Aur. Baryt. Bell. Bry. 

Calc. carl). Calc. phosphor. Caps. 

Carbo an. Carbo veg. Caust. Cham. 

Chin. Colch. Dig. Dulcam. Ferr. 

Graph. Hep. Ignat. Iod. Kail, car- 
bon. Kail bichr. Led. Lye. M. austr. 

Merc. Mezer. Natr. Natrum mur. 

Nux vom. Phosphor. Puis. Rhodod. 

Rhus. Sablna. Sassap. Sep. Sil. 

Spong. Slaphys. Sulph. Thuj. Ye- 

ratr. Vit. Zinc. 
GRASPING AT FLOCKS : Arsen. 

Bell. Hell. Hyosc. Iod. Muriat. ac. 

Op. Phosph. ac. Rhus. Stram. 
HEATED, consequences of getting: 



Aeon. Bel!. Bry. Calc. Carbo. veg. 

Kali. Lye. Nux vom. Puis. Sil. 
HEAVINESS OF THE BODY: 

Chin. Lach. Kali. Natr. Natr. mur. 

Phosph. Sep. Stann. 
HUNGER, ill effects of: Ant. crud. 

Ars. Bry. Calc carb. Chin. Ipec. 

Puis. Sulph. 
HYDROPHOBIA: Lobelia. Arsen. 

Bell. Canthar. Hyosc. Lach. Phos. 

Stram. 
HYPOCHONDRIA: Asa feet. Aur. 

Bellad. Calc. Canth. Caust. Cham. 

Cina. Coccul. Con. Ferr. Graphit. 

Ignatia. Iodine. Lach. Lye. Magn. 

mur. Merc. Mill. Mosch. Natrum* 

Natrum mur. Nux mosch. N. vom. 

Phosph. ac. Plat. Puis. Sabin. Sep. 

Staph. Sulph. Yaler. Veratr. 
HYSTERIA : Agn. Asa f. Aurum. 

Bell. Calcar. Caustic. Coccul. Con. 

Ignatia. Lach. Nux mosch. Phosph. 

Plat. Puis. Sep. Sil. Sulph. Yaler. 

Viola od. 
INDURATIONS: Arn. Ars. Aur. 

Bell. Calc. Camphor. Carbo an. 

Cham. Chin. Clem. Con. Dulc. Ferr. 

Graphit. Hep. Iodine. Lach. Lye. 

Magn. mui\ Phosph. Plumb. Fuls. 

Sep. Sil Sulph. Thuj. 
INFLAMMATIONS: Aeon. Antim. 

crud. Ant. tart. Am. Arsenic. Bell. 

Bry. Calc. Cannab. Canth. Carbo 

veget. Cham. Con. Creos. Cupr. 

Dig. Dros. Dulc. Euphorb. Euphr. 

Hepar. Hyosc. Iod. Ipecac. Kali. 

Lach. Lye. Magn. carb. Merc. Mur. 

ac. Nitr. Nitr. ac. Nux vom. FJios. 

Plumb. Puis. RJius.Ruta. Sec. corn. 

Sep. Spong. Squill. Sulph. Sulph. 

ac. Veratr. 
NERYOUS EXCITEMENT : Ambr. 

Bell. Calc. c. Cham. Chin. CofFea. 

Ferr. Iod. Laur. Merc. Nux vom. 

Fhosph. Phosph. ac. Puis. Bhus. 

Sep. Sulph. Yaler. Yeratr. 



146 



GENERAL SYMPTOMS. 



NEUBALGIA : Aeon. Arnic. Arsen. 

Beilad. Bry. Calc. Capsic. Chain. 

Coccul. Coif. Colchic. Hep. Ignat. 

Kali. Merc. Mezer. Natr. Nux youi. 

Puis. Kims. Spig. Staph. Sulph. 

Thuj. Valer. Veratr. 
NODES, gouty: Antim crud. Arnica. 

Bry on. Calc. carbon. Calc. Phosph. 

Caust. Graph. Hepar. Led. Lycop. 

Mercur. Nux vom. Pulsat. Rliodod. 

Ehus. Staph. Sulph. 
ONANISM, consequences of: Calc. 

Carbo veg. Carbo animal. China. 

Coccul. Con. Kali. Lach. Lycop. 

Merc. Natr. Natr. mur. Nux yom. 

Oleand. Phos. Phosph. ac. Pulsat. 

Ehus. Sil. Staph. Sulph. Thuj. 
PAINS, wandering : Arn. Bell. Chin. 

Mang. N. mosch. Puis. Bhocl. Ehus. 

Sabin. Sep. Sulphur. 
PAEALYSIS : Anac. Arn. Asar. 

Bar. Bell. Bry. Calc. Caps. Carbo 

veg. Canst. China. Cic. Cocc. Con. 

Croc. Crot. Dig. DulcTferr. Fluor. 

acid. Ilyosc. Ign. Kali. Lach. Laur. 

Lye. Magn. mur. Merc. Natr. Natr. 

mur. Nitric ac. Nux vom. Oleand. 

Op. Phosph. Plumb. Puis. Rhus. 

Sec. corn. Sil. Stann. Stram. Sulph. 

Veratr. Zinc. 
PHLEGMATIC TEMPEBA- 

MENTS : Bell. Caps. Chin. Lod. 

Lach. Merc. Natr. Natr. mur. Nitric 

ac. Puis. Sulph. 
PLETHOEA : Aeon. Arn. Aur. Bell. 

Bry. Calc. Chin. Dig. Ferr. Graph. 

Ilyosc. Kali. Lycop. Natr. mur. 

Nitric ac. Nux Yom. Phosph. Puis. 

Ehus. Stram. Sulph. 
POISONING WITH ALUM: Puis. 

Veratr. 
— with arsenic : Carbo veget. China. 

Ferr. Hep. Ipec. Lach. Lye. Nux 

vom. Sulph. Veratr. 
— with lead: Alum. Bell. Nux vom. 

Op. Plat. 



— with colchicum : Coccul. Nux vom. 

Puis. 
— with iron : Ars. Hep. Ipecac. FulSo 
— with adipic poison : Arsenic. Phos. 

acid. 
— with" fish-poison : Bell. Camphor. 
— with honey : Camph. 
— with iodine : Arsen. Beilad. China. 

Phosph. Sulph. 
— with toad-poison: Ars. (?) 
— with copper: Bell. Hepar. Ipec. 

N. vom. 
— with opium : Bell. Com Nux vom. 
— with phosphorus : Coff. Nux yom. 

Sulph. 
— with mushroom : Carbo veget. Coff. 

Puis. 
— with mercury: Arn. Aur. Bell. 

Carbo veg. Cham. Chin. Dulc. 

Hep. Iodine. Kali biclir. Lach. 

Lye. Nitr. ac. Mezer. Phos. ac. Sil. 

Staph. Sulph. Thuj. 
— with sal. ammoniac : Coff. N. vom. 
— with sarsaparilla : Bell. Merc. 

Sulph. 
— with acids: Aeon. Bry. Op. Puis. 
— with sulphur : Arsen. Mercur. Puis. 

Sil. 
— with stramonium : Coff. Hyoscyam. 

Nux vom. 
— with poison- vine : Bell. Bry. Merc. 

Sulph. 
— with alcohol : Coff. Nux vom. 
— with sausage^oison : Arsen. Bell. 

Bry. 
— with tin : Carbo veget. Hep. Puis. 
PBEGNANCY, ailments incident to : 

Aco. Bell. Bry. Calc. Chamom. 

Con. Hyosc. Lach. Lye. N. vom. 

Phos. Plat. Puis. Sep. Sulph. Ve- 
ratr. 
EAPHANIA: Arsen. [Bell. China. 

Hyosc. Iod. Op. Ehus. Secale corn. 

Sol.nigr. Stram. 
EHEUMATISM: Aco, Arn. Ars. 

Bell. Bry. Carb. veg. Caustic. Cham. 

China. Colch. Hep. Ignat. Kali 



GENEKAL SYMPTOMS. 



147 



bichr. Lack. Lye. Mere. Nitric ac. 

Nux vom. Pulsat. RhoUod. Rhus. 

Sassap. Sep. SpigeL Sulph. Tliuj. 

Veratr. 
BIDING- IX A CARRIAGE, ail- 
ments from: Ars. Carbo veg. Coc- 

cul. Coleh. Ferr. Ign. Xatr. Petr. 

Psor. Sil. Sulph. 
RICKETS: Asa f. Bell. Calc c. 

Calc. phosph. Lye. Jferc. Pkosph. 

Palsat. Rhus. Siiic Sulph. 
SALT, ill effects of eating too much : 

Carbo veg. Merc. Xux vom. 
S A N G V I N TEMPERAMENT : 

A on. Am. Bnj. Bell. Cham. 

Hyoscyam. Ign. Nux vom. Rhus. 

Sulph. Sulph. etc. Veratrum. Zinc. 
SCURVY: Amm. mur. Ars. Aur. 

Bor. Cede. Carbo an. Carbo yeg. 

Creos. Hep. lod. Mercnr. Mur. ac. 

Natrum mur. Nitric ac. Nux vom. 

Silic. Staph. Sulph. Sulph. ac. 
SEA-SICKNESS: Ars. Coccul. 

Creos. Ipecac. Peir. Rhus. Sulph. 

Veratr. 
SEDENTARY HABITS, ill effects 

of: Aco. Carbo veg. Cede. Ignat. 

Natr. Natrum mur. N. vom. Puis. 

Sulph. 
SEMILATERAL AILMENTS, left 

side : Aeon. Alum. Amm. mur. 

Apis. Arn. Asa f. Asar. Bry. Caic. 

Cann. Chin. Cic. Colch. Coloc. 

Croc. Cupr. Daph. Dulc. Ign. lod. 

Lach. Lye. Mercur. Natr. Nitric 

ac. Nux mosch. Nux vom. Petr. 

Phos. Shod. Seleu. Sep. Spig. 

Sulphur. Sulphur, etc. Tar. Tart. 

emet. Thuj. Veratr. Yiola od. 
— right side : Agar* Alum. Bar. Bell. 

Bism. Brom. Bry. Co nth. Carbo an. 

Canst, Cina. Con. Crot. Dig. Dros. 

Hepar. Ignat. Kali. Led. M. arct. 

Mosch. Oleand. Phosph. ac. Plumb. 

Rims. Buta. Sabad. Sabina. Sangn. 

Sil. Spongia. Staph. Stront. Sulph. 

ac. Tart. emet. Thuj. Yit. 



— cross-wise: Agar. Mangan. Sil. 
SENSATION AS IE BLOWN UP- 
ON BY WIND : Nux vom. Ole- 
ander. Rhus. Stram. 
— as if congealing: Bellad. Cic. Chi. 

Dros. Hyosc. Led. Puis. Sec. com. 

Stram. 
— as if growing larger : Asa feet. Bell. 

Ignat. Laur. Phosph. Puis. Rhus. 
— as of a hair: Lycop. Natr. mur. 

SuIjjJi. 
—as of growing smaller : Calc. Croc. 
— as of something alive: Croc. Ign. 

Lach. Mercur. Sec. corn. Sulph. 

Thuj. 
SPANISH FLIES, iU effects of: 

Camph. 
SPASMS, generally : Aeon. Ang. 

Arn. Ars. Asa f. Bell. Bry. Calc. 

carb. Camph. Caust. Cham. Cic. 

Cina. Coccul. Coff. Con. Croc. 

Cupr. Hell. Hyosc. Ign. Ipec. Lach. 

Laur. Lycop. Merc. Mosch. Nux 

mosch. Nux vom. Op. Plat. Plumb. 

Puis. Rhus. Ruta. Sec. corn. Stann. 

Stram. Sulph. Tart. emet. Veratr. 

Zinc. 
— in the evening: Caust. Cina. Laur. 

Nux vom. Puis. Stann. Stram. 
— with anxiety : Ars. Bell. Calc. Cham. 

Cin. Cupr. Hyosc. Ign. Lach. Puis. 

Veratr. 
— with dyspnoea : Ang. Bell. Camph. 

Cupr. Ign. Ipec. Xux vom. Op. 

Pids. 
— with staring eyes : Bell. Hyoscyam. 

Xux vom. Op. Sec. corn. Stram. 
— with contortion of the eyes : Aeon. 

Bell. Coccul. Cuprum. Hyosc. Ign. 

Lach. 
— with upwards : Bell. Ignat. Lach. 
— with downwards : Cic. Lach. 
— vith sidewise : Bell. Caust. Hyosc. 

Lach. 
— glazed eyes : Coccul. 
— half open eyes : Caust. Cina. Ipec. 
— with eyes protruded : Hyosc. 



148 



GENEKAL SYMPTOMS. 



— with eyes closed : Bell. Cham. Coc- 

cul. Croc. Hyosc. Merc. Natr. mur. 

Op. 
— after repelled eruptions : Calc. 

Caust. Lach. Nux vom. Sulph. 
— with bloated bowels: Calc. Cham. 

Cin. Merc. 
— with violent movements : Calc. Cin. 

Cupr. Hell. Hyosc. Op. Stram. 
— from contact : Bell. Coccul. Stram. 
— with loss of sense : Bell. Camph. 

Cic. Cina. Cupr. Hyosc. Ign. Ipec. 

Lach. Nux vom. Op. Sil. Stann. 

Stram. 
— with nausea : Ipec. Nux vom. Puis. 

Tart. emet. Veratr. 
— with clenched thumb : Bell. Hyosc. 

Ign. Lach. Merc. 
— with delirium: Bell. Crot. Hyosc. 

Op. 
— with diarrhoea : Chin. Hyosc. 
— with thirst : Cham. Nux vom. 
— with eclampsia : Bell. Caust. Cham. 

Cic. Cin. Ignat. Hyosc. Laur. Nux 

mosch. Nux vom. Op. Phosph. Sec. 

corn. 
— epileptic: Agar. Ars. Bell. Calc c. 

Camph. Caustic. Cham. Cic. Cina. 

Coccul. Cupr. Glon. Hepar. Hyosc. 

Ign. Lach. Merc. Nitr. ac. N. vom. 

Op. Plumb. Puis. Rhus. Sec. corn. 

Sil. Stann. Stram. Sulph. Verat. 
— with vomiting : Cupr. Ipecac. Nux 

vom. Puis. Sec. corn. 
— with danger, of suffocation : Cupr. 

Ign. Nux vom. Op. 
— with yawning : Ign. Veratr. 
— after emotions : Ballad. Coff. Hyos- 

cyam. Ign. Nux vom. 
— with pale face : Ipec. Natrum. Sil. 

Stann. 
— with blue face: Camphor. Cupr. 

Cin. Op. Veratr. 
— yellow face : Cic. Nux vom. 
—red face : Bell. Ign. Stram. 
—with cold sweat in the face : Cocc. 



— with distorted features : Belladona. 

Cham. Coccul. Ipecac. Stram. Ve- 
ratr. 
— with involuntary emission of urine : 

Caust. Coccul. Hyosc. 
— with palpitation of the heart: Lach. 

Sec. corn. Spig. 
— with heat : Bell. Cham. Nux vom. 
— with seansation of hunger : Hyosc. 
— hysteric : Aur. Belladona. Caustic. 

Cham. Coccul. Coff. Cupr. Ignatia. 

Ipec. Mosch. Nux vom. Plat. Puis. 

Stram. Veratr. 
— internal : Calc. carb. Caust. Cocc. 

Coloc. Graph. Ipecac. Magn mur. 

Stann. 
— with delirium : Bell. Cin. 
— with coldness of the body: Cin. 

Hyosc. Puis. Veratr. 
— with coldness of the limbs : Caust. 

Hyosc. Op. Veratr. 
— cataleptic: Agar. Bell. Cham. Cic. 

Hyosc. Ipec. Stram. Yeratr. 
— with locked jaw : Bell. Hyoscyam. 

Lach. Nux vom. Opium. Plat. Ve- 
ratr. 
— of children: Bellad. Calcar. Cham. 

Cina. Coffea. Ipec. Nux vom. Op. 

Sulph. 
— clonic : Agr. Ambr. Arnica. Arsen. 

Bar. Bellad. Calc. Camph. Canthar. 

Caust. Cham. Cic. Cina. Coccul. 

Con. Cupr. Hell. Hyosc. Ign. Ipec. 

Laches. Kali. Magn. Merc. N. vom. 

Op. Phosph..R/*i£6'. Sec. com. Sepice. 

Stann.] Stram. Sulph. Veratr. 
— with movements of the head : Bell. 

Cham. Cic. Hell. Lach. Op. Stram. 
— opisthotonic : Ign. 
— preceded by head-ache : Bell. Hy- 
oscyam. Lach. Nux vom. 
— succeeded by head-ache: Bellad. 

Cina. 
— with contraction of the limbs : Hy- 
oscyam. 
— with laughter: Bellad. Calc. Canst. 

Ign. Lach. 



GENERAL SYMPTOMS. 



149 



— with creeping as of a mouse : Bell. 

Sulph. 
— with colic: Caustic. Cham. Cin. 

Cupr. Merc. Sulph. 
SWEAT, anxious: Am. Ars. Calc. 

Cliam. Ferr. Ign. Merc. Natr. Nux 

vom. Phos. Puis. Elms. Sep. Spong. 

Stramon. Sulph. Veratr. 
— bloody : Lach. Lye. Nux vom. 
— musty smell : N. vom. Puis. Rhus. 
— exhausting : Ambra. Arsen. Bryon. 

Calc. Carbo an. Chin. Digit. Ferr. 

Hep. Iod. Lye. Mercur. Natr. mur. 

Nitric acid. Nux vom. Phosphor. 

Samb. Sep. Stann. Sulph. Veratr. 
— fatty: Bryon. China. Merc. Selen. 
— staining the linen: Ars. Graphit. 

Merc. Selen. 
— yellow: Graph. Lach. Merc. 
— semilateral : Cham. Chin. Nux vom. 

Puis. 
— smelling like juniper: Sep. 
— cold : Aeon. Amm. mur. Ant. tart. 

Arn. Ars. Bryon. Calcar. Camph. 

Cannab. Carbo veg. China. Cin. 

Coccul. Cupr. Dulc. Hell. Hep. Ign. 

Ipec. Lach. Lye. M. arct. Mercur. 

Nux vom. Puis. Rheum. Rhus. Sa- 

bad. Sec. corn. Sep. Staph. Sulph. 

Veratr. 
— smelling like old cheese : Plumbum. 
— viscous : Aeon. Ant. tart. Ars. Bry. 

Cham. Daph. Ferr. Hep. Iod. Lye. 

Merc. Phosph. Phosph. ac. Plumb. 

Sec. corn. Veratr. 
— red: Arn. Calc. Dulc. Lycop. Nux 

vom. 
— sour smelling: Am. As ar. Bellad. 

Cham. Ferr. Hep. Ignat. Iod. Ipec. 

Kali. Lye. Merc. Nitric ac. Rhus. 

Sep. Sil. Sulph. Veratr. 
— stinging: Cham. Con. 
— fetid : Ammon. mur. Baryt. Canth. 

Con. Dulc. Ferr. Fluor, ac. Graph. 

Hep. Kali. Led. Lye. Merc. Nitric. 

ac. Nux vom. Phosph. Puis. Rhus. 

Selen. Sep. Staph. Veratr. 



— having an urinous smell : Canthar. 

Nitric ac. 
— smelling like onion : Bov. Lycop. 
— in the morning: Op. Nux vom. 

Plat. 
— with open mouth : Mosch. Op. 
— with distorted mouth : Bellad. Nux 

vom. Op. Strain. 
— followed by weariness : Bell. 
— at night : Bell. Calc. carbon. Calc. 

caust. Cham. Cin. Ign. Merc. Op. 

Sulph. 
— during new-moon: Calc. Caustic. 

Cupr. Sil. 
— falling down unconscious: Bell. 

Cupr. 
— after onanism: Calc. China. Coc- 
cul. Lach. Lye. N. vom. Op. Staph. 

Sulph. Veratr. 
— with dilated pupils: Bellad. Calc. 

Cic. Cin. 
— during the menses : Coccul. Cupr* 

Ignat. Nux vom. Plat. Puis. 
— with rattling breathing: Ipec. 

Lach. Nux vom. 
— in the back: Bell. Ign. Ipec. Op. 

Rhus. 
— falling backwards: Bell. 
— with froth at the mouth : Chamom. 

Cupr. Hyosc. Ign. Lach. Nux vom. 
— with froth at the mouth, bloody: 

Lach. Op. Pyrocarb. 
— during sleep : Bellad. Calcar. caust. 

Cin. Sil. 
— followed by drowsiness : Bell. Dros. 

Ign. Lach. Op. 
— after a fright : Bellad. Coffea. Ignat. 

Lach. Op. Nux vom. Veratr. 
— with a scream : Cina. Crot. Hyosc. 

Lach. Nux vom. Op. Sulph. 
— followed by weakness : Bell. Calc. 

Cic. Sec. corn. Veratr. 
— with sticky sweat on the head: 

Camph. 
—tetanic : Aconit. Ars. Bell. Camph. 

Cic. Cupr. Ign. Ipec. Laur. Op. 



150 



GEXESAL SYMPTOMS. 



Plat. Rhus. Secale corn. Stram. 

Veratr. 
— Saint Yitus' dance, chorea: Bell. 

Caust. Coccul. Croc. Cupr. Hyosc. 

Ign. Lach. Laur. Nux vom. Stram. 

Zinc. 
— after an injury : Am. Pulsat. Ehus. 

Sulph. 
— alternately red and pale : Ign. 
— with crying: Bell. Caust, Cuprum. 

Ign. Lach. Puis. 
— of lying-in females : Bell. Chamom. 

Coff. Hyosc. Ign. Puis. 
— caused by worms: Cole. Cin. Hy- 
osc. Merc. N. vom. Sulph. 
— dentition: Bell. Calc. Coff. Cham. 

Ign. Merc. Sulph. 
— with gritting of the teeth: Cin. 

Coff. Hyosc. 
— with trembling : Cupr. Lach. 
— with twitching: Bell. Calc. Canst. 

Cham. Cina. Cuprum. Hyosc. Ign. 

Ipecac. Lach. Merc. Op. Plumb. 

Ehus. Sec. corn. Strain. Sulphur. 

Veratrum. 
SPIEITS OF CAMPHOR, ill effects 

of: Coff. Op. 
STRAINING BY LIFTING, ill ef- 
fects of : Am. Bryon. Calc. Coccul. 

Con. Graph. Lye. Natr. Nitric ac. 

Nux vom. Phosph. Phos. ac. Rims. 

Euta. Sil. Sulph. Sulph. ac. 
SWEAT, ill effects of suppression of 

sweat : Aeon. Bell. Bry. Cham. Chin. 

Dulcam. Lach. Nux vom. Pulsat. 

Sil. Sulph. 
TEA, ill effects of: China. Ferrum. 

Lach. 
THIEST : Aeon. Ars. Bellad. Bryon. 

Canth. Cham. Ipecac. Merc. Nux 

vom. Puis. Rhus. Sulph. Veratr. 
TOBACCO, ill effects of: Cham. 

Coccul. Nux vom. 



UNEASINESS, bodily: Aconitum. 

Anae. Ars. Asar. Bellad. Bry. Calc. 

Cann. Carbo veg. Cham. Chin. Cof- 

fea. Croc. Cupr. Ferr. Graph. Ky- 

oscyam. Ign. Iod. Kali. Lycop. M. 

austr. Merc. Mur. ac. Natr. N. vom. 

Op. Phos. Plat. Rhus. Samb. Sep. 

Sil. Staph. Stram. Sulph. Veratr. 
VASCULABEBETHISM: Aconit. 

Ambra. Arn. Aurum. Bellad. Bov. 

Bry. Calc. c. Carbo veget. Caustic. 

China. Con. Creos. Ferr. Hep. Iod. 

Kali. Lyeop. Natrum mur. N. vom. 

Op. Petr. Phosph. Ehus. Sassap. 

Sepiae. Sil. Stann. Sulph. 
WALK, difficulty of learning to walk : 

Calcar. Mercur. Sil. Sulph. 
WEAKNESS, general: Agar. Amm. 

Anac. Arn. Ars. Bell. Brom. Calc. 

Carb. an. Carbo veg. China. Cocc. 

Conium. Ferr. Fluor, ac. Grapldt. 

Ipecac. Kali. Lach. Lycop. Magn. 

mur. Merc. Natr. Natr. mur. Nitric 

ac. Nux vom. Oleand. Op. Phosph. 

Phosph. ac. Plat. Puis. Ehus. Sec. 

corn. Sepiae. Sil. Staph. Sulphur. 

Veratr. 
WEANING, ailments from : Bellad, 

Bry. Calc. Puis. 
WEARINESS: Arn. Ars. Bell. Calc. 

Cann. Caust. Chin. Coccul. Coffea. 

Con. Croc. Ferr. Graph. Hep. Ign. 

Ipec. Kali. Lycop. Merc. Natr. Nux 

vom. Oleand. Phosph. Plat. Puis. 

Ehod. Rhus. Spong. Sulph. Tart. 

em. Thuj. Veratr. 
— consequences of: Arn. Bry. Coff. 

Rhus. Puis. 
WHITE, red parts turning: Arsen. 

Bor. Calc. Ferr. Hell. Mercur. Ni- 
tric ac. Nux vom. Phos. Secale 

corn. Staph. Sulph. Sulph. ac. 
WOUNDS: Arn. Calendul. Hyper. 
BURNS: Arnica. Urtica. 
PAIN FROM BURNS : Ars. Caust 



INDEX 



INDEX TO REPERTORY, OR LIST OF SYMPTOMS. 



A 

Abdomen, morbid symptoms 

in 37 

Abscesses 127 

Acne rosacea 17 

Acid stomach 35 

After pains, abnormal 95 

Aggravation of pains 132-137 

Amaurosis .. 9 

Amelioration of pains 137 

Anaemia — 140 

Aneurysm 140 

Anger, effects of 3 

Anus, excoriated 77 

Anus and rectum, affections 

of 77 

Anxiety and fright, effects of 3 

Aphonia, loss of voice 56 

Aphthae 24 

Apoplexy 140 

Apparent death 140 

Appetite, loss of 29 

Arms and armpits 102 

A sthma 45 

Atrophy 140 

Aversion to various kinds of 

food and drink 29 

Axillae, svmptoms in 65 

B 

Back, morbid feelings in re- 
gion of 70-71 

Bad effects of food or drink. 30 

Ball, hysteric 25 

Bed sores 122 

Black pores on nose 16 

Blackness of vision, sudden 9 

Bladder, affections of 85 

Bladder, catarrh of the 85 

Bladder, inflammation of. . . 85 

Blotches 122 

Blue disease 140 

Blurred sight 9 

Bones, affections of 140 

Brain, concussion of 5 

Brain, inflammation of 5 



Breath and breathing, abnor- 
mal 45 

Burns UO 

c 

Calves of the legs, symptoms 

of 121 

Cancer of the breast 66 

Cancer of the lips 21 

Cancer of the nose. 16 

Cancer of the stomach 35 

Cancer of the tongue 27 

Cantharis, ill effects of 147 

Cardialgia 38 

Caries t 140 

Cataract 9 

Catarrh 42 

Catarrh, accompanying ail- 
ments of 44 

Catarrhal fever . . 42 

Chagrin, consequences of 140 

Chapping of lips. . . .' 21 

Chamomilla, ill effects of... 140 

Chest, morbid symptoms of 61 

Chilblains 121 

China, ill effects of 140 

Cholera. Asiatic 141 

Cholerine 141 

Colic, various kinds of 38 

Color, illusions of 9 

Comedones . 122 

Confinement, ailments dur- 
ing and after 95 

Consciousness, loss of 1-2 

Constipation 74 

Contusions 141 

Cornea, spots on 11 

Coryza 4-' 

Cough, various kinds of.. . . . 51-59 

Cough, causes of 51-52 

Cough, accompanying ail- 
ments of 53-56 

Cracking of skin 122 

Cracking of tongue 27 

Cramp of the stomach. 35 

Croup, disposed to 2-5 



151 



152 



INDEX TO REPERTORY. 



Croup, various forms of 57-58 

Croup, gangrenous 25 

Crustalacta 19 

D 

Deafness 15 

Debility, nervous 141 

Delirium 2 

Desire for certain kinds of 

food and drink 29 

Diabetes insipidus 82 

Diarrhoea 74 

Dilation of pupils 12 

Dreams 131 

Dropsy of the abdomen 39 

Dry coryza of infants 141 

Dysentery 42 

E 

Earache. .' 14 

Ears, i n flam mation of 15 

Ears, pains in 15 

Ecchymosis in eyes 11 

Emotions, causing disease.. 3 

Epistaxis 16 

Eructations 31 

Erections 90 

Eruptions on various parts. 8-21-19 

Erysipelas 125 

Erysipelas of mamnise 66 

Erysipelas of scrotum 89 

Eyelids, paralysis of 13 

Eyelids, spasm of 13 

Eyelids, inflammation of.... 13 

Eyes, affections of the. . .... 9 

Eyes, inflammation of the. . 11 

Eyes, swollen 12 

Eyes, ulcerated 13 

Exhaustion from mental la- 
bor 2 

Expectoration, various kinds 50-51 
Extremities, symptoms of. .. 102 
Extremities, lower, symp- 
toms of 112 

Extremities, upper, symp- 
toms of 102 

F 

Face, eruption in 19-21 

Eace, swelling of 18 

Fat, tendency to get 142 

Fear, consequences of 142 

Feet, symptoms of 116 

Feet, dorsum, symptoms of. . 118 

Feet, soles, symptoms of.... 118 

Females, diseases of 92 

Fever, bilious 142 

Fever, catarrhal, 42-142 

Fever, dentition. 142 

Fever, gastric 142 

Fever, hectic 142 

Fever, milk 142 

Fever, puerperal 142 

Fever, rheumatic 142 



Fever, wound 142 

Fever, yellow . 142 

Fever, particular symptoms 

of 142 

Figwarts at anus 78 

Figwarts on private parts. .. 94 

Fingers, symptoms of 109 

Finger joints, symptoms of.. in 

Finger nails, symptoms of. . 112 

Finger tips, symptoms of. . . Ill 

Fitful ' 1 

Fistula lachrymalis 14 

Fistula dentalis 23 

Freckles. 18^125 

Forebodings 2 

Freezing, consequences of.. . 142 

Fright 3 

Fungi, articular, haematodes, 

medullaris 119 

Fungus, haematodes of eye. . 11 

G 

Ganglia 125 

Gangrene 87-125 

Glans, affections of the 87-^8 

Glands, affections of 59-60-145 

Glaucoma 9 

Goitre 59 

Gonorrhoea 87 

Gout 145 

Gravel 86 

Grief, ill effects of 3 

H 

Hemorrhage from ears 15 

Hemorrhage from eyes 11 

Hemorrhage from nose 16 

Hemorrhage, uterine 94 

Hands, symptoms of 107 

Hang-nails 112 

Hard hearing 15 

Head, peculiar sensations in 

external 8 

Head, trembling of — 9 

Headache 6 

Headache, various forms of. 6 

Hearing, defects of 15 

Hearing, illusions of 16 

Heart, inflammation of 67 

Heart, affections of, aggra- 

vated by — 67 

Heartburn • 32 

Heels, symptoms of 115 

Hemeralopia 9 

Hemicrania 6 

Herpes 123 

H erpes in face 19 

Hip joint 118 

Hoarseness 57 

Hunger, abnormal 30 

Hunger, ill effects of 145 

Hydrocephalus 6 

Hydrophobia 145 

Hypochondria 145 



INDEX TO REPERTORY. 



153 



Hypochondriac region, mor- 
bid sensations in the 37 

Hysteria 4-145 

Hysteric ball 25 

i 

Illusions of color 9 

Illusions of hearing 16 

Illusions, optical 10 

Illusions of size, shape, dis- 
tance 10 

Illusions of things not pres'nt 10 

Indurations 145 

Inflammations 145 

Inflammation of bladder. ... 85 

Inflammation of the bowels. 39 

Inflammation of the ears 15 

Inflammation of the eyes... 11 

Inflammation of eyelids .... 13 

Inflammation of the heart.. 67 

Inflammation of the larynx. 51 

Inflammation of mammas... 66 

Inflammation of mouth 25 

Inflammation of nose 16 

Inflammation of ovaries 94 

Inflammation of palate 35 

In flammation of pharynx ... 26 

Inflammation of the tongue. 28 

Inflammation of trachea 57 

1 nflammation of urethra 86 

Insanity 2 

Intoxication 1 

Ischuria 83 

Itch 126 

Itching of scalp 8 

J 

Jaundice 18-144 

Jaws, affections of the 22 

Jealousy 3 

Jealousy, ailments from 144 

Joy, consequences of 144 

K 

Kidneys, affections of 86 

Knee-joints, symptoms of. .. 119 

L 

Lachrymation 11 

Larynx, inflammation of. .. 57 

Larynx, morbid sensations in 56 

Larynx, phthisis of 57 

Lips, affections of the 21 

Lips, cancer of the 21 

Lips, eruptions on 21 

Lips, rhagades of 22 

Lips, swelling of 22 

Lochia, derangement of 144 

Long-sighted 12 

Loss of blood between peri- 
ods 95 

Loss of consciousness. .... .. 2 

Loss of voice, see aphonia. .. 56 

Lumbago, see small of back. 12 

C3 



M 

Mammas, cancer of 66 

Mammas, erysipelas of 66 

Mammas, inflammation of. .. 66 

Mammas, swelling of 66 

Mammary glands, affections 

of 66 

Measles 123 

Memory, defects of 3 

Meningitis 5 

Menses, character of 96-97 

Mental derangements 3 

Micturition, nocturnal 82 

Micturition, abnormal 83 

Micturition, at night in bed 83 

Miliaria 124 

Milk, defects of 66 

Mind derangementand weak- 
ness of 1 

Miscarriage 91 

Moles 125 

Moles in uterus, see polypi. . 94 

Mouth, affections of the 24 

Mouth, inflammation of 25 

Mucus, dropping of, from pos- 
terior nares 72 

N 

Nape of the neck, stiff. 60 

Neck, stiff 60 

Nervousness ... 145 

Neuralgia 146 

Nipples, affections of 66 

Nipples, sore 66 

Nodes, gouty 146 

Npma 125 

Nbse, affections of 16 

Nose, dry 42-48 

Nose, inflamed 16 

Nose, polypus of the 17 

Nose, stoppage of 43 

Nose, swelling of the 17 

Nose, ulceration of 17 

o 

Obscuration, see blackness. . 11 

Onanism, consequences of. .. 146 

Opisthotonos 72 

Optical illusions 10 

Ovaries, affections of 94 

Ovarian dropsy 94 

P 

Pains, spurious labor. ....... 95 

Pains, wandering 146 

Palate, affections of 25 

Palpitation 57 

Paralysis 146 

Paralysis of eyelids 13 

Pellicle on the eyes 12 

Penis, affections of 81 

Perineum, affections of, see 

anus 79 

Pharynx, affections of 25 



154 



INDEX TO REPERTORY. 



Pharynx, inflammation of. . 26 

Photophobia 10 

Phthisis laryngea, (see Phthi- 
sis of larynx) 57 

Pimples in face 20 

Pityriasis 126 

Placenta, adhesion of . . 95 

Plethora 146 

Poisoning with various sub- 
stances 146 

Polypi of the nose 17 

Pores, black 126 

Pregnancy, ailments inci- 
dent to.. 146 

Prepuce, affections of 88 

Prosopalgia 20 

Prostate gland, affections of 90 
Pudendum, affections of ex- 
ternal 92-93 

Pupils, contracted 12 

Pupils, dilated 12 

Ptyalism (see salivation) 27 

Purple rash 124 

Pus, various kinds of 126 

Pustules 124 

Q 

Qualmishness 33 

R 

Rage 4 

Raphania 146 

Rash 124 

Regurgitation, (see Rising).. 32 

Reports in ears 16 

Rhagades of lips, (see Chap- 
ping) 21 

Rhactiitis 147 

Rheumatism 146 

Rickets 147 

Risings 32 

Rubeola 124 

Rush of blood 6 

S 

Saliva, morbid 26 

Salt, ill effects of 147 

Scaly head 9 

Scales on scalp 9 

Scapulae, morbid feelings in 

region of 10 

Scarlet-rash 124 

Scrotum, affections of 89 

Scurfs on head 9 

Tcurfs in nose 17 

Scurvy 147 

Seasickness 147 

Sedentary habits, ill-effects 

of 147 

Sediment in urine 81 

Semen, morbid character of 

the 91 

Sexual desire, unnatural ... 92 
Sexual instinct of females, 

excited 95 



Sexual intercourse of females 

aversion to 95 

Sexual weakness 92 

Shortsighted 10 

Shoulder joints, symptoms of 104 

Skin, character of the 122 

Skin, symptoms of 122 

Sleep, character and accom- 
panying conditions of 128-129 

Sleeplessness 130 

Small of back, morbid sensa- 
tions in 72 

Smallpox 124 

Sneezing 43 

Somnambulism 4 

Sopor 130 

Sore nipples 66 

Sere throat, see also Angina 

faucium , 25 

Spasms 147 

Spasm of the eyelids..... .. . 13 

Spasms, uterine 94 

Speech, impeded 28 

Spermatic cord, affections of 89 

Spine, curvature of 71 

Spots 124 

Spots on cornea 11-12 

Squinting 12 

Stammering 28 

Stiff neck 60 

Stomach, acid 35 

Stomach, cancer of 35 

Stomach, cramp of the 35 

Stomach, schirrus of 35 

Stomach and pit of stomach 

morbid sensations 35-36 

Stone in bladder 85 

Stool, ailments accompany- 
ing 76 

Stool, character of 73-75 

Stoppage of nose 43 

Stuttering 28 

Styes H 

Suffocative fits 47 

Suicide, disposition to 4 

Sweat 149-150 

Sweat, ill effects of suppress'd 150 

Swellings 127 

Swelling of eyes 12 

Swelling of eyelids 13 

Swelling of face 18 

Swelling of lips 22 

Swelling of mammae 66 

Swelling of the nose 17 

Swelling of the ovaries 194 

Swelling of tongue 28 

Sycosic warts 125 

T 

Tarsal joints, symptoms of. . 118 

Taste, morbid 30 

Tea, ill effects of 150 

Teeth and gums, affections of 

the 23 



INDEX TO REPERTORY. 



155 



Teething 23 

Teni per. defects of 1 

Tenesmus of anus 77 

Testicles, affections of 88 

Thighs, symptoms of 119 

Thirst, abnormal 30 

Tibia, symptoms of 120 

Tobacco, ill effects of 150 

Toes, nails and joints 120-1-1 

Tongue, affections of 27 

Tongue, cancer of the 27 

Tongue, cracked 27 

Tongue, inflammation of — 28 

Tongue, swelling of 28 

Trachea, inflammation of.. 56 
Trachea, morbid sensations 

in 57 

Trembling of the head 9 

Typhus, abdominal 142 

Typhus, cerebral 142 

Typhus, putrid 142 

u 

Ulceration of eyes 13 

Ulceration of the nose 17 

Ulcers 41 

Urethra, affections of 85 

Urethra, discharges from 86 

Urinary organs, affections of 79 

Urinate, urging to 82 

Urine, morbid sensations ac- 
companying the emission 

of 83 

Urine, quality of 79-82 

Uterus, diseases of 93 



Uterus, falling of 94 

Uterus, hemorrhage from ... 94 

Uterus, inflammation of 94 

Uterus, putrefaction of 94 

Uterus, spasms of 94 

v 

Vagina, affections of 93 

Vagina, inflammation of 93 

Vanishing of sight, see black- 
ness 11 

Varicella 125 

Varices 128 

Varices at anus 79 

Vertigo 4 

Vertigo, accompanying ail- 
ments of 5 

Vision, sudden blackness of. 10 

Vomiting 34 

Vomit, inclination to 33 

w 

Wandering of the mind 3 

Waking, see sleeplessness. . . 130 

Warts 125 

Weakness, general 150 

Weak back 72 

Weak digestion 35 

Weakness, sexual 92 

Weaning 150 

Wounds 128-150 

Wrath 3 

Wrist-joints, symptoms of. .. 106 

z 

Zona 125 



GENERAL INDEX. 



bdomen, pain in the 

.bdominal deformity after 
labor , 

Abdomen pendulous 

Abdomen, diseases of 

Abortion (see miscarriage)... 

Abscess of the liver 

Abscess Psous- Psoitis 

Abscess neucleatus 

A bilious constitution 

Acclimation 

Accessory or palliative treat- 
ment 

Aching pains in the back 
(Lumbago) 

Accidents of various kinds... 

11 rules for restoration 

after drowning 

Accidents, to excite breathing 
after 

Acidity, sour stomach during 
pregnancy 

Acidity, sour stomach, etc., 
of infants 

Aconite as an external appli- 
cation 

A constitution in which the 
skin is liable to become dis- 
eased 

Acute contagious diseases 

Acute articular rheumatism. 

Acna Rosacea — Gutta rosacea 

Adenitis (see inflammation of 
the glands) 

Administration of Homoeo- 
pathic medicines 

A dry wiry constitution 

A feeble constitution 

After effects of small pox 

After effects of scarlet fever- 
After effects of typhus fever. 

After effects of cholera 

After pains 

Age and the conditions qual- 
ifying it 

Age, different periods of. 

Ague, see intermittent Fever 

Air as a modifier of disease... 

Air and exercise during preg- 
nancy 

A lax lymphatic constitution 

Alcoholism 



309 

682 
682 
240 
664 
342 
517 
513 
26 
110 

87 

484 
724 

725 

725 

659 



93 



27 
521 
594 
508 

494 



26 
26 
542 
534 
577 
592 
672 

29 

29, 30 

544 

106 

655 

27 
144, 146 



Aliments allowed during 
treatment 

Aliments prohibited during 
treatment 

Alum whey 

Amenorrhea (scanty menses) 

An apoplectic constitution... 

Anaemia of the brain 

Analogous remedies, table of 

A nervous constitution 

Angina (sore throat) 

Angina pectoris 

Animation suspended (see ap- 
parent death) 

Antharax 

Antidotes, table of 

Anthony 's,St.fire (erysipelas) 

Aphthous sore throat 

Aphthous sore thorat, allo- 
pathic treatment 

Aphthous sore throat, homoe- 
opathic treatment 

Aphthae 

Apoplectic constitution 

Appetite, the, and its indica- 
tions 

Apoplexy as a symptom of 
disease 

Apoplexy 

Apoplexy allopathic treatm't 

Apoplexy homoepathic treat- 
ment 

Apoplexy home treatment. 

Apparent death 

Apparent death from hunger 

Apparent death from a fall... 

Apparent death from suffo- 
cation 

Apparent death from light- 
ning 

Apparent death from drown- 
ing 

Apples, roast 

Apple water.... 

Arnica, external application 
of 

Arsenicum, external applica- 
tion of in bed sores 

Art of feeling the pulse 

Arteries and veins, diseases 
of the 

Arteries, diseases of the 



109 

110 
751 

628 
26 

122 
86 
26 

218 

468 

724 
514 
753 
498 
218 

220 

221 

216 
26 

49 

52 
124 
125 

126 

128 
724 
724 

724 

724 
725 

725 

750 
750 

92 

95 
35 

470 
470 



916 



GENERAL. INDEX. 



917 



Arteries and veins, wounds 
of the 

Arthritic rheumatism 

Arrowroot gruel 

Asiatic cholera 

Asthma 

Asthma, allopathic treatm't 
for 

Asthma, homoeopathic treat- 
ment for 

Asthma, home treatment for 

Asthma, hay (hay fever) 

Asthmatic " affections as a 
complication of smallpox... 

Asthma of infants 

Asphyxia (see apparent death) 

Atmospheric and other influ- 
ences of disease 

Atrophy of infants 

Auraepileptica 

Author's preface, first edit'n 

Author's preface, seventh edi- 
tion 

Baby, essentials for 
aby pudding 

Back, aching pain in the 
(Lumbago) 

Back, crick in the 

Bandages for ulcers and sores 

Bandages, elastic, to be used 
after labor 

Barber's itch 

Barley coffee 

Bath, regulations for 

Bath, hot fresh water 

Bath, cold, salt and fresh wa- 
ter 

Bath for infants, tempera- 
ture for 

Bathing, precautions to be 
observed in 

Bathing, cold, when benefi- 
cial 

Beating of the heart (see pal- 
pitation) 

Bed wetting, the, of young 
children 

Bed sores 

Beef tea 

Belching eructations 

Bilious constitution 

Bilious complaints 

Bilious or sick headaches 

Bilious fever 

Bilious fever, allopathic treat- 
ment for 

Bilious fever, homoeopathic 
treatment for 

Bilious colic 

Biliary calculi 

Blackish, dry, furred and 
tremulous tongue 



732 

598 
749 

587 
439 

440 

442 

443 
442 

5 42 
711 
724 

32 
713 
148 

8 



746 
746 

484 

484 
736 

683 

507 

750 

95 

95 

96 

98 

97 

96 

462 

368 
578 
748 
265 
26 
240 
265 
289 

290 

290 
312 
346 

51 



Bladder, inflammation of the 

Bladder, chronic inflamma- 
tion of the 

Bladder, spasm of the 

Bladder, paralysis of the 

Bladder, stone or gravel in 
the 

Bladder, spasm of the, after 
labor 

Bleeding of the nose 

Bleeding of the lungs 

Bleeding from the womb 

Bleeding from wounds 

Bleeding piles 

Bleeding from the stomach... 

Blindness 

Blindness, treatment for 

Blood, the condition of the,as 
animportantsign of the na- 
ture of the disease 

Blood, spontaneous dischar- 
ges of 

Bloodshot eye 

Blood, vomiting of 

Blood, vomiting of, allopathic 
treatment for 

Blood, vomiting of, homoeo- 
pathic treatment for 

Blood, spitting of 

Blood, discharges of, from the 
nose 

Bloody urine 

Bloody flux, (see Dysentery).. 

Blotches milk, milk scab 

Boils 

Boils and glandular swellings 
in connection with small- 
pox 

B'»o s of the nose, ulceration 
of the 

Bones, broken 

Bones, diseases of the 

Bottle nose 

Bowels, diseases of the 

Bowels, inflammation of the 

Bowels of infants, flatulent 
distention of 

Bowel complaints of infants. 

Bowels, looseness of the af- 
ter measles 

Bowels, loosene&s of the after 
smallpox 

Bowels constipation of the.... 

Bowels, constipation alterna- 
ting with looseness 

Bowels, confinement of the 
during pregnancy 

Brain, nerves, sensations, and 
senses and their indications 

Brain, diseases of the 

Brain, congestion of blood to 
the 

Brain, passive congestion of 



364 

364 
370 
372 

362 

673 
210 
402 
673 
732 
316 
266 
188 
189 



40 

41 
191 

266 

268 

269 
402 

210 
366 
300 
701 
513 



542 

204 
738 
4 76 

508 
277 
296 

700 
704 

527 

542 

326 

330 

660 

61 
113 

117 
120 



918 



GENERAL INDEX. 



Brain, lack of blood to the.... 122 
Brain, inflammation of 

the.. 134 

Brain fever 134 

Brain fever, allopathic treat- 
ment for 135 

Brain fever, homoeopathic 

treatment for 137 

Brain, dropsy of the 139 

Brain, water on the 139 

Brain, water on the, treat- 
ment for 140 

Brain and nervous systems 
sympathetic affections of. . 243 

Brain the, in dyspepsia 261 

Brain, conclusion of the 728 

Breathing and its indications 

in disease 44 

Breath the, in health 44 

Breathing, difficult, and its 

meaning 45 

Breath offensive. 46 

Breathing, difficult, treatm't 

of 208 

Breathing, to excite or assist 

in after accident 725 

Breathing, frequent, slow, 
quick, tardy, deep, or long 
small or short, difficult, 
moaning or sighing, oppres- 
sed, panting, suffocative, 
warm, cold, unequal, noisy, 
fetid or offensive, etc., and 
what is meant by these terms 44, 45 
Breasts, inflammation of the646,683 

Breasts, ulceration of the 646 

Breasts, preparation of the, 

before confinement. . . 667 

Breasts, swelling of the, of 

infants 712 

Breasts, cancer of the 650 

Bread and milk 746 

Bright's disease of the kid- 
neys 355 

Bright's disease of the kid- 
neys, allopathic treatment 358 
Bronchitis, inflammation of 

the bronchial tubes 406 

Bronchitis, inflammatory. . .. 408 
Bronchitis, inflammatory, al- 
lopathic treatment 410 

Bronchitis, inflammatory, ho- 
moeopathic treatment 412 

Bronchitis, capillary 412 

Bronchitis of children 414 

Bronchitis, home treatment. 414 

Bronchitis, chronic 415 

Bronchitis, chronic, allo- 
pathic treatment 4H 

Bronchitis, chronic, homoeo- 
pathic treatment 419 

Bronchial catarrh 415 

Broth for infants 745 



Broth, chicken 749 

Bruises or contused wounds. 735 

Buzzing in the ears 201 

Bunions 520 

Burns and scalds 741 

Calculi, renal 362 

alculi, biliary, (gall-stones) 346 

Camp fever, (see typhus) 355 

Calendula off, as an external 

application 93 

Cancer of the liver 348 

Cancer of the breast 650 

Cancer of the uterus (womb). 649 
Canker of the mouth . . . . 215 
Canker of the mouth, allopa- 
thic treatment 217 

Canker of the mouth, homoe- 
opathic treatment 218 

Canker of the mouth, home 

treatment 218 

Cantharis or cantharides as 

an external application 93 

Capillary bronchitis 412 

Carbo vegetabilisas an exter- 
nal application 95 

Carbuncle.... 514 

Carcinoma hepatis, cancer of 

the liver 348 

Carcinoma uteri 649 

Carcinoma mammae 650 

Cardialgia 270 

Caries of the bone 479 

Catalepsy 156 

Catarrhal ophthalmia 180 

Catarrhal inflammation of the 

eyelids 180 

Catarrh of the head 204 

Catarrhal constitution 27 

Catarrhal dysentery 299 

Catarrh or common cold. . . . J- 80 

Catarrhal fever . 380 

Catarrhal fever, allopathic 

treatment 380 

Catarrhal fever,homceopathic 

treatment 383 

Catarrh, bronchial 415 

Catarrh, Epidemic — Influ- 
enza.... 420 

Catarrh, epidemic— Influenza 

allopathic threatment 421 

Catarrh, epidemic— Influenza 

homoeopathic treatment. . . 422 
Catarrh of the sexual mucous 

lining, Leueorrhcea 637 

Catarrh of the bladder, (see 

chronic inflammation) 364 

Causes of disease 32 

Causticum or lime water for 

burns 94 

Cerebral system, diseases of 

the 113 



GENERAL INDEX. 



910 



Cephalalgia, Headache 167 

Cerebro spinal meningitis, 
Spotted fever " .. 113 

Cerebrospinal meningitis, al- 
lopathic treatment 115 

Cerebrospinal meningitis ho- 
moeopathic treatment 116 

Chapter I How to investi- 
gate the condition of the 
patient and determine the 
nature of disease 25 

Chapter II Investigation of 
the disease 32 

Chapter III Investigation 
of the disease contin- 
ued 72 

Chapter IVDiet and manner 
of living 78 

Chapter V Administration 
and repetition of homoeopa- 
thic remedies 80 

Chapter VI Cerebro Spinal 

meningitis 113 

Chapter VII The brain and 

nerves 167 

Chapter VIII Diseases of 
the eye 180 

Chapter IX Diseases of the 
ear 195 

Chapter X Diseases of the 
nose 204 

Chapter XI Diseases of the 
mouth and throat 215 

Chapter XII Diseases of the 
stomach 240 

Chapter XIII Diseases of the 

intestines 277 

Chapter XIV Diseases of the 

liver 338 

Chapter XV Diseases of the 
spleen 349 

Chapter XVI Diseases of the 
kidneys 352 

Chapter XVII Diseases of the 

bladder 364 

Chapter XVIII Diseases of 

the male sexual organs 373 

Chapter XIX Diseases of 

the larynx and trachea... 380 

Chapter XX Diseases of the 
lungs 400 

Chapter XXI Diseases of the 

Pleura 446 

Chapter XXII Diseases of 
the organs of circulation. .. 455 

Chapter XXIII Diseases of 
the arteries and veins 470 

Chapter XXIV Diseases of 
the bones, muscles and 
joints 476 

Chapter XXV Diseases of 
the glands 494 

Chapter XXV r I Diseases of 
the skin 497 



Chapter XXVII Acute con- 
tagious disease? 521 

Chapter XXVIII Epidemic 
and endemic infectious 

diseases 544 

Chapter XXIX Constitu- 
tional diseases without defi- 
nite infection 595 

Chapter XXX Diseases of 

the female sexual organs. 621 
Chapter XXXI Pregnan- 
cy 652 

Chapter XXXII Diseases 

following confinement 674 

Chapter XXXIII Infants 

treatment after birth 685 

Chapter XXXIV Diseases 

of infancy 695 

Chapter XXXV Accidents of 

various kinds 724 

Chapter XXXVI Food for 

infants and invalids 744 

Chapter XXXVII TheReper- 

tory 760 

Change of life 644 

Change of life, symptoms of 

the 645 

Chafing of infants 710 

Charcoal 95 

Characteristics, individual... 31 

Chest, sounds from the 75 

Chest, concussion of 729 

Chest, contusion of 72^ 

Childhood, periods of 30 

Children, derangements of 

the stomach of 260 

Children, fits of little.. 155 

Children, still-born 68-5 

Children, young, food for.... 746 

Children's pie 746 

Children, sleeplessness of 692 

Children and infants, treat- 
ment of 685, 695 

Children, bowel complaints 

of 704 

Children derangements of 

during teething 717 

Children, convulsions of 721 

Child, care of during labor. . 671 

Child-bed fever 678 

Child, when may it be put to 

the breast 687 

Chicken-pox 543 

Chicken broth 749 

Chilblains 519 

Chill and fever as symptoms 66-68 

Chill and fever 544 

Chlorosis (green sickness) 626 

Cholelithiasis (see gall stone) 346 

Choice of habitation 102 

Choleric temperament 28 

Cholera morbus 285 

Cholera morbus, allopathic 

treatment.. 286 



920 



GENERAL INDEX. 



Cholera morbus, homoeopa- 
thic treatment 287 

Cholera, asiatic 587 

Cholera, malignant 587 

Cholera, epidemic 587 

Cholera, causes of 588 

Cholera, after effects of 592 

Cholera infantum 706 

Chorea « 164 

Chorea, allopathic treatment 164 
Chorea, homoeopathic treat- 
ment . . . 165 

Chronic articular rheuma- 
tism 596 

Chronicrheumatism of joints 601 
Cinchona tincture, applica- 
tion externally 95 

Cirrhosis, see chronic inflam- 
mation of the liver 343 

Cleanliness, value of in pre- 
vention of disease 106 

Climate, modification of 102 

Clothing and habits 80 

Clothing during pregnancy... 656 

Clothing, see apparel 101 

Coffee, barley. 750 

Coffee, oatmeal 750 

Cold in the head 204 

Cold in the head, allopathic 

treatment for 205 

Cold in the head, homoeopa- 
thic treatment for . . . 206 

Cold in the head, home treat- 
ment for 209 

Cold, constitutional tendency 

to take 208 

Cold in the head, of infants. . 696 

Colic 309 

Colic, various forms of 310 

Colic, from worms 315 

Colic, crying and wakefulness 

of infants 697 

Common cold 380 

Common cold allopathic treat- 
ment 380 

Common cold, homoeopathic 

treatment .. 383 

Complicated forms of scarlet 

fever 533 

Complication and after-effects 

of smallpox 542 

Complexion the, its indica- 
tion 74 

Concussion of the brain 728 

Concussion of the chest 729 

Condensed signs of pregn'ncy 652 
Conditions which qualify the 

age 29 

Confinement or labor 669 

Confinement, duration of . . . . 674 
Confinement, diseases follow- 
ing 674 

Confluent smallpox 540 



Congestion of blood to the 

brain 117 

Congestion of blood to the 

lungs , 400 

Congestion of the liver 338 

Constitution and its varieties 26 

Constitution, feeble 26 

Constitution, bilious 26 

Constitution, apoplectic 26 

Constitution, a nervous 26 

Constitution, dry, wiry 26 

Constitution, lax, lymphatic. 27 
Constitution in which the 
skin is liable to become dis- 
eased. 26 

Constitution, rheumatic 27 

Constitution, Consumptive.. 27 

Constitutional diseases 521 

Constitutional diseases with- 
out definite infection 595 

Constipation 326 

Constipation, allopathic treat- 
ment . 326 

Constipation, homoeopathic 

treatment 328 

Constipation alternating with 

looseness 330 

Constipation of aged persons 331 
Constipation after purging.. 331 
Constipation during pregn'n- 
cy 660 

Constipation of infants 703 

Consumption 607 

Consumption, preventive 

treatment for 615 

Contagious diseases 521 

Contagious diseases, sanitary 
rules of the N. Y. Board of 

Health 525 

Contents, table of 16 23 

Convalescence after typhus.. 576 

Convulsions of infants 721 

Convulsions and spasms as 

symptoms 58 

Copper nose 508 

Corns 520 

Coryza 20t 

Coryza, snuffles of infants. . . 696 

Costiveness, its indications. . 47 

Costiveness, see constipation. 326 
Cotton wool as an external 

application 94 

Coughs, their indications... 72 

Cough, treatment of 388 

Cough, nervous 388 

Coupdesoleil, (see sunstroke) 742 

Coughs, after measles 527 

Coughs, in connection with 

smallpox 542 

Cough, whooping 423 

Cow's milk for infants 745 

Cowpox (see vaccination.).. 723 

Coxalgia (see hip disease). . .. 486 



GENERAL INDEX. 



921 



Coxalgia, allopathic treat- 
ment 487 

Coxalgia, homoeopathic treat- 
ment 488 

Cranberries for children 746 

Critical sweat 74 

Crick in the back 484 

Cross-eyes 199 

Croup, laryngitis 393 

Croup, laryngitis, allopathic 

treatment 393 

Croup, laryngitis, homoeopa- 
thic treatment 399 

Croup, false ; 95 

('roup, true 395 

Crusta lactea 701 

I rying and wakefulness of 

new born infants 697 

Cup pudding, tapioca 749 

Cup pudding, invalids' 749 

Cutaneous diseases (see disea- 
ses of the skin) 497 

Cuts (see wounds) 731 

Cystitis, inflammation of the 

bladder 364 

Cystospasmus, spasm of the 

bladder 370 

Dandruff. 505 

eafness 196 

Deafness, allopathic treat- 
ment 197 

Deafness, homoeopathic treat- 
ment 199 

Death, apparent, from hun- 
ger 724 

Death, apparent, from a fall. 724 
Death, apparent from suffo- 
cation 724 

Death, apparent, from light- 
ning 725 

Death, apparent, from drown- 

ing 725 

Death, apparent, from being 

frozen 726 

Death, apparent, from nox- 
ious vapors. . 727 

Death, verification of 727 

Decline, first period of 30 

Dedication 3 

Deforming rheumatism 598 

Delay of the menses 628 

Delirium, its indications.... 52 

Delirium tremens 144 

Delirium tremens, allopathic 

treatment 145 

Delirium tremens, homoeo- 
pathic treatment 146 

Delivery, perspiration after. 676 

Delivery, weakness after 682 

Delivery, treatment after 672 

Dentition, teething 717 

Depression of spirits 261 



Derangements attendant 
upon the first appearance 

of the menses 624 

Derangement of the stomach 257 

Diarrhoea 277 

Diarrhoea, allopathic treat- 
ment 278 

Diarrhoea, homoeopathic 

treatment 281 

Diarrhoea, its indications...'. 47 

Diarrhoea, chronic. . 279 

Diarrhoea of children, allo- 
pathic treatment 280 

Diarrhoea alternating with 

constipation 330 

Diarrhoea of lying-in women 681 
Diarrhoea of infants, descrip- 
tion and homoeopathic 

treatment 701 

Diagnosis :5 

Diet and manner of living. . 78, 105 

Diet, rules for, synopsis 109 

Diet during nursing 689 

Diet, supplementary of in 

fants 690 

Difficult breathing 45 

Digestive functions and their 

indications 47 

Digestion, deranged 240 

Dilation of the veins 471 

Dilation of the veins, allopa- 
thic treatment 473 

Dilation of the veins, homoe- 
opathic treatment 474 

Diphtheria 227 

Diphtheria, allopathic treat- 
ment 229 

Diphtheria, homoeopathic 

treatment 232 

Discharges of blood, sponta- 
neous 41 

Discharge from the ear 196 

Discharge of blood from the 

lungs 402 

Diseases to which the patient 

is especially liable 31 

Disease, the part or organ 

usually affected 32 

Disease, investigation of 32 

Disease, consideration of the 

cause of 32 

Disease, general character of 34 

Disease, the causes of 32 

Diseases of the brain, spinal 

cord, and nervous system. . 113 

Diseases of the head 167 

Diseases of the eye 180 

Diseases of the ear 195 

Diseases of the nose 201 

Diseases of the mouth and 

throat 215 

Diseases of the stomach 240 

Diseases of the intestines... 277 



922 



GENERAL INDEX. 



Diseases of the liver and 




Duration of suckling — wean- 




spleen 


338 
352 


ing 


691 


Diseases of the kidneys 


Dysentery, catarrhal 


299 


Diseases of the bladder 


364 


Dysentery, epidemic 


300 


Diseases of the male sexual 




Dysentery, allopathic treat- 




organs 


373 


ment 


304 


Diseases of the respiratory 


Dysentery, homoeopathic 


organs 


380 


treatment 


307 


Diseases of the larynx and 


Dysmenorrhcea (painful 




trachea 


380 


menstruation) 






400 


Dyspepsia 


240 


Diseases of the pleura 


446 


Dyspepsia, allopathic treat- 




Diseases of the organs of cir- 




ment 


250 


culation 


455 


Dyspepsia, homoeopathic 




Diseases of the heart 


455 


treatment 


252 


Diseases of the arteries and 








veins 


470 
476 


T?ar, diseases of the 

JCJar, inflammation of the... 




Diseases of single systems . . . 


195 






195 


cles an d j oi n ts 


476 
494 


Ear, discharge from 


196 


Diseases of the glands 


Ear, neuralgia of 


198 


Diseases of the skin 


497 

470 


Ear, humming or buzzing in 
Earache 


201 


Diseases of the arteries 


195 


Diseases of the veins 


470 


Earache, rheumatic or ner- 




Diseases, epidemic and en- 
demic infectious 


544 


vous 


200 


Eclampsia, spasms of infants 


155 


Diseases, acute contagious... 


521 


Eczema 


511 


Diseases, constitutional, 


Eggs, allowed in sickness. . . 


106 


without definite infection. 


595 


Eggs, soft boiled 


748 


Diseases of the female sexual 




Eggs and milk 


748 


organs 


621 


Egg toast, how to make .... 


747 


Diseases following confine-* 




Electricity in paralysis of the 




ment 


674 

729 


eye : 


189 


Dislocations, partial 


Electricity in colic 


315 


Division and repetition of 




Elm bark mucilage 


751 


doses. ... 


85 
85 
84 


Emaciation of infants 

Emansio mensium 


713 


Doses and their division. . 


626 


Dose for an adult 


Empty pulse 


37 


Dose for infants and chil- 


Employment of the mind 




dren . 


84 


during pregnancy 


656 




*83 




745 


Dose of globules (pills) 


83 


Enlargement of the heart. .. 


467 


Dose of tinctures 


84 


Enteritis — Inflammation of 




Dose of triturations 


84 

87 


the bowels 

Enteritis, allopathic treat- 


296 


Dose, to insure a proper 




Dose, for eradicative treat- 


108 
102 


ment 


297 


ment 


Enteritis, homoeopathic 
treatment 




Drainage, to prevent disease 
Dropsy of the brain 


299 


139 


Enteralgia 


309 


Dropsy of the brain, congen- 


Enteric fever 


555 


ital 


140 


Enteric fever, homoeopathic 




Dropsy of the brain, allopa- 




division and treatment of. 


564 


thic treatment 


140 


Enteritis as a complication 




Dropsy of the brain, homoeo- 
pathic treatment 

Dropsy of the chest 


140 


of measles 


523 




368 


450 


Epidemic and endemic infec- 




Dropsical swellings after scar- 
let fever 




tious diseases 


544 


534 


Epidemic catarrh 


420 


Dropsy 

Dry, wiry constitution 


743 




587 


26 


Epileptic vertigo 


149 


Drowning, apparent death 




Epilepsy 


147 


from. ... 


725 


Epilepsy, allopathic treat- 




Duration of confinement. . . . 


674 


ment 


150 



GENERAL INDEX. 



9^3 



Epilepsy, homoeopathic treat- 
ment 153 

Epilepsy, onanism as a cause 14v> 

Epistaxis LlO 

Eradicative and preventive 

treatment 98, 107 

Eructations — Belching 265 

Essentials for a baby 746 

Evacuations, their indica- 
tions 47 

Excess of blood to the brain 117 
Excess of blood to the brain 

allopathic treatment 120 

Excess of blood to the brain 

homoeopathic treatment. .. 121 
Excessive secretion of milk. 675 
Excessive perspiration af- 
ter delivery 676 

Excoriation of the nipples. . 683 

Excoriation of infants 710 

Exercise, the value of in pre- 
vention of disease 106 

Exercise of infants 693 

Expectoration, and its indi- 
cations 77 

External remedies and appli- 
cations 92 

External application of a 

poultice 92 

External application of a 

fomentation 92 

External application of Ar- 
nica 92 

External application of cal- 
endula 93 

External application of rhus. 92 
External application, for in- 
cised wounds 732 

External application, for lac- 
erated wounds. 734 

External application, for 

contused wounds or bruises 735 
External application, for 

punctured wounds 736 

External application, for 
gunshot wounds, splinters, 

etc 736 

External application, for dis- 
locations 729 

External application, for 

sprains 729 

External application, for 

burns or scalds 741 

External application, for 

stings of insects 742 

Erysipelas 498 

Erysipelas, allopathic treat- 
ment 501 

Erysipelas, homoeopath ic 

treatment 502 

Erysipelas, home treatment. 503 

Erysipelas, of infants 5< 

Erysipelas, symptomatic... 500 i 



Erysipelas, wandering 5C0 

Erysipelas, deviations from 

the common course of 499 

Erysipelas, fever 499 

Erysipelas, susceptibility to, 

in the face 503 

Erythema— Simple redness 

of the skin 497 

Eye, the, affords a multitude 
of symptoms and indica- 
tions in disease 69, 70 

Eye, diseases of the 180 

Eye, inflammation of the 180 

Eye, weeping or watery 190 

Eye, bloodshot 191 

Eye, crossed 192 

Eyes, inflammation of the, of 

infants 695 

Face, ache. 173 

ace, ague 173 

Facial herpes 509 

Fainting, its indications 52 

Fall, apparent death from a. 724 

Falling down of the bowel.. 331 

Falling of the womb 641 

Falling sickness— Epilepsy.. 147 

False pains before labor 669 

Fat, excessive 76 

Fatty degeneration of the 

heart 465 

Favus — Scald head 515 

Feeble pulse 37 

Feeble constitution 26 

Felon or whitlow 519 

Females, affections peculiar 

to 621 

Female sexual organs, dis- 
eases of the 621 

Ferunculus — Boils 513 

Ferunculus, malignant. ..... 514 

Fetid or offensive breath ... 46 

Fetid discharges after labor, 681 

Fever, general remarks on. . 287 
Fever, general treatment and 

diet during 288 

Fever, gastric or bilious 289 

Fever, gastric or bilious, al- 
lopathic treatment 290 

Fever, gastric or bilious, ho- 
moeopathic treatment 293 

Fever, catarrhal 3s0 

Fever, scarlet 527 

Fever, scarlet, symptoms and 

course of 528 

Fever, scarlet, uraemia in. . . 531 

Fever and ague 544 

Fever, intermittent 544 

Fever, intermittent, allopa- 
thic treatment 546 

Fever, intermittent, homoeo- 
pathic treatment 550 

Fever, inflammatory 554 



924 



GENERAL INDEX. 



Fever, typhoid 555 

Fever, enteric 555 

Fever, typhus 555 

Fever, yellow 581 

Fever, hay 442 

Fever, erysipelas 499 

Fever, milk 677 

Fever, child-bed or puerperal 678 

Fever, sun 742 

Fever, brain 134 

Fever, spotted, see Meningi- 
tis 113 

Fever, remittent 290 

Fevers, the urine foretells the 

changes at next crisis 42 

First signs of approaching 

labor 668 

Fistula lachrymalis 190 

Fits of little children 155 

Flatulency, its indications.. 48 

Flatulence of infants 696 

Flatulent distention of the 
stomach and bowels of in- 
fants 700 

Flaxseed tea 750 

Flesh, loss of or unhealthy 

increase of 76 

Flour as an external applica- 
tion for burns and scalds. . 95 

Flooding after labor.... 673 

Flux — Dysenteria 301 

Flux — Dysenteria, allopathic 

treatment 304 

Flux — Dysenteria,homoeopa- 

thic treatment 307 

Fly, Spanish, as an outward 

application 93 

Fomentations, application of 92 

Food, see aliments 101 

Food of infants 744 

Food for invalids 747 

Food for young children. . . . 746 
Foot, inflammation of the 

joints of the 493 

Fractures of bones 738 

Freezing, apparent death 

from 726 

Frequent pulse 37 

Frozen limbs 520 

Full pulse .. 37 

&al actor rhoea 675 

all-stone 346 

Galling— Excoriation of in- 
fants 710 

Gastric or bilious fever 289 

Gastric or bilious fever, allo- 
pathic treatment 290 

Gastric or bilious fever, hom- 
oeopathic treatment 293 

Gastric derangements during 

pregnancy 657 



General habits and method 

of living 31 

General remarks on fever.... 287 
General treatment and diet 

during fever . 288 

Glandular swelling and boils 
in connection with small- 
pox 542 

Glands, congloate,diseases of 

the 494 

Gonitis 489 

Gout 

Granular ophthalmia 184 

Gravel 362 

Green sickness — Chlorosis. .. 626 
Grief, see mental emotions.. 

Groaning as a symptom 77 

Groin, rupture of the, of in- 
fants 687 

Gruel, how to make 747 

Gruel, arrow-root 749 

Gruel, water 749 

Gruel, rice 749 

Gruel, sago 749 

Gunshot wounds 736 

Gutta rosacea 508 



Habits of living 101 

abits and clothing 80 

Habits of regularity 106 

Habits during pregnancy 556 

Habitation, choice of 102 

Haematemesis 266 

Haemorrhoids 316 

Haemorrhoids, allopathic 

treatment ... 316 

Haemorrhoids, homoeopathic 

treatment 319 

Haemorrhoids, home treat- 
ment 319 

Haemoptysis, see Spitting of 

blood 402 

Hard pulse 37 

Hardness of hearing 196 

Hay fever 442 

Hay Asthma 442 

Head, diseases of the 167 

Head, cold in the 201 

Head, cold in the, allopathic 

treatment 205 

Head, cold in the, homoeopa- 
thic treatment 206 

Head, swelling of the, of in- 
fants 686 

Head, congestion of blood to 

the 117 

Head, cold in the, of infants. 696 
Head, dropsv of the, see drop- 
sy of the brain 139 

Headache 167 

Headache, allopathic treat- 
ment 168 



GENERAL INDEX. 



925 



Headache, homoeopathic 
treatment 

Headache, neuralgic 

Headache, bilious or sick 169 

Heat and cold — chill and fev- 
er as symptoms 

Heat, exposure to (sunstroke) 

Hearing, the, as a symptom 
in disease ' 

Hearing, hardness of 

Heart, diseases of the 

Heart, inflammation of the.. 

Heart, palpitation of the 

Heart, fatty degeneration of 
the 

Heart, hypertrophy of the. . 

Heart, enlargement of the. .. 

Heartburn 

Helminthiasis— Worms 

Hematuria 

Hematuria, allopathic treat- 
ment 

Hematuria, homoeopathic 
treatment. 

Hemicrania or megrim 

Hemorrhage from the lungs 

Hemorrhage from the stom- 
ach 

Hemorrhage from the nose.. 

Hemorrhage from the womb 
see flooding 

Hemorrhage from wounds, 
means of stopping ... 

Hemorrhage from extracting 
a tooth 

Hereditary disease 

Hernia, see rupture. . . 

Herpes— Tetter. 

Herpes— Tetter, of the face. . 

Herpes, zoster. Zona 

Herpes iris and circinnatus.. 

Hiccup as a symptom of dis- 
ease 

Hiccup, general article on. .. 

Hiccup, treatment for 

Hiccup of infants 

Hip-joint, infiammat'n of the 

Hives — Urticaria 

Hoarseness as a symptom. .. 

Homoeopathic m edicines, 
their administration, repe- 
tition, doses, preservation, 
etc 

Home, choice of (see habita- 
tion) 

Honeycomb tetter 

Hordeolum— Stye 

Hot fresh water bath 

Humming or buzzing in the 
ears 

Hunger, apparent death from 

Hydrocephalus— W a t e r on 
the brain 



170 

168 
,205 

66 
742 

71 
196 
455 
455 
462 

465 

467 
467 
659 
320 
366 

367 

367 
167 
402 

266 
211 

673 

730 

733 
29 

687 
509 
509 
96 
510 

60 
443 
444 
696 
486 
503 

75 



102 
515 

V.rl 
95 

201 
724 

139 



Hydrocephalus, a 1 lo pathic 

treatment 140 

Hydrocephalus, homoeopa- 
thic treatment 140 

Hygiene of pregnancy 655 

Hyperemia of the brain 117 

Hyperemia of the brain, al- 
lopathic treatment 120 

Hyperemia of the brain, ho- 
moeopathic treatment 121 

Hypertrophy of the heart. . . 467 

Hypochondriacal affections. 261 

Hysterics 157 

Hysterics, allopathic treat- 
ment 162 

Hysterics, homoeopathic 

treatment 159 

Hysterics, home measures. . 162 

Incised wounds 722 

Dcontinence of urine 368 

Indications of the pulse 35, 37 

Indications of the urine ... 41 

Indications of the breathing 44 
Indications of the digestive 

functions 47 

Indications of the evacuations 47 
Indications of wind in the 

stomach 48 

Indications of nausea and 

vomiting 48 

Indications of thirst 50 

Indications of the tongue. . . 51 
Indications of motion and 

rest 56 

Indications of the sensations 61 
Indications of tearfulness 

and laughter 76 

Indications of coughs 72 

Indigestion 240, 241 

Individual characteristics... 31 

Infants, treatment of 685 

Infants, swelling of the head 

of 686 

Infants, rupture of 687 

Infants, rupture of navel of. 687 

Infants, rupture of groin 687 

Infants, when may they be 

put to the breast 687 

Infants, observations on the 

suckling of 688 

Infants, food for 691,744 

Infants, sleeplessness of 602 

Infants, hiccup of 69H 

Infants, snuffles of 696 

Infants, vomiting of milk of b99 

Infants, sour stomach of. . . . 699 

Infants, erysipelas of 600 

Infants, flatulence of 699 

Infants, flatulent distention 

of the stomach and bowels 700 

Infants, aphthae— Thrush of. 702 

Infants, nursing sore mouth 702 



926 



GENERAL INDEX. 



Infants, constipation of 703 

Infants, diarrhoea of 704 

Infants,su miner com plaint of 700 
Infants, chafing- Excoria- 
tions of 710 

Infants, asthma of 711 

Infants, swelling of the 

breasts of 712 

Infants, atrophy — E macia- 

tionof 713 

Infants, teething of 717 

Infants, spasms of 721 

Infants, broth 745 

Infants, inflammation of the 

eyes of 695 

Infancy, diseases of 695 

Inflammation of the brain. . 134 
Inflammation of the brain 

allopathic treatment for. .. 135 
Inflammation of the brain, 

homoeopathic treatment. . 137 

Inflammation of the eyes. . .. 180 
Inflammation of the eyes, 

allopathic treatment .. .. 182 
Inflammation of theeyes, ho- 
moeopathic treatment 186 

Inflammation of the Iris. . . 181 

Inflammation of the ear 195 

Inflammation of the nose 210 

Inflammation of the mouth. 215 

Inflammation of the tonsils. 221 

Inflammation of the bowels. 296 
Inflammation of the bowels, 

allopathic treatment 297 

Inflammation of the bowels 

homoeopath ic treatmen t . . . 299 
Inflammation of the perito- 
neum 332 

Inflammation of the perito- 
neum, allopathic treatm't. 334 
Inflammation of the perito- 
neum, homoeopathic treat- 
ment 3°5 

Inflammation of the liver. .. 338 
Inflammation of the liver, al- 
lopathic treatment 339 

Inflammation of the liver, 

homoeopathic treatment.... 340 

Inflammation of the spleen.. 349 

Inflammation of the kidne} r s 352 
Inflammation of the kidneys 

allopathic treatment 353 

Inflammation of the kidneys 

homoeopathic treatment.. . 354 
Inflammation of the bladder 364 
Inflammation of the testes. . 373 
Inflammation of the larynx. 385 
Inflammation of the bron- 
chial tubes 406 

Inflammation of the lungs. 429 

Inflammation of the pleura. . 446 
Inflammation of the womb 

see Leucorrhoea 6J7 



Inflammation of the veins ... 470 
Inflammation of the bones 

and periosteum 476 

Inflammation of the joints. . 485 

Inflammation of the hip joint 486 
Inflammation of the knee 

joint 489 

Inflammation of the joints 

of the foot 493 

Inflammation of the breasts. 646, 683 

Inflammatory bronchitis 408 

Inflammatory jaundice . 346 

I inflammatory fever 554 

Influenza 420 

Influenza, allopathic treat- 
ment 421 

Influenza, homoeopathic 

treatment 422 

Injections, rules for. 87 

Injuries, see wounds 731 

Insects, stings of 712 

Intermittent pulse 37 

Intermittent fever 544 

Internal remedies and doses 83 

Intestines, diseases of 277 

Introduction. Dr. Bean's.. 11, 15 

Invalids, food for 744 

Invalids' cup pudding 749 

Invalids, apple pie 749 

Investigate of disease (diag- 
nosis) 32 

Investigation of urine, the 

proper time for 42 

Investigation of the patient. 25 

Invermination — Worms 320 

Itch, barbers' 507 

Itch — Scabies 516 

Itching of the genitals dur- 
ing pregnancy 663 

Jaundice 343 
aundice, allopathic treat- 
ment 344 

Jaundice homoeopathic treat- 
ment 345 

Jaw, locked 141 

Joints, diseases of the 47(3 

Joints, inflammation of the. 485 

Joints, rheumatism of the.. . 595 

Kidneys, diseases of the .. 352 
idneys, inflammation of 

the 352 

Kidneys, inflammat'n of the 

allopathic treatment 353 

Kidneys, homoeopathic treat- 
ment 354 

Kidneys, Bright's disease of 355 

Knee joint, inflammation of. 489 
Knee joint, inflammation of 

allopathic treatment 490 

Knee joint, inflammation of 

homoeopathic treatment . . , 492 



Labor, first signs of 668 
abor, preparation of the 

bed for 6C8 

Labor, or parturition 6(59 

La bo r , ca re o f child during. 671 
Labor, the attentions to the 

woman after 672 

Labor, general management 

diet, etc 672 

Labor, flooding after. 673 

Labor, retention of the urine 

after 673 

Labor, incontinence of urine 

after 674 

Labor, preparation of the 

breasts before 667 

Labor, false pains before 669 

Labor, after pains of 672 

Labor, duration of confine- 
ment 674 

Labor, excessive perspiration 

after 677 

Labor, milk fever after 677 

Labor, child-bed fever after. 678 
Labor, irregular discharges 

of the lochia after .". . . 680 

Labor, diarrhoea after 681 

Labor, weakness after 682 

Lacerated wounds 734 

Lachrymal sack, obstruction 

or fistula of the 190 

Large pulse 37 

Laryngitis — croup 393 

Laryngitis, allopathic treat- 
ment 393 

Laryngitis, homoeopathic 

treatment 399 

Larvnx and trachea, diseases 

of the 3S0 

T arynx. inflammation of the 3S5 
Laughter and tearfu In ess 

and what they indicate. ... 76 

Leuchorrhcea — Whites 637 

Lemonade 750 

Life, the change of in females 644 
Lightning, apparent death 

from 725 

Limbs, retarded strength of, 

in infants 694 

Limbs, frozen 520 

Lime water, external applica- 
tion of 94 

Liver, diseases of the 338 

Liver complaint 338 

Liver, inflammation of the. . 338 

Liver, abscess of the 342 

Liver, chronic inflammation 

of the 343 

Liver, cancer of the 348 

Living, habits of 101 

Living, manner of life 31 

Lochial discharge and irreg- 
ularities of 680 



GENERAL INDEX 927 

Lochial discharge, excessive 681 
Lochial discharge, suppres- 
sed 681 

Lochial discharge, offensive. 681 

Lock-jaw .... 141 

Lock-jaw, allopathic treat- 
ment 142 

Lock-jaw homoeopathic treat- 
ment 144 

Lock-jaw, of infants 143 

Loss of consciousness, its in- 
dications in disease 52 

Loss of or unhealthy increase 

of flesh .... 76 

Looseness of the bowels dur- 
ing Small Pox 542 

Lumbago, crick in the back. 484 

Lungs, diseases of the 400 

Lungs, congestion of the 410 

Lungs, congestion of the, al- 
lopathic treatment 400 

Lungs, congestion of the, ho- 
moeopathic treatment 401 

Lungs, bleeding from the. .. 402 

Lungs, inflammation of the. 429 
Lungs, inflammation of the 

of children. 436 

Lymphatic tumors 494 

Male sexual organs, diseases 

of the 373 

Malignant cholera 587 

Mammae (breasts) inflamma- 
tion of the 683 

Mania a potu — Delirium Tre- 
mens 144 

Marasmus, of infants 713 

Marrow, inflammation of the 478 
Mastitis (inflammation of the 

breasts) 646 

Maturity, first period of 30 

Maternity (see pregnancy). . 652 
Means to be employed 

against cholera 594 

Measles — Morbili 521 

Measles — Morbili, allopathic 

treatment 524 

Measles— Morbili, homoeopa- 
thic treatment 526 

Measles, after effects of 527 

Measles, enteritis as a compli- 
cation of 523 

Medicines, when to be taken 87 
Medicines, homoeopathic 

rules for preserving 87 

Medicines, systematic table 

of rules for giving 89 

Megrim — Headache 167 

Melancholic temperament.. 28 

Meningitis, cerebro-spinalis. 113 

Meningitis, cerebrale 134 

Meningitis, chronic 136 

Menorrhagia 633 



928 



GENERAL. INDEX. 



Menorrhagia, mechanical 

means for suppressing 637 

Menopause — Change of life . . 644 

Menstruation 621 

Menses, derangements upon 

the appearance of the 624 

Menses, suppressed, delayed 

or scanty . . 628 

M enses, profuse 633 

Method of living, general 

habits 31 

Milk, secretion of the 674 

Milk, scanty secretion of the 675 

Milk, suppression of the 675 

Milk, excessive secretion of 

the 675 

Milk fever 677 

Milk, vomiting of, by infants 699 

Milk scab, milk crust... 701 

Milk, cow's for infants 745 

Milk toast 748 

Milk, thickened 748 

Milk and eggs 748 

Mind, employment of the 

during pregnancy 656 

Miscarriage.. 664 

Miscarriage, to prevent a ten- 
dency to 665 

Modified smallpox 541 

Monthly flux or periodical 

discharges of females 621 

Morbus divinas 147 

Morbus herculeus — Epilepsy 147 

Morbus Brightii 355 

Morbili— Measles 521 

Morbili, allopathic treatm'nt 524 
Morbili, homoeopathic treat- 
ment 526 

Morning sickness during 

pregnancy 657 

Motion or rest as symptoms 5G 

Mouth, diseases of the 215 

Mouth, canker of the 215 

Mouth, inflammation of the. 215 

Mouth, wounds of the 733 

Mucilage of elm bark 751 

Mumps , 234 

Mumps following other dis- 
eases 235 

Mumps, treatment 236 

Muscles, diseases of the 476 

Mush, brown, for supper 746 

Mustard whey 751 

Mutton tea 749 

Myelitis, see inflammation 

of the marrow 478 

TVTasitis-Inflammation of the 

1\ nose 210 

Nausea and vomiting, their 

indications 48 

Nausea, general article on . . . 264 

Naval rupture of infants 687 



Near-sighted 192 

Necrosis (death of bone) 479 

Nephritis — Inflammation of 

the kidneys 352 

Nerves, brain, sensations and 

senses and their indications 52 
Nervous or rheumatic ear- 
ache 200 

Neuralgic headache 168 

Neuralgic headache, allopa- 
thic treatment 168 

Neuralgic headache, homoeo- 
pathic treatment. 170 

Neuralgia 173 

Neuralgia, allopathic treat- 
ment 174 

Neuralgia, homoeopathic 

treatment 1 76 

Neuralgia of the ear 198 

Nipples, sore 683 

Nose, diseases of the 204 

Nose, polypi of the 210 

Nose, inflammation of the.. 210 

Nose, bleeding from the 210 

Nose, bleeding from the, allo- 
pathic treatment 211 

Nose, bleeding from the, ho- 
moeopathic treatment . 212 
Nose, bleeding from the, 

home treatment 214 

Nose, bottle 508 

N ose, copper 508 

Nurse, the choice of a 689 

Nursing, diet during 689 

Nursing sore mouth of in- 
fants ..-. 702 

Oatmeal coffee 750 

bservations on pregnancy. 654 
Observations on the suckling 

of infants 688 

Obstipation, see Constipation 326 

Odontalgia — Toothache 236 

Offensive or fetid breath 46 

Onanism as a cause of epi- 
lepsy 149 

Ophthalmia 179 

Ophthalmia, purulent 181 

Ophthalmia, granular 184 

Ophthalmia, chronic 184 

Ophthalmia, of infants 185, 695 

Ophthalmia, scrofulous. . 185 

Organs of respiration, disea- 
ses of 380 

Orange whey 751 

Orchitis 373 

Ostitis— Inflammation of the 

bones 476 

Otitis— Infl'mat'n of the ear 195 
Otorrhcea— Discharge from 

the ear 196 

Overheating 742 

Oyster soup for invalids 74S 



GENERAL INDEX. 



929 



Pain in the teeth 236 
ains of various kinds as 

symptoms 61, 65 

Pains, false, before labor 669 

Pain in the chest or painful 
respiration and what it in 

dicates 45 

Pain in the bowels 309 

Pain, absence or sudden sup- 
pression of 62 

Pain, intermittent and what 

it indicates 63 

Pain, inflammatory or ner- 
vous 64 

Pain in the nerves of the 

face 173 

Painful and difficult menstru- 
ation 633 

Printers' colic 310 

Palsy or paralysis 130 

Patient, condition of the, 
method of investigating.... 25 

Palliative treatment 87 

Palpitation of the heart 462 

Parturition, treatment before 667 
Part first, diagnosis and prog- 
nosis 25 

Part second, Diseases of the 

brain and nerves 113 

Part third, Diseases of the 

head 167 

Part fourth, the gate 215 

Part fifth, the digestive func- 
tions 240 

Part sixth, Diseases of the 

liver and spleen 338 

Part seventh, Diseases of the 

kidneys and bladder 352 

Part eighth, Diseases of the 

male sexual organs 373 

Part ninth, Diseases of the 

respiratory organs 380 

Part tenth, Diseases of the 

organs of circulation 455 

Part eleventh, Diseases of 

single systems 476 

Part twelfth, Constitutional 

diseases 521 

Part thirteenth, Diseases pe- 
culiar to women 621 

Part fourteenth, Treatment 

of infants 685 

Part fifteenth, Surgery 724 

Part sixteenth, Repertory 760 

Panada, how to make 747 

Paralvsis as a symptom 60 

Paralysis 130 

Paralysis, allopathic treat- 
ment 130 

Paralysis, homoeopathic 

treatment 133 

Paralysis, home treatment... 133 
Paralysis of the face 132 

59 



Paralysis of the insane 133 

Paralysis, infantile 132 

Paralysis of the bladder 372 

Parotitis 234 

Parotitis, treatment for 236 

"Pap," English 745 

Patientgeneral investigation 

of 25 

Passive congestion of the 

brain 120 

Pendulous abdomen 682 

Pepsin, formula for making. 495 

Periods of life 29, 30 

Period of approaching ma- 
turity SO 

Period of decline 30 

Peritonitis 332 

Peritonitis, allopathic treat- 
ment 334 

Peritonitis, homoeopathic 

treatment 335 

Periostitis 478 

Perspiration after delivery... 676 
Perspiration after delivery, 

excessive 677 

Pertussis — Whooping cough. 423 

Phlegmatic temperament 29 

Phlebitis — Inflammation of 

the veins 470 

Phrenitis 134 

Phthisis— Consumption 607 

Pie, children's 746 

Pie, invalids' apple 749 

Piles 316 

Tiles, allopathic treatment... 316 
Piles, homoeopathic treat- 
ment 319 

Pityriasis 505 

Plethoric constitution 25 

Pleura, diseases of the 446 

Pleura, inflammation of the 446 

Pleuritis 446 

Pleurisy 446 

Pleurisy, allopathic treatm't 448 
Pleurisy, homoeopathic treat- 
ment 453 

Pleurisy of infants 452 

Pneumonia 429 

Pneumonia, allopathic treat- 
ment 433 

Pneumonia, homoeopathic 

treatment 437 

Pneumonia, of young c h i 1- 

dren 436 

Poisons, their antidotes— see 

table of remedies 752 

Polypi of the nose 210 

Position of the patient as a 

symptom 58 

Potencies (strength) of medi- 
cine 85 

Pott's disease 476 

Poultice, application of ^2 



930 



GENERAL INDEX. 



Pox, small 535 

Pox, chicken 543 

Precautions to insure proper 

doses 87 

Preface to First Edition 5 

Preface to Second Edition 4 

Pregnancy 652 

Pregnancy, condensed signs 

of 652 

Pregnancy, observations on.. 654 

Pregnancy, hygiene of 655 

Pregnancy, employment of 

the mind during 656 

Pregnancy, gastric derange- 
ment during 657 

Pregnancy, nausea and vom- 
iting of 657 

Pregnancy, clothingand hab- 
its during 656 

Pregnancy, constipation dur- 
ing 660 

Pregnancy, toothache dur- 
ing 661 

Pregnancy, urinary difficul- 
ties during 663 

Preservative measures against 

cholera 594 

Preventive and eradicative 

treatment 98 

Profuse menstruation 633 

Prognosis 25 

Prolapsus uteri 641 

Prolapsus ani 331 

Proof spirits of wine as an 

application for burns 94 

Pruritis-Itching of the geni- 
tals ?. 663 

Prunes, stewed 750 

Psoriasis 506 

Psous psoitis 517 

Pudding for babies 746 

Pudding, tapioca cup 749 

Pudding, invalid's cup 749 

Puerperal fever 678 

Purulent ophthalmia 181 

Pustula nigra 514 

Pyrosis 659 

Quick pulse 37 

VcTuick breathing 45 

Quinsy . 221 

Quinsy, allopathic treatm'nt • 224 
Quinsy, homoeopathic treat- 
ment 225 

Rash, nettle 503 

ash, scarlet 527 

Raw cotton as an external 

application 94 

Red, dry and glassy tongue. 51 
Redness, swelling, heat, and 
tingling of the skin (erysi- 
pelas) 498 



Regularity of habits 106 

Regulations, general, for diet 

and regimen 78 

Regulations and remarks re- 
specting internal remedies 

and their application 83 

Regulations respecting the 

bath 95 

Regurgitation of milk, acid- 
ity, etc., of infants 699 

Relaxation of the bowels dur- 
ing Pregnancy 277 

Relaxation of the bowels of 

lying-in women 681 

Remedies and doses, remarks 

etc., respecting them ..... 83 
Remedies, table of analogous 86 
Remedies, table of, with La- 
tin and English names, an- 
tidotes, etc 752 

Remedies and applications, 
external, remarks etc., re- 
specting 92 

Remittent or bilious fever. . . 289 

Renal calculi 362 

Rennet whey 751 

Repertory 760 

Repetition and selection of 

medicines 81 

Respiratory organs, diseases 

of 380 

Rest, its indications 56 

Restlessness as a symptom. . 57 

Retarded strength of the 

limbs 694 

Rheumatic or catarrhal con- 
stitution 27 

Rheumatic or nervous ear- 
ache 200 

Rheumatism, articular 594 

Rheumatism of the joints 594 

Rheumatism, chronic 596 

Rheumatism, deforming 598 

Rheumatism, arthritic 598 

Rheumatism, chronic of the 

joints 601 

Rheumatism of the sciatic 

nerve 605 

Rheumatism of the back — 

Lumbago 484 

Rhus tox. as an external ap- 
plication 93 

Rickets 480 

Rickets, home and mechani- 
cal measures for 481 

Rickets, allopathic treatm't. 481 
Rickets, homoeopathic treat- 
ment 482 

Rice gruel 749 

Rice water 751 

Ringing and buzzing in the 

ears. . f 201 

Ringworm 510 



GENERAL INDEX. 



931 



Roast apples for invalids 750 

Rose— Erysipelas 498 

Rules for preserving homoeo- 
pathic medicines 87 

Rules for diet, under treatm't 109 

Rules for injections 87 

Rules for restoring persons 

after accidents 725 

Rupture in infants 687 

Rupture, navel, of infants. .. 687 

Rupture, groin, of infants. . . 687 

Saliva, its indications 77 

alt water bath, cold 96 

SaltBheum 511 

Sago gruel 749 

Sanguine constitution 25 

Sanguine temperament 28 

Scabies— Itch 516 

Scab, milk— milk crust 701 

Scald head 515 

Scalds and burns 741 

Scarlet fever— Scarlatina 527 

Scarlet fever, complicated 

forms of 533 

Scarlet fever, after effects of 534 
Scarlet fever, symptoms and 

course of 528 

Scarlet fever, uraemia in 531 

Scarlet fever, Belladonna as 

a preventive 532 

Scarlet rash 527 

Scarlatina 527 

Scanty secretion of milk 675 

Scanty or suppressed men- 
strual flow 628 

Sciatic rheumatism 605 

Scorbutis 238 

Scrofulous ophthalmia 185 

Scrofula, Scrofulosis 617 

Scurvy 238 

Secretion of the milk 674 

Secretion of the milk, sup- 
pressed after delivery 675 

Secretion of the milk, exces- 
sive after delivery 675 

Selection, repetition and ad- 
ministration of the medi- 
cines 81 

Selection of a nurse 689 

Sensations of discomfort. . . . 66 
Sensations of anxiety, their 

indications 68 

Sensations and senses 52 

Sexes, the, and their distinc- 

. tiojis 29 

Sexual organs, male, disea- 
ses of the 373 

Sexual organs, female, disea- 
ses of the 621 

Shingles 510 

Short-sightedness 188 

Sick headache 265 



Sickness at the stomach, nau- 
sea and vomiting, indica- 
tions afforded by 48 

Sickness in the morning, dur- 
ing pregnancy 657 

Sickness, green, predisposing 

causes and treatment of. . . 626 

Sight, the 70 

Sight, short 188 

Signs of pregnancy 652 

Skin, diseases of the 497 

Skin, simple redness of the, 

erythema 497 

Skin, inflammation of the, 
with swelling, heat, red- 
ness and tingling, (erysipe- 
las) 498 

Sleep, its character as a symp- 
tom 58 

Sleep, sleeplessness of infants 692 

Slow pulse 37 

Slow breathing 45 

Sluggish pulse 37 

Small pulse 37 

Smallpox — Variola 535 

Smallpox, allopathic treat- 
ment 537 

Smallpox, homoeopathic 

treatment 539 

Smallpox, confluent 540 

Smallpox, modified 541 

Smallpox, complications and 

after-effects of 542 

Smallpox, boils during 542 

Smallpox, cough during 542 

Smallpox, asthma during. . . 542 
Smallpox, looseness of the 

bowels during 542 

Smallpox, mode of living 

during 542 

Smell, the sense of 71 

Sneezing, yawning, groaning 

etc., their indications 76 

Singultus 443 

Snuffles, cold in the head, of 

infants 696 

Soap plaster as an applica- 

cation for burns 94 

Soft pulse 37 

Soft toast, how to make 747 

Sore throat— Angina 218 

Sore throat, allopathic treat- 
ment 220 

Sore throat, homoeopathic 

treatment 221 

Sore throat, ulcerated 221 

Sore nipples 683 

Sore mouth, nursing of in- 
fants. 702 

Sores or ulcers .•••.• 494 

Sounds from chest and indi- 
cations 75 

Sour stomach, see Heartburn. 659 



932 



GENERAL INDEX. 



Sour stomach of infants 699 

Spanish fly as an outward 

application 93 

Spasm of the stomach 270 

Spasm of the stomach, allo- 
pathic treatment 271 

Spasm of the stomach, hom- 
oeopathic treatment 272 

Spasm of the bladder 370 

Spasm of the bladder, after 

labor 673 

Spasms and convulsions as 

symptoms 58 

Spasms of infants 721 

Speech and voice, and their 

indications 75 

Speech, loss of as a symptom 76 

Spermatorrhoea 374 

Spine, disease of the 478 

Spirits, depression of the 261 

Spitting of blood 402 

Spitting of blood, allopathic 

treatment 403 

Spitting of blood, homoeopa- 
thic treatment 404 

Spleen, inflammation of the 349 

Spotted fever 113 

Spotted fever allopathic treat- 
ment 115 

Spotted fever, homoeopathic 

treatment 116 

Sprains 729 

Stammering as a symptom. . 75 

St. Anthony's fire, erysipelas 498 

Stenocardia 468 

Stenocardia, allopathic treat- 
ment 469 

Stenocardia, home treatment 470 

Stillborn ch ildren 685 

Stings of Insects 742 

Stomatitis 215 

Stomach, diseases of the 240 

Stomach, derangements of 

the, not habitual 257 

Stomach, derangements of 

the, of children 260 

Stomach, hemorrhage from 266 

Stomach, spasm of the 270 

Stomach, spasm of the, allo- 
pathic treatment ... 271 

Stomach, spasm of the homoe- 
opathic treatment 272 

Stomach of infants, flatulent 

distention of 700 

Stomach, sickness at the, 

nausea . 264 

Stone in the bladder 362 

Stone, inflammation of the 

kidneys connected with.... 352 

Stone cutters' asthma 712 

Stoppage of the bowels — Con- 
stipation 326 

Strains or sprains in general 729 



Strabismus 192 

Strength, retarded of the 

limbs 694 

Strong pulse 37 

St. Vitus' dance — Chorea 164 

St. Vitus' dance, allopathic 

treatment 164 

St. Vitus' dance, homoeopa- 
thic treatment 165 

Suckling, duration of; wean- 
ing... 691 

Suckling of the infant, gene- 
ral observations 688 

Suffocation, apparent death 

from 724 

Summer complaint of infants 706 

Sunstroke, sun fever 742 

Supper, brown mush for 746 

Suppression of perspiration 

after delivery 677 

Suppression or delay of the 

menses 628 

Suppression or scanty secre- 
tion of milk 675 

Surgery 724 

Suspension of doses 85 

Suspended animation 685 

Sweat, its indication 73 

Sweat, critical 74 

Swelling of the limbs during 

pregnancy 662 

Swelling of the head of inf'ts 686 
Swelling of the breasts of in- 
fants 712 

Swollen cracked and furrowed 
or swohen and indented, 

swollen and red tongue 51 

Swooning— Fainting 52, 54 

Stye 192 

Sycosis mentagra 507 

Symptoms exhibited by irri- 
tation of the lining or mu- 
cous membrane of the sto- 
mach 246 

Symptoms exhibited by irri- 
tation of the nerves of the 

stomach 248 

Symptoms of the change of 

life 644 

Symptomatic erysipelas 500 

Sympathetic affection of the 
brain and nervous system. 261 

Synochia 554 

Synochial or inflammatory 

fever 554 

Synovitis, see inflammation 

of the joints 485 

Synopsis of the rules for diet 

under treatment 109 

Systematic table of rules for 
the administration of doses 89 

Table of analogous remedies 86 

able of contents 16 



GENERAL. INDEX. 



o:;s 



Table of remedies with their 
English and Latin names 

and their antidotes 752 

Tape worm 324 

Tape worm, allopathic treat- 
ment 325 

Tape worm, home treatment 325 

Tapioca cup pudding 749 

Tardiness in breathing, its 

indications 26 

Tarsus .. 493 

Taste, the, its indications... 71 

Tearfulness and laughter. .. 76 

Tea, beef, for invalids 748 

Tea, mutton, for invalids ... 749 

Tea, flaxseed, for invalids.... 750 

Teeth, pain in the 236 

Teething of infants 717 

Temperament, sanguine 28 

Temperament, choleric 28 

Temperament, melancholic. 28 
Temperament, phlegmatic. 29 
Temperaments and their var- 
ieties 28 

Temperature of bath for in- 
fants 98 

Tenderloin, broiled, for in- 
valids 748 

Testes, inflammation of the. 373 
Testes, inflammation of the, 

treatment for 374 

Tetanus— Lock-jaw 141 

Tetanusallopathic treatment 142 
Tetanus, homoeopathic treat- 
ment 143 

Tetter, scaly 506 

Tetter— Herpes 509 

Tetter, honeycomb 515 

The antecedents of a patient's 

family 29 

The sexes and their distinc- 
tions 29 

Theage and conditions which 

qualify it 29 

The part or organ usually 

diseased 32 

The pulse; its varieties and 

indications 35 

The art of feeling the pulse. . 35 

The condition of the blood... 40 
The urine; its varieties and 

indications 41, 42 

The healthy appearance of 

urine 41 

The proper time for investi- 
gating the urine 42 

The breath in health 44 

The digestive functions 47, 240 

The evacuations, and indica- 
tions 47 

The appetite and its indica- 
tions 49 

The tongue, its indications.. 51 



The sensations and their in- 
dications 61 

The organs of sense, their in- 
dications 69 

Thecomplex'n,its indication 74 
The voice and speech, its in- 
dications 75 

The saliva, its indications... 77 
The expectoration, its indica- 
tions 77 

The habits of living 101 

The change of life 644 

Thickened milk 748 

Thirst, its indications 50 

Throat, aphthous sore 218 

Throat, to clear the, after ac- 
cident 725 

Thrush— Aphthae 216 

Thrush— Aphthae of infants. 702 
Time etc., for investigating 
the urine as a clue to the 

nature of the disease .... 42 

Toast, soft, how to make 747 

Toast, egg, how to make 747 

Toast, dry, how to make 748 

Toast, milk, how to make. . . 748 

Toast, water 750 

Tonsils, inflammation of the 221 
Tonsils, chronicenlargement 

ofthe 224 

Tonsilitis. 221, 224 

Tongue, the, and its indica- 
tions 51 

Tongue, furred, yellow, clear, 
dry, red, glazed, swollen, 
cracked, furrowed, inden- 
ted, tremulous, blackish, 

and their indications 51 

Toothache 236 

Toothache during pregnancy 661 
Tooth, bleeding after extrac- 
tion 733 

Transpiration from the skin 

its indication 73 

Trance 156 

Treatment, preventive and 

eradicative 98 

Treatment of infants 685 

Treatment after birth 685 

Trembling as a symptom 60 

Tremens delirium 114 

Trismus 141 

Trismus, allopathic treatm't 142 
Trismus, homoeopathic treat- 
ment. . 144 

Tuberculosis 607 

Tuberculous meningitis 136 

Tumors, lymphatic 494 

Tussis convulsiva 423 

Typhoid fever 555 

Typhoid and typhus fever, 
homoeopathic division and 

treatment 564 






934 



GENERAL INDEX. 



Typhus fever 555 

Typhus characterized by stu- 
por 576 

Typhus, abdominal 568 

Typhus, convalescence and 

"debility after 576 

Typhus, after effects of 577 

Ulcers, lymphatic tumors 
diseases of the cinglo- 

bate glands 494 

Ulcerated sore throat 212 

Unequal pulse 37 

Uremia in scarlet fever 531 

Urine and its varieties 41 

Urine, healthy appearance of 41 

Urine, bloody 366 

Urine, proper time for inves- 
tigating 42 

Urine, its variations, the in- 
dications . 42 

Urine, retention after labor.. 673 
Urine, inability to hold after 

labor 674 

Urine, the foretells — the 

change at crisis 42 

Urinary difficulties during 

pregnancy 663 

Urtica Diocia,or Urtica Urens 

externally applied 94 

Urticaria 503 

Uterus, cancer of the 649 

Yaccination . , , 723 

arieties of temperaments. 28 

Varicose veins 471 

Varicose veins, during preg- 
nancy 662 

Varices 471 

Variola — Smallpox 535 

Varioloid 541 

Veins, diseases of the 470 

Veins, inflammation of the. . 470 

Veins, varicose 471 

Veins, dilation of 471 

Verification of death 727 

Vinegar whey 751 

Voice and speech, and their 

indications 75 

Voice, loss of, as a symptom. 75 
Vomiting, its indications in 

disease 48 

Vomiting of blood 266 

Vomiting during pregnancy 655 

Vomiting of milk by infants 699 

Wakefulness of infants.... 697 

andering erysipelas 500 

Warmth, to restore after ac- 
cident 725 

Water, pure as a necessity for 

health 106 

Water on the brain 139 

Water on the brain, allo- 
pathic treatment 140 



Water on the brain, homoeo- 
pathic treatment 140 

Watery, or weeping eye 190 

Water brash during preg'ncy 659 

Water, gruel for invalids 749 

Water, apple for invalids 750 

Water, toast for invalids 750 

Water, rice for invalids 751 

Weakness after delivery 682 

Weaning of infants ..."". 691 

Weeping eye 190 

Wetting the bed, see Enuresis 

nocturni 368 

When medicines should be 

taken 87 

Whey, alum 751 

Whey, mustard 751 

Whey, vinegar 751 

Whey, rennet 751 

Whey, orange 751 

White swelling 489 

Whites, leuchorrhoea 637 

Whitlow, or felon 519 

Whooping cough 4 3 

Whooping cough, allopathic 

treatment 426 

Whooping cough, homoeopa- 
thic treatment 427 

Wind in stomach and bowels. 

as a symptom 48 

Windpipe, diseases of the. . . 380 

Womb, falling of the 641 

Womb, cancer of the , . 649 

Womb, inflammation of the 

see Leuchorrhoea 637 

Women, diseases peculiar to. 621 

Worm colic 315 

Worms— Helminthiasis 320 

Worms, allopathic treatment 

for.... 321 

Worms, homoeopathic treat- 
ment for 322 

Worms, tape 324 

Worms, pin, (thread worms) 321 

Worms, long round 322 

Wounds 731 

Wounds, incised. 732 

Wounds, manner of dressing 732 

Wounds of arteries and veins 732 

Wounds of the mouth . 733 

Wounds, lacerated 734 

Wounds, contused bruises... 735 

Wounds, gun shot 736 

Wounds, punctured 736 

Yawning, as a symptom.... 77 

ellow fever 578 

Yellow fever, its symptoms. 581 
Yellow fever, allopathic 

treatment 583 

Yellow fever, homceopatic 

treatment 585 

Young children, food for 746 



